ankle assessment

• special objective

  • swlling/ bruising
  • weight bearing
  • pes planus=flat foot/ pes cavus=high arch
  • hallux alignment= big toe pointing to other toes
  • hindfoot forefoot varus & valgus
• common issue

  • trauma/ acute injury(ligamentous sprain, muscle tedon strain)
  • tarsal tunnel syndrome=tibial nerve in ankle compressed
  • sinus tarsi syndrome=lateral ankle swelling & instable due to sinus tarsi inflammation
  • tenosynovitis=inflammation of tendon sheath surround ankle
  • osteochondritis dissecans of talus: talus bone detached due to poor blood supply
  • osteoarthrtis=breakdown of joint cartilage
  • rheumatoid arthritis=immune system attack joint
• ottawa ankle rule: guideline used to determine need of x ray

  if there is pain in...

  • posterior edge or tip of medial lateral malleolus
  • navicular
  • base of 5th metatarsal
• talocrual joint —> plantarflexion (PA talus on tibia) / dorsiflexion (AP talus on tibia)

  
• subtalar joint (inversion/ eversion)

  
• Anterior drawer test

  • test ATFL

  
• Inversion talar tilt test

  • test ATFL & calcenofibular ligament

  • in plantarflexion

  • Hold talus and stabilise distal tibia and fibula

  Eversion talar tilt test

  • test deltoid ligament

  • Hold calcaneus and talus stabilise tibia

  
• Thompson’s test

  • test achilles tendon

  • squeeze calf (gastrocnemius/ soleus/ plantaris)

  • Positive if absence of ankle plantarflexion