Foot and Ankle Assessment-Investigations and Tests

Original Editor - Rachael Lowe

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This article is currently under review and may not be up to date. Please come back soon to see the finished work! (8/01/2022)

Introduction[edit | edit source]

Taking a patient's history and completing an objective assessment is a gold standard of the foot and ankle assessment. The purpose of using special investigations and tests is to confirm the clinical diagnosis.

"We can't treat the patient just on x-rays or just on MRI findings. These things have to come together (with the objective assessment)". Helene Simpson

Techniques[edit | edit source]

Investigations[edit | edit source]

X-Rays[edit | edit source]

  • Can help to investigate bone, air and soft tissue injury
  • Assist with the diagnosis of the Achilles tendon rupture based on the presence of five radiological x-ray signs[1]
  • Lateral ankle X-ray is reliable to support diagnosis of the Achilles tendon rupture[1]
  • X-ray may not be sufficient to identify malleolar fractures[2]
  • Syndesmosis injury is often overlooked on X-ray[2]

Diagnostic Ultrasound[edit | edit source]

MRI[edit | edit source]

the gold standard for the diagnosis of Achilles tendon rupture[1]

value of MR in evaluation of patients with ankle pain caused by traumatic injury. He concluded MR gives additional insight into ligamentous, tendon and cartilage injuries. However MR is expensive and not easily accessible on many ERs around the world

While applying their classification, Rosenberg et al found MRI for diagnosing ruptures of the tendons to be sensitive in (95%) of cases and specific in (100%). MRI has (96%) accuracy in detecting tendon rupture [3]

MRI is particularly advantageous for assessing soft tissue structures around the ankle such as tendons, ligaments, nerves, and fascia and for detecting occult bone injuries[3]

CT Scan[edit | edit source]

The use of CT in cases of foot and ankle trauma has been proposed in several previous studies

CT is a very useful tool for assessing fractures in the ankle joint area [2]

Special Tests[edit | edit source]

Ottawa Foot and Ankle Rules[edit | edit source]

Knee To Wall Test[edit | edit source]

Anterior Drawer Test[edit | edit source]

Squeeze Test[edit | edit source]

External Rotation Test[edit | edit source]

Cotton Test[edit | edit source]

Coleman Block Test[edit | edit source]

Other special tests include:

Questionnaires[edit | edit source]

FAAM

FADI

Visa-A

CRPS

Additional details can be found on the Foot and Ankle Assessment page.

The following video demonstrates the application and interpretation of special tests for foot and ankle assessment:

[4]


References[edit | edit source]

  1. ↑ 1.0 1.1 1.2 Bowen L, Evans R, Bodger O, Howard J, Anne-Marie H. Investigating the Validity of Soft Tissue Signs on Lateral Ankle X-Ray to Aid Diagnosis of Achilles Tendon Rupture in the Emergency Department. Int J Foot Ankle. 2019;3:033.
  2. ↑ 2.0 2.1 2.2 Szymański T, Zdanowicz U. Comparison of routine computed tomography and plain X-ray imaging for malleolar fractures—How much do we miss?. Foot and Ankle Surgery. 2021 Apr 1.
  3. ↑ 3.0 3.1 Elgohary MM, Abdul Rahim SA, Ibrahim TA. Role of MRI in Evaluation of Traumatic Ankle Injuries. The Egyptian Journal of Hospital Medicine. 2017 Oct 1;69(3):2016-24.
  4. ↑ Kris Porter DPT. Movement Screen of the Lower Quarter. Available from: https://www.youtube.com/watch?v=l6gkHR02rIM [last accessed 30/6/2021]


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