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Ankle and Foot Examination
ID Self and PT
- Hello, my name is Jonathan May. I am a 3rd year medical student. Could you please tell me your name and date of birth? And could i check your ID band? Thank you
- Explanation
Today I've been asked to perform an examination of your feet and ankles. This would involve me having a look at your feet, shoes and lower legs, and then asking you to perform some movements.
- ExposureIn order for me to examine you, i would ask you to remove your shoes and socks, as well as raise your trousers so that I am able to see your leg below the knee.
- Pain
This examination shouldn't be painful, but if you do experience any discomfort, please do let me know.
- Consent
Are you happy for me to proceed with this examination? Are you in any pain at the moment?
- Positioning
In that case, if I could ask you to remove your shoes and socks, roll up your trousers to the knee, and then lie down flat on the bed with your feet hanging over the edge.
- End-of-bed
On initial inspection, the PT doesn't appear to be in any obvious pain or distress requiring immediate intervention. There doesn't currently appear to be any NEWS chart for me to inspect, nor any relevant equipment in the vicinity, such as any walking aids or an oxygen mask. I am therefore happy to proceed with my examination.
- Adjust bed height
- Inspection
> Calf swelling or muscle wasting
> Foot wounds, rashes, scars, callosities
> Toe nail changes, joint swellings, halux valgus, clawing
- Palpation
> Check temperature forefoot, midfoot, hindfoot
> Tenderness MTP joints, subtalar joint, ankle joint
> Posterior tibial and dorsalis pedis pulses
- Movement
> Active plantarflexion, dorsiflexion of feet
> Active flexion, extension of great toes
> Passive plantarflexion, dorsiflexion of feet
> Passive inversion, eversion of foot
- Standing inspection
> Toe alignment
> Arches of the feet
> Vargus, varus
> Achilles tendon tenderness
Standing gait
- Walk back and forth
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