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    Ankle and Foot Examination

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    Hafizah Hoshni
    The document provides instructions for conducting an ankle and foot examination. The exam involves inspecting the ankles and feet for swelling, deformities, or injuries. Sensation is checked by feeling for temperature differences or tenderness when palpating joints, bones, pulses and the Achilles tendon. Range of motion is assessed through active and passive movement tests of the ankles, feet, toes and special tests like Simmonds' test to check for Achilles tendon rupture. Further exams of the knees, hips, and imaging may be recommended based on abnormalities found.

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    Ankle and Foot Examination

    Uploaded by

    Hafizah Hoshni
    315 views2 pages
    The document provides instructions for conducting an ankle and foot examination. The exam involves inspecting the ankles and feet for swelling, deformities, or injuries. Sensation is checked by feeling for temperature differences or tenderness when palpating joints, bones, pulses and the Achilles tendon. Range of motion is assessed through active and passive movement tests of the ankles, feet, toes and special tests like Simmonds' test to check for Achilles tendon rupture. Further exams of the knees, hips, and imaging may be recommended based on abnormalities found.

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    HAFIZAH BINTI MOHD HOSHNI ANKLE AND FOOT EXAMINATION

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    The document provides instructions for conducting an ankle and foot examination. The exam involves inspecting the ankles and feet for swelling, deformities, or injuries. Sensation is checked by feeling for temperature differences or tenderness when palpating joints, bones, pulses and the Achilles tendon. Range of motion is assessed through active and passive movement tests of the ankles, feet, toes and special tests like Simmonds' test to check for Achilles tendon rupture. Further exams of the knees, hips, and imaging may be recommended based on abnormalities found.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    315 views2 pages

    Ankle and Foot Examination

    Uploaded by

    Hafizah Hoshni
    The document provides instructions for conducting an ankle and foot examination. The exam involves inspecting the ankles and feet for swelling, deformities, or injuries. Sensation is checked by feeling for temperature differences or tenderness when palpating joints, bones, pulses and the Achilles tendon. Range of motion is assessed through active and passive movement tests of the ankles, feet, toes and special tests like Simmonds' test to check for Achilles tendon rupture. Further exams of the knees, hips, and imaging may be recommended based on abnormalities found.

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    ANKLE AND FOOT EXAMINATION

    Introduction Swelling or erythema of the foot or ankle – may


    suggest injury / inflammatory arthritis / septic
    Wash hands arthritis / cellulitis
    Introduce yourself – state your name and role Inspect from the side
    Confirm patient details – name and DOB Foot arches – observe for evidence of flat feet (pes
    Explain examination: planus) or high arched feet (pes cavus)

    “I’d like to examine your ankles and feet. This will If patient has flat feet ask to stand on
    involve having a look and feel of these joints, in tiptoes – supple flat feet will correct / rigid flat
    addition to assessing the joints’ movement” feet will not

    Gain adequate exposure – both legs should be Inspect from the back
    exposed from the knee down Foot/ankle symmetry – heel alignment – valgus or
    Position patient – ask patient to stand up straight varus deformity?
    with their feet aligned facing forwards Achilles tendon – deformity / discontinuity /
    Look swelling (may suggest Achilles tendonitis) /
    erythema
    Gait
    Feel
    Is the patient demonstrating a normal heel
    strike/toe off gait? Ask the patient to lay on a bed

    Is each step of normal height? – increased Assess temperature and compare between legs
    stepping height is noted in foot drop – ↑ temperature may indicate inflammatory
    pathology / septic arthritis / cellulitis
    Is the gait smooth and symmetrical?
    Assess pulses in both feet – posterior tibial and
    Examine the patient’s shoes – evidence of dorsalis pedis
    asymmetrical wearing may indicate abnormal gait
    Palpate the achilles tendon:
    Ask the patient to walk on their tip-toes, then on
    their heels – problems with this may point to  Position the patient kneeling on a chair
    multiple problems such as arthritis, muscle strength  Palpate the gastrocnemius muscle and
    in the calf muscles which help in plantarflexion and achilles tendon
    anterior muscles of the lower leg which help in
    dorsiflexion  Note any focal tenderness or swelling
    – achilles tendonitis
    Inspect from the front
     Note any apparent gaps in the tendon
    Symmetry of feet and ankles – suggestive of rupture
    Toe alignment – hallux valgus of the big toe may be Palpate the joints and bones
    noted
    Work distal to proximal – assess for tenderness /
    Bunions – located at the 1st metatarsal phalangeal swelling / irregularity
    joint (MTP) joint
     Squeeze MTP joints
    Deformities of the toes (claw/mallet/hammer toes)
     Metatarsal and Tarsal bones
    Scars – suggestive of previous injury / surgery
     Tarsal joint
    Calluses – may indicate foot/gait deformity or
    poorly fitting footwear  Ankle joint
     Subtalar joint To complete the examination

     Calcaneum Thank patient

     Medial/lateral malleoli Wash hands

     Distal fibula Suggest further assessments and investigations

    Move  Examine the knee and hip joint

    Active and passive assessment  Full neurovascular examination of


    the lower limbs
    Assess each of the following movements actively
    and passively, feeling for crepitus (excluding toe  Further imaging of the relevant joints if
    flexion/extension) indicated (Xray / CT / MRI)

    Foot plantarflexion – “push your feet downwards,


    like pushing a car pedal” – 0-50º

    Foot dorsiflexion – “point your feet towards your


    head” – 0-20º

    Toe flexion – “curl up your toes”

    Toe extension – “point your toes towards your


    head”

    Ankle/foot inversion – 0-35º

    Ankle/foot eversion – 0-15º

    Passive assessment only

    Assess the passive movement of:

     Ankle joint

     Subtalar Joint

     Mid-tarsal joint

     Metatarsal-phalangeal and Interphalangeal


    joints (proximal and distal)

    Special tests

    Simmonds’ test

    Simmonds’ test is used to assess for rupture of


    the achilles tendon

    1. Ask patient to kneel on a chair with their


    feet hanging off the edge

    2. Squeeze each calf in turn

    3. Normally the foot should plantarflex

    4. If the achilles tendon is ruptured there will


    be no movement of the foot

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