Lower leg
Leg pain with exercise, can be accompanied by weakness and numbness
Chronic exertional compartment syndrome
Manometric studies best for diagnosis
Ligament most commonly injured in ankle sprains
anterior talofibular ligament (ATFL)
First ray deformity that causes difficulty with shoe wear
Hallux valgus (bunion)
-risk factors: female, genetics, hypermobility, 2nd toe deformity or amputation, pes planus, RA, CP
-sx: pain with walking, progressive deformity
tx: shoe modifications, orthotics, spacers vs surgery
Peripheral nerve to gastrocnemius
tibial nerve (S1-S2)
16 year old girl with shin pain at the start of track season
-risk factors?
medial tibial stress syndrome (shin splints)
-pain along posteromedial border of tibia
-risk factor: hyperpronation
Maisonneuve fracture
rupture of anterior tibiofibular ligament through interosseous membrane resulting in proximal fibular fracture
-mechanism: hyperdorsiflexion and forceful eversion
Foot deformity with extension of MTP, flexion of PIP and flexion of DIP
Claw toe deformity
-incompetent intrinsic foot muscles
-if progressive, think neurological conditions
Nerve to abductor hallucis muscle
The most specific imaging to diagnose stress fracture
MRI or CT
-bone scans can be used but have low specificity
-x-ray- first line but do not show changes for 2-3 weeks
Cause of adult acquired flatfoot deformity
Posterior tibial tendon insufficiency
-Presentation: medial ankle pain and foot pain, weakness
-loss of medial arch progressing to hindfoot valgus, forefoot abduction and midfoot arthritis
-unable to perform single limb heel rise after stage I
-Tx: AFO (Arizona, molded, articulating) or shoe orthotics
Most common location of a Morton's neuroma
Between third and fourth digits (followed by between second and third)
-irritation of distal interdigital nerves
-tx: shoe modifications, metatarsal pads, corticosteriod injection
Peripheral nerve to peroneus longus
superficial peroneal (fibular) nerve (L5, S1)
The area that achilles tendons are most likely to rupture
2-5cm proximal to the tendon insertion
excessive foot pronation causing adduction of talus and talocalcaneal ligament sprain
sinus tarsi syndrome
-pain on anterolateral aspect of foot and ankle
-risk factors: RA, gout, spondyloarthropathies, prior ankle injury
Location of lisfranc joint injury
Tarsometatarsal (TMT) joint
-generally caused by low-energy trauma- axial loading and rotation of joint
-presents with vague foot or ankle pain, easy to miss
Peripheral nerve to extensor hallucis longus
Deep fibular nerve (L5)