Foot And Ankle Examination

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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.