Exam 22: The Ankle and Foot

Your patient has regained normal strength (5/5) and ROM during rehabilitation following a traumatic injury that severely stressed several ligaments and joints of the ankle.He continues to have poor control while walking on gravel or other uneven surfaces.To address this problem, your exercise program should focus on:

Your uncle called you last night after playing three games in a softball tournament yesterday.He indicated that late in the third game while trying to stretch a double into a triple, he felt a sudden sharp pain in his calf, which significantly interfered with his ability to continue running.He is able to move his foot "up and down," but both motions are painful.He is also able to walk if he "takes it slow." From the information your uncle gave you and the fact that he is a 42-year-old weekend warrior, your preliminary hypothesis is that your uncle may have sustained a(n):

Which of the following special tests may be used to confirm or rule out a rupture of the Achilles tendon during a patient's physical examination?

A patient underwent a triple arthrodesis of the hindfoot 12 weeks ago and is now allowed to ambulate without the rigid boot.The patient has been referred to you for exercises to improve ROM and strength of the operated lower extremity and to re-establish a normal gait pattern.Which of the following interventions is inappropriate to include in your treatment plan to restore this patient's function?

Following a severe, third-degree (grade 3) inversion sprain, your patient complains of pain just distal and lateral to the knee joint.The pain is likely the result of:

Your patient has RA and is complaining of pain in her ankles and feet when walking.You observe her gait and notice short steps and poor push-off.This is consistent with what deformity in RA?

Your patient has a diagnosis of RA and is developing a capsular pattern in the foot and ankle.Which joint-mobilization technique could perpetuate or worsen the impairment/deformity typically associated with RA of the foot and ankle?

Each of the following is true about surgical repair/reconstruction of the lateral ligament complex of the ankle and postoperative management except:

Which of the following most accurately describes the deformities that progressively develop in rheumatoid arthritis (RA) of the foot/ankle?

During initial evaluation of a patient with a complaint of low back pain, you perform a standing posture alignment screening and discover that his left leg appears shorter than the right as you compare iliac crests, greater trochanter, head of the fibula, and medial malleolus.What related possible foot deformity should you look for while still in standing?

Which one of the following ligaments of the ankle is most frequently stressed with an inversion sprain?

Each of the following is a true statement about total ankle arthroplasty (TAA) and postoperative rehabilitation except:

A 40-year-old teacher who has been referred to you has experienced pain along the plantar aspect of the heel for more than 6 months.It is most noticeable when getting out of bed in the morning, upon standing after sitting for longer than 1 hour, and after playing racquetball.During walking, pain is most noticeable at the terminal stance/pre-swing phase of gait.The mostly likely disorder causing these symptoms is:

John is a 25-year-old active athlete and outdoorsman who suffered a severe lateral ankle injury 5 years ago, resulting in progressive subtalar arthritis, pain, and instability of the ankle and hindfoot.His quality of life and ability to work are now restricted owing to the pain and instability despite repeated sessions in therapy.The surgical procedure of choice for John is most likely:

Your patient sustained a fracture of the right calcaneus as the result of a motor vehicle accident 3 months ago.After 10 weeks in a cast followed by a rocker bottom immobilization boot that prevented ankle and foot motion, the fracture shows radiological evidence of bony union.The patient has been ambulating (weight bearing as tolerated) while wearing the boot and is now supposed to discontinue wearing it slowly.Your examination reveals marked limitation of dorsi- and plantarflexion and a high, rigid arch.There is no visible swelling, and pain (2/10) occurs at the end of the day and during passive range of motion (PROM) with overpressure.Which of the following is the most appropriate intervention during the first week of therapy?

Each of the following is an expected improvement after TAA for advanced arthritis except: