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Clinical Examination of the Foot and Toes

History

Examination Map HISTORY

Past Medical History

History of Present Condition

FUNCTIONAL ASSESSMENT

Gait analysis

Tasks that increase symptoms

INSPECTION

General Inspection of the Foot

General foot type classifications

Feiss line

Inspection of the Toes

Toe postures

Posture of the first ray

Inspection of the Medial Structures

Medial longitudinal arch

Inspection of the Lateral Structures

Fifth MT

Inspection of the Dorsal Structures

Long toe tendons

Inspection of the Plantar Surface

Plantar fascia

Medial calcaneal tubercle

Callus/blister formation

Inspection of the Posterior Structures

Achilles tendon

Calcaneus

Retrocalcaneal exostosis

Inspection of Foot and Calcaneal Alignment

Assessment of STJN

Common foot postures assessed in STJN

Position of first tarsometatarsal joint

Palpation

Palpation of the Medial Structures

First MTP joint

First MT

First cuneiform

Navicular

Talar head

Sustentaculum tali

Calcaneonavicular ligament

Medial talar tubercle

Calcaneus

Tibialis posterior

Flexor hallucis longus

Flexor digitorum longus

Posterior tibial pulse

Palpation of the Lateral Structures

Fifth MTP joint

Fifth MT

Styloid process

Cuboid

Lateral calcaneal border

Peroneal tubercle

Peroneal tendons

Palpation of the Dorsal Structures

Rays

Cuneiforms

Navicular

Dome of the talus

Sinus tarsi

Extensor digitorum brevis

Inferior extensor retinaculum

Tibialis anterior

Extensor hallucis longus

Extensor digitorum longus

Dorsalis pedis pulse

Palpation of the Plantar Structures

Medial calcaneal tubercle

Plantar fascia

Intermetatarsal neuromas

Lateral four MT heads

Sesamoids

JOINT AND MUSCLE FUNCTION ASSESSMENT

Goniometry

Rearfoot inversion and eversion

First MTP abduction

MTP flexion and extension

Active Range of Motion

Toe flexion

Toe extension

Manual Muscle Tests

Toe flexion

Toe extension

Passive Range of Motion

Toe flexion

Toe extension

Mobility of first ray

JOINT STABILITY TESTS

Stress Testing

MTP and IP joints

  • Valgus and varus stress testing of the MTP and IP joints

Joint Play Assessment

Intermetatarsal joints

Tarsometatarsal joints

Midtarsal joints

NEUROLOGICAL EXAMINATION

L4–S2 Nerve Roots

Tarsal Tunnel Syndrome

Interdigital Neuroma

VASCULAR EXAMINATION

Dorsalis Pedis Pulse

Posterior Tibial Pulse

Capillary Refill

REGION-SPECIFIC PATHOLOGIES AND SELECTIVE TISSUE TESTS

Foot Type

Navicular drop test

Pes Cavus

Plantar Fasciitis

Test for supple pes planus

Plantar Fascia Rupture

Heel Spur

Tarsal Coalition

Tarsal Tunnel Syndrome

Dorsiflexion–eversion test

Metatarsal Fractures

Acute fractures

Stress fractures

Lisfranc Injury

Phalangeal Fractures

Intermetatarsal Neuroma

Mulder sign

Hallux Rigidus

Hallux Valgus

First MTP Joint Sprains

Sesamoiditis

Inspection

Inspection of the Foot

image Inspection Findings 5-1: General Foot Type Classifications (Weight Bearing)

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  Pes Planus Neutral Pes Cavus
 

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Description Medial bulge; abducted forefoot, everted calcaneus The calcaneus is slightly everted. The calcaneus must be inverted greater than 3° from perpendicular relative to the position of the ground.
A medial bulge must be present at the talonavicular joint, indicating excessive talar adduction. A medial bulge is not present. A medial bulge is not present.
The medial arch must be low. This is determined by the Feiss line, formed by connecting the points formed by the head of the 1st MT, ...

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