Foot And Ankle Examination
With the patient on a couch, feet overhanging the end of it:
- Compare for symmetry.
- Look for nail changes
- Skin rashes.
Look at shoes for:
- Asymmetrical wearing of the sole
- Presence of insoles
- and other signs of poor fit.
- 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
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.