OnExam

Inspection

  • Non-weight bearing: use SEADSS (Swelling, Erythema, Atrophy, Deformity, Symmetry, Skin changes), nodules, calluses/corns
  • In weight-bearing patients, have them remove their socks and shoes and inspect them both walking, sitting, and standing
    • Foot position
    • Arches
    • Supination/pronation

Palpation

  • Note areas of pain, swelling, deformity or crepitus in the following structures:
    • Medial malleolus (tibia)
    • Achilles Tendon
    • Lateral malleolus (fibula)
    • Tibiotalar joint line
    • Talus
    • Medial and Lateral ligaments
    • Calcaneus (bone spurs)
    • Navicular
    • Metatarsophalangeal joitns and metatarsal heads
    • Plantar fascia

Range of Motion

References

  1. Baxter S, ed., McScheffrey G, ed. Toronto Notes: Comprehensive Medical Reference & Review for MCCQE 1 & USMLE 2. 26th ed. Toronto: Toronto Notes for Medical Students Inc; 2010.
  2. Bickley L. Bate’s Guide to Physical Examination and History Taking. 10th ed. New York: Lippincott Williams & Wilkins; 2009.
  3. Filate W, Leung R, Ng D, Sinyor M, eds. Essentials of Clinical Examination Handbook. 5th ed. Toronto, ON. University of Toronto, 2005.