Foot and Ankle Examination

Dr. Abdulrahman Algarni, MD, SSC (Ortho), ABOSAssist. Professor, King Saud University

Consultant Orthopedic and Arthroplasty Surgeon

Foot and Ankle Examination

Bilateral exposure: at least mid leg

Compare, front, back and side

Standing and supine position

Foot and Ankle Examination

Standing

Look

Special test

Gait

Neurovascular examination

Supine

Look

Feel

Move

Special test

Standing

Look

Skin changes

Soft tissues: Muscle wasting (leg), swelling

Standing

Look

Bone alignment: (hind foot: varus or valgus, mid foot: cavus, flat foot. Forefoot: hallux valgus), swelling

StandingLook

Bone alignment: (hind foot: varus or valgus, mid foot: cavus, flat foot. Forefoot: hallux valgus), swelling

Standing

Special test:

If patient has flat foot (pes planus): ask the pt to tip toe to check if it is flexible or rigid flatfoot.

Observe if the heel will correct from valgus to varus or not as well as midfoot arch reconstitution.

Standing

Gait

Foot-dropt: foot-slap and high-stepping gait

Fixed equinus deformity

Supine

Look

Plantar surface (Sole): skin changes (callosities)

Supine

Feel

Skin: temperature.

Soft tissue: Achilles tendon.

Bone: Bony Landmarks (LM, MM, medial and lateral collateral ligaments, joint line, calceneum) for tenderness.

Supine

Move

Active and passive ankle ROM (dorsiflexion and planterflexion)

Passive subtalar ROM (ankle to neutral, and stabilize it then apply inversion and eversion to assess subtalar ROM).N.B: note if painful or painless

Supine

Special tests

Anterior drawer test with ankle in planterflexion to evaluate anterior talofibular ligament

Supine

Special tests

Achilles tendon test: Thompson test.

Neurovascular examination