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Forefoot Examination: Difference between revisions
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Forefoot examination in isolation is a thorough assessment of the hallux and the lesser toes from the dorsum and plantar aspects as well as their tips | Forefoot examination in isolation is a thorough assessment of the hallux and the lesser toes from the dorsum and plantar aspects as well as their tips | ||
'''Gait''' | '''Gait''' | ||
*Observe particularly the last phase of stance of [[Gait|gait]] for forefoot problems | |||
*Limp | |||
*Calcaneal varus or valgus | |||
*Marked pronation or supination | |||
*Forefoot valgus (forefoot strikes on first MTP) or varus (first MTP often fails to make solid contact). | |||
''' | '''Shoes''' - wear pattern | ||
''' | '''Hindfoot''' - assess for relevant pathology as hindfoot problems can lead to gait abnormality and forefoot overload | ||
*Malalignment - looking from behind, should be mildly valgus | |||
*Restricted dorsiflexion | |||
*Unable to single heel raise - tibialis posterior insufficiency or hindfoot or subtalar motion stiffness. | |||
''' | '''General Inspection''' | ||
*Callosities - under metatarsal heads (metatarsal overload) or tips of digits or medial hallux or lateral fifth toe. These can be indicators of painful areas for footwear or during weightbearing activity | |||
*Malalignment - of digits and crowding or clawing of the lesser toes | |||
*Nail deformities and condition | |||
*Wasting, swelling, or tenderness of joints | |||
*Erythema, sensory abnormalities, ulcers | |||
''' | '''Passive Movement''' | ||
*Range of motion - hindfoot, ankle, midfoot, hallux, lesser toes | |||
*Deformities - are they correctable | |||
''' | '''Palpation''' | ||
*Peripheral pulses | |||
*Tenderness - of MTPJs or digits with palpation or pain with movement | |||
'''Mulder's click''' | |||
*Firm palpation with knuckle applied to webspace between affected heads | |||
*The other hand applies compressive force across metatarsal heads | |||
*Looking for clicking and replication of pain in Morton's neuroma. | |||
[https://vimeo.com/188756744 Video of forefoot examination] | |||
[[Category:Examination]] | [[Category:Examination]] |
Latest revision as of 08:40, 28 June 2021
This article is still missing information.
Forefoot examination in isolation is a thorough assessment of the hallux and the lesser toes from the dorsum and plantar aspects as well as their tips
Gait
- Observe particularly the last phase of stance of gait for forefoot problems
- Limp
- Calcaneal varus or valgus
- Marked pronation or supination
- Forefoot valgus (forefoot strikes on first MTP) or varus (first MTP often fails to make solid contact).
Shoes - wear pattern
Hindfoot - assess for relevant pathology as hindfoot problems can lead to gait abnormality and forefoot overload
- Malalignment - looking from behind, should be mildly valgus
- Restricted dorsiflexion
- Unable to single heel raise - tibialis posterior insufficiency or hindfoot or subtalar motion stiffness.
General Inspection
- Callosities - under metatarsal heads (metatarsal overload) or tips of digits or medial hallux or lateral fifth toe. These can be indicators of painful areas for footwear or during weightbearing activity
- Malalignment - of digits and crowding or clawing of the lesser toes
- Nail deformities and condition
- Wasting, swelling, or tenderness of joints
- Erythema, sensory abnormalities, ulcers
Passive Movement
- Range of motion - hindfoot, ankle, midfoot, hallux, lesser toes
- Deformities - are they correctable
Palpation
- Peripheral pulses
- Tenderness - of MTPJs or digits with palpation or pain with movement
Mulder's click
- Firm palpation with knuckle applied to webspace between affected heads
- The other hand applies compressive force across metatarsal heads
- Looking for clicking and replication of pain in Morton's neuroma.