Diagnostic Tests for Foot conditions
Foot conditions Tests: Book Excerpts
Foot conditions Diagnosis: Book Excerpts
Diagnostic Tests for Foot conditions: Online Medical Books
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FOOT DEFORMITIES:
DIAGNOSTIC WORKUP
(Algorithmic Diagnosis of Symptoms and Signs)
Rather than undertaking an extensive diagnostic workup, it is wise to refer the patient to the appropriate specialist. If there are neurologic signs, the patient should be referred to a neurologist. Otherwise, the patient should be referred to an orthopedic surgeon or podiatrist.
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Source: Algorithmic Diagnosis of Symptoms and Signs, 2003
FOOT ULCERATION:
DIAGNOSTIC WORKUP
(Algorithmic Diagnosis of Symptoms and Signs)
Diminished pulses is a clear indication for Doppler ultrasound studies. Routine tests include a CBC, sedimentation rate, urinalysis, chemistry panel, VDRL test, and glucose tolerance test. An x-ray of the involved foot should be done to rule out osteomyelitis. A bone scan is even more sensitive to osteomyelitis and other disorders of the bone that may be causing the ulcer. A smear should be made of the ulcer material and a culture done also, not just for the common pathogens, but for AFB and fungi. A dark field preparation may be necessary. Skin testing for blastomycosis and other fungi should be done. A nerve conduction velocity study of the lower extremities will be helpful in differentiating neurologic causes. Femoral angiography may be valuable in determining the exact level of the lesion and whether it can be approached surgically.
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Source: Algorithmic Diagnosis of Symptoms and Signs, 2003
FOOT AND TOE PAIN:
DIAGNOSTIC WORKUP
(Algorithmic Diagnosis of Symptoms and Signs)
Routine diagnostic tests include a CBC, sedimentation rate, chemistry panel, VDRL test, and an x-ray of the foot. If the peripheral pulses are diminished, Doppler studies and angiography should be considered. If there is diffuse swelling and erythema, venography may need to be done. If there are neurologic findings, nerve conduction velocity studies and electromyograms (EMGs) may be helpful. Consider bone scans, CT scans, and arthroscopy if the above tests are negative. An MRI may be needed to diagnose stress fractures. Abnormal weight distribution is diagnosed by quantitative scintigraphs. It is wise to refer the patient to an orthopedic surgeon or podiatrist before ordering expensive diagnostic tests.
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Source: Algorithmic Diagnosis of Symptoms and Signs, 2003
Footdrop:
History and physical examination
(Professional Guide to Signs & Symptoms (Fifth Edition))
Ask the patient about the sign’s onset, duration, and character. Does the footdrop fluctuate in severity or remain constant? Does it worsen with fatigue or improve with rest? Ask the patient if he feels weak or tires easily.
During the physical examination, assess muscle tone and strength in the patient’s feet and legs, and compare findings on both sides. Assess deep tendon reflexes (DTRs) in both legs as well. Have the patient walk; inspect his shoes for wear and observe the patient for steppage gait—a compensatory response to footdrop in which the legs are raised abnormally high.
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Source: Professional Guide to Signs & Symptoms (Fifth Edition), 2006
Ankle/Foot Pain:
Diagnostic Approach
(Field Guide to Bedside Diagnosis)
In acute ankle injury, ability to bear weight for four steps and absence of bone tenderness at the posterior edge or the tip of either malleolus rule out a significant fracture (Ottawa ankle rule).
In acute foot injury, ability to bear weight for four steps and absence of bone tenderness at the navicular or the base of the fifth metatarsal rule out a significant midfoot fracture (Ottawa foot rule).
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Source: Field Guide to Bedside Diagnosis, 2007
Footdrop:
Physical assessment
(Signs & Symptoms: A 2-in-1 Reference for Nurses)
During the physical examination, assess muscle tone and strength in the patient’s feet and legs, and compare findings on both sides. Assess deep tendon reflexes (DTRs) in both legs as well. Have the patient walk; inspect his shoes for wear and observe the patient for steppage gait — a compensatory response to footdrop in which the legs are raised abnormally high.
» READ BOOK EXCERPT ONLINE »
Source: Signs & Symptoms: A 2-in-1 Reference for Nurses, 2007
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