Foot and Ankle Sprains Quiz

Foot and Ankle Sprains

• Low ankle sprains are more common than high ankle sprains.
• The most common mechanism of a low ankle sprain is inversion and plantar flexion.
• Structures involved in low ankle sprains include the anterior talofibular ligament (ATFL), calcaneofibular ligament (CFL), and posterior talofibular ligament (PTFL).
• Prognosis for low ankle sprains is shorter than high ankle sprains (approximately 1 week).
• High ankle sprains involve the syndesmotic ligaments.
• The typical mechanism of a high ankle sprain is external rotation of the tibia and dorsiflexion of the ankle.
• The prognosis for high ankle sprains is longer than low ankle sprains, approximately 2-7 weeks.

Chronic Ankle Instability (CAI)

• Chronic pain and reoccurring sensation of instability are common symptoms of CAI.
• Some cases of low ankle sprains can develop into chronic ankle instability.
• 40% of individuals develop persisting symptoms of CAI following an ankle sprain.

Lateral Ankle Sprain Grades

• Grade I: minimal loss of function, negative anterior drawer and talar tilt tests, little to no hemorrhaging, and minimal swelling.
• Grade II: some loss of function, positive anterior drawer test, negative talar tilt test, moderate hemorrhaging, moderate swelling, and moderate pain.
• Grade III: near total loss of function, positive anterior drawer and talar tilt tests, severe hemorrhaging, severe swelling, and severe pain.

Ottawa Ankle Rules

• Used to determine if ankle X-rays are needed.
• X-ray needed if pain in the malleolar or midfoot zone and bone tenderness at particular points, and/or inability to bear weight both immediately and in the emergency department.

Bernese Ankle Rules

• Procedure involves 3 stress tests: Indirect Fibular Stress, Direct Medial Malleolar Stress, and Mid- & Hind-Foot Compression Stress.
• Radiograph needed if symptoms reproduced from any 1 of the 3 above.

Hip Examination

• Hip dysplasia is a shallow acetabulum/decreased coverage of the femoral head.
• Hip instability is the increased stress on anterior capsul.

Developmental Dysplasia of the Hip (DDH)

• The typical presentation of an adult with DDH is an insidious onset of moderate to severe groin or lateral hip pain.
• Activity restriction, limping, and positive impingement signs are common indicators.

Slipped Capital Femoral Epiphysis (SCFE)

• Slippage of the femoral head relative to the femoral neck, often occurring in adolescents.
• Clinically, there may be gradual or sudden pain in the hip, groin, thigh, or knee.
• The pain is typically worse with activity but can occur at rest.

Legg-Calvé-Perthes Disease

• Idiopathic avascular necrosis of the femoral head, typically affecting children aged 4-10.
• It's more common in boys.
• The presence of pain in the groin, thigh, or medial knee along with an antalgic gait and reduced hip abduction/muscle spasms is indicative.

Osteoarthritis

• Results from the degradation of the articular cartilage with subsequent osteophyte formation, narrowing of the joint space, and sclerosis of bone.
• Clinically, there may be moderate to severe anterolateral hip pain during weight-bearing, morning stiffness lasting under an hour, and limited hip IR below 24º.

Rheumatoid Arthritis

• A systemic autoimmune inflammatory disease affecting the synovial lining, cartilage, and bone.
• Common presentation includes symmetrical involvement of multiple joints, pain, swelling, redness, and stiffness.
• Morning stiffness typically exceeding 1 hour, decreased range of motion, and presence of rheumatoid factor support diagnoses.

Greater Trochanteric Pain Syndrome (GTPS)

• A cluster of symptoms including trochanteric bursitis, abductor tendinopathy, and abnormal mechanical loads.
• Clinically, there may be insidious, chronic, and intermittent pain in the proximal lateral hip radiating to the distal thigh.
• Positive 30-second single-leg stance test (pain due to, and not necessarily weakness).

Labral Lesions

• Labral function includes shock absorption, pressure distribution, joint stabilization, and proprioception.
• Presentation features include anterior hip/groin pain, clicking, catching, and difficulty with range-of-motion, particularly rotation.

Iliotibial Band Syndrome

• Lateral hip or knee pain, weaker hip abductor strength, and a relationship to increased hip adduction and knee internal rotation during stance.

Avulsion Fractures

• common in 14-17 years old boys.
• Typically involve sudden onset pain.
• Limited active range of motion, weakness, and pain.

Ischemic Necrosis of the Femoral Head (AVN)

• Avascular necrosis of the femoral head characterized by interruption of blood supply.
• Pain in the groin (often worsened by weightbearing and relieved by rest), and limitation in range of motion in the non-capsular pattern.

Coxa Saltans/Snapping Hip

• Snapping hip is when various structures snap over the superior portion of the hip joint.
• Extra-articular snapping hip is more common and is often linked to GTPS.

Gluteal Syndrome

• Cluster of pain that may be caused by disorders of the piriformis or hamstrings.
• Common in those who sit a lot and have buttock pain.
• Pain often worsens with prolonged sitting or activity; referral to the knee may be common.

Athletic Pubalgia/Core Muscle Injury (CMI)

• Chronic pain in the abdominal/groin area radiating into the perineum or proximal adductors.
• Exacerbation of pain occurs with kicking, cutting, or sprinting.
• Imbalance between adductor and abductor muscle strength, and decreased ROM are often present.

Test your knowledge on foot and ankle sprains, including their mechanisms, common symptoms, and prognoses. Learn about the differences between low and high ankle sprains and the risks of chronic ankle instability. This quiz is ideal for students and professionals in sports medicine and physical therapy.