History and examination of the foot and ankle including special clinical tests

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QUESTION 1 OF 7

‘Too many toes’ sign would most likely be seen in which case?

QUESTION ID: 1327

1. A.Charcot–Marie–Tooth disease
2. B.Fibular hemimelia
3. C.Stage IIA tibialis posterior tendon dysfunction
4. D.Stage IIB tibialis posterior tendon dysfunction
5. E.Iselin’s disease
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QUESTION 2 OF 7

99.This patient has a leg length inequality.
With regards to clinical assessment of this patient which statement is most accurate

Answer A- Block test is most reliable.png

QUESTION ID: 2239

1. Apparent leg length will be abnormal
2. Block test is most reliable
3. Galeazzi test will be useful
4. Radiographic assessment will be best because clinical examination will be unreliable
5. True leg length measurement will be abnormal
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QUESTION 3 OF 7

102.A 34-year-old male presents to you with pain on the lateral aspect of his foot and on clinical examination you notice he has increased medial longitudinal arches. He also has a callosity on the base of the 1st metatarsal head. The patient has tried non-operative treatment in the form of shoe modifications and orthotics. You use a board and ask the patient to rest the lateral board over it with the hallux and metatarsal head off to check for hindfoot alignment with the ankle.
The basis of this test lies in.

QUESTION ID: 3300

1. Confirming normal heel varus in toe rise
2. Elevating the medial arch in a cavovarus foot
3. Eliminating the effect of first ray plantar flexion
4. Locking the transverse tarsal joint to form a rigid lever.
5. Placing the hindfoot into an equinus posture
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QUESTION 4 OF 7

103.A 25-year-old male presents to the foot and ankle clinic and is found to have long standing pain localized to a tendon pathology. This tendon contracts concentrically during terminal stance and pre-swing phase of the gait cycle. It is also primarily involved in the pathology that leads to the “too many toes” sign.
The origin of the muscle is from

QUESTION ID: 3301

1. Distal Femur and proximal tibia
2. Fibula only
3. Interosseous membrane
4. Tibia and Fibula
5. Tibia only
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QUESTION 5 OF 7

106.A 52-year-old woman presents with an acute onset positional change to her foot where the foot has become supinated and adducted. She has a history of complex regional pain syndrome. She complains of pain along the medial arch. An examination under anaesthetic as per images, shows a complete correction of her deformity on giving muscle relaxation.
What is the most likely diagnosis?

106A Small.jpeg 106B Small.jpeg

QUESTION ID: 3304

1. Dystonia
2. L5 nerve root palsy
3. Peroneus brevis rupture
4. Tibial posterior tendon entrapment
5. Tibialis Anterior rupture
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QUESTION 6 OF 7

107.A 35-year-old female presents with medial arch pain and has noted her foot has become flat. On examination, the patient is unable to do a single leg heel raise on the affected side. The posture of the foot is of a flattened medial longitudinal arch, which is passively correctable. The patient has “too many toes sign” when viewed from behind. She exhausts conservative measures and wants surgery.
What is the most appropriate surgical intervention?

QUESTION ID: 3305

1. Talanavicular and Subtalar joint fusion.
2. Tibialis posterior reconstruction and gastrocnemius slide
3. Tibialis posterior reconstruction and medializing calcaneal osteotomy.
4. Tibialis posterior reconstruction, medializing calcaneal osteotomy, gastrocnemius slide, Cotton osteotomy.
5. Tibialis posterior reconstruction, medializing calcaneal osteotomy, gastrocnemius slide, spring ligament reconstruction.
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QUESTION 7 OF 7

119.This 50-year-old patient is requiring surgical treatment for his right foot.
Which one of the following is the most appropriate initial surgical treatment?

QUESTION ID: 3312

1. Calcaneal osteotomy
2. Dorsal wedge osteotomy.
3. Plantar fascia release.
4. Split tibialis anterior tendon transfer.
5. Tibialis posterior tendon transfer.
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