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Clinical Examination of the Ankle and Leg

Examination Map HISTORY

Past Medical History

History of the Present Condition

Location of pain

Mechanism of injury

FUNCTIONAL ASSESSMENT

Gait analysis

INSPECTION

Inspection of the Lateral Structures

Peroneal muscle group

Distal one-third of fibula

Lateral malleolus

Inspection of the Anterior Structures

Sinus tarsi

Malleoli

Talus

Inspection of the Medial Structures

Medial malleolus

Medial longitudinal arch

Inspection of the Posterior Structures

Gastrocnemius and soleus

Achilles tendon

Bursae

Calcaneus

Palpation

Palpation of the Fibular

Structures

Common peroneal nerve

Peroneal muscle group

Fibular shaft

Anterior tibiofibular ligament

Posterior tibiofibular ligament

Interosseous membrane

Superior peroneal retinaculum

Palpation of the Lateral Ankle

Lateral malleolus

Calcaneofibular ligament

Anterior talofibular ligament

Posterior talofibular ligament

Inferior peroneal retinaculum

Peroneal tubercle

Cuboid

Base of 5th MT

Peroneus tertius

Palpation of the Anterior Structures

Anterior tibial shaft

Tibialis anterior

Extensor hallucis longus

Extensor digitorum longus

Dome of the talus

Extensor retinacula

Sinus tarsi

Palpation of the Medial Structures

Medial malleolus

Deltoid ligament

Sustentaculum tali

Spring ligament

Navicular

Navicular tuberosity

Tibialis anterior

Tibialis posterior

Flexor hallucis longus

Flexor digitorum longus

Palpation of the Posterior Structures

Gastrocnemius and soleus

Achilles tendon

Subcutaneous calcaneal bursa

Calcaneus

Subtendinous calcaneal bursa

JOINT AND MUSCLE FUNCTION ASSESSMENT

Goniometry

Plantarflexion/dorsiflexion

Active Range of Motion

Plantarflexion

Dorsiflexion

Inversion

Eversion

Manual Muscle Tests

Dorsiflexion and supination

Eversion and pronation

Plantarflexion

Rearfoot inversion

Passive Range of Motion

Plantarflexion

Dorsiflexion

Inversion

Eversion

JOINT STABILITY TESTS

Stress Testing

Inversion stress test

Eversion stress test

Joint Play Assessment

Medial talar glide

Lateral talar glide (Cotton test)

Distal tibiofibular glide

NEUROLOGICAL ASSESSMENT

Lower Quarter Screen

Common peroneal nerve

Tibial nerve

VASCULAR EXAMINATION

Dorsalis pedis pulse

Posterior tibial pulse

Capillary refill

REGION-SPECIFIC PATHOLOGIES AND RELATED SELECTIVE TISSUE TESTS

Ankle Sprains

Lateral ankle sprain

  • Anterior Drawer test

Distal tibiofibular syndesmosis

  • Squeeze test

    Medial ankle sprain

Ankle and Leg Fractures

Os trigonum injury

Achilles Tendon Pathology

Achilles tendon tendinopathy

Sever's disease

Achilles tendon rupture

  • Thompson test

Peroneal Tendon Pathology

Medial Tibial Stress Syndrome

Stress Fractures

Compartment Syndromes

History

Table 6-1Differential Diagnosis Based on the Location of Pain

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