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Foot And Ankle Examination

Look

With the patient on a couch, feet overhanging the end of it:

  • Compare for symmetry.

Nails

  • Look for nail changes
  • Skin rashes.

Toes

  • Toe alignment
  • Hallus varus or valgus
  • Clawing of the toes
  • Joint swelling
  • and Callus formation

Look at shoes for:

  • Asymmetrical wearing of the sole
  • Presence of insoles
  • and other signs of poor fit.

Feel

  • Assess temperature of ankle and fore foot
  • Feel for peripheral pulse

Whilst watching patient's face, squeeze across the:

  • Metatarsal-pharyngeal joints
  • Tarsal joints
  • Ankle joint line
  • Subtalar joints

Move

Perform, actively and passively:

  • Inverse and eversion.
  • Dorsi flexion and plantar flexion of the toe...
  • ...and of the ankle joint.

Midtarsal and subtalar movements can be tested passively. Get the patient to stand, looking for:

  • Toe alignment
  • The foot arch.
  • Enlarged Achilles tendon.

Standing on tiptoes, should resolve a dropped arch in a normal subject.

Finally, test gait, looking for normal toe strike and foot off.