Examination: Foot and Ankle
There are 6 main concepts that need to be remembered for ALL of the regional examination of the musculoskeletal system:
- Position – always position your patient as you would like to examine them before you begin
- Look – inspect and observe the patient and around the patient's bedside
- Feel – for example, feeling a joint to see if it is hot or swollen
- Move – actively (the patient moves the joint) then passively (you do the movements for them)
- Function – can the patient move their joints in order to complete day to day tasks?
- 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:
- Examination of the hand and wrist
- Examination of the elbow
- Examination of the shoulder
- Examination of the spine
- Examination of the hip
- Examination of the knee
- Examination of the ankle and foot
written by: celine_lakra, first posted on: 21/01/12, 22:13
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POSTED ON: 18/07/13, 16:49
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