Examination: Foot and Ankle

There are 6 main concepts that need to be remembered for ALL of the regional examination of the musculoskeletal system:

  1. Position – always position your patient as you would like to examine them before you begin
  2. Look – inspect and observe the patient and around the patient's bedside
  3. Feel – for example, feeling a joint to see if it is hot or swollen
  4. Move – actively (the patient moves the joint) then passively (you do the movements for them)
  5. Function – can the patient move their joints in order to complete day to day tasks?
  6. Special tests – if applicable

  • Wash hands
  • Introduce yourself
  • Ask permission to examine the relevant part of the body
  • Expose the patient – ideally in underwear only, at least exposing the joint of interest and the joints above and below this
  • Reposition the patient – standing up at first

Position :
  • The patient standing up for looking, then lying down

Look:
  • At the Achilles‘ tendon
  • For ankle varus and valgus deformity
  • Foot arch
  • At dorsal and plantar aspect of foot
  • Calyces
  • Halluces valgus
  • Claw toe
  • At patient’s shoes for abnormal wear patterns on the sole

Feel:
  • Temperature
  • Dorsalis pedis pulse (at the proximal end of the webbed space between the first and second toes)
  • Palpate each metotarsal phalangeal joint for tenderness and swelling
  • Ankle joint - palpate along the bony edges of the joint (anterior/posterior/medial/lateral)

Move:
  • Passively and actively:
    • Ankle/foot eversion (sole of foot faces outwards)
    • Ankle/foot inversion (sole of foot faces inwards)
    • Ankle dorsiflexion
    • Ankle plantarflexion
    • Big toe flexion and extension

Function:
  • Walk to end of room, turn and walk back
  • Looking for normal heel-strike toe-off

To conclude the examination:
  • Thank the patient
  • Tell them they can get dressed now
  • Offer to examine the joint above and the joint below
  • Consider neurological examination of the limb examined



The complete examination of the musculoskeletal system includes:


written by: celine_lakra, first posted on: 21/01/12, 22:13

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Comments:

mahmoudbasheer says...
good effort thanks
POSTED ON: 18/07/13, 16:49

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