- results when the bursa over a hallux valgus deformity becomes inflamed

Bunion

- commonly involved the secon toe, where the MPT joint is hyperextended, PIP joint is flexed, and DIP joint is extended

- callus often develops over the PIP joint

- usually caused by shoes that are too short

Hammer toe

- most common foot problem

- inflammatory condition that develops as a consequence of repeated overstretching of the plantar fascia

- affects women more than men

- pts report pain over medial calcaneal tuberosity

- most severe in morning or after prolonged sitting

- flat feet, high arches, age, obesity all causes

- heel spurs may grow in response

Plantar Fasciitis

- causes pain over the posterior aspect of the heel

- bursa becomes inflamed and damaged from pronation, supination, excessive weight, over-use, high heels, diabetes or gout

Achilles (Calcaneal) bursitis

- affects tendon on the back of the ankle

- caused by over-pronation, improper shoes, inadequate stretching

- insertion becomse inflamed, pulls on bone, causing a bone spur --> point tenderness develops

- poor blood supply can lead to weakening of tendon, tearing, scar tissue, or rupture

- pain is worse upon arising and walking down stairs

Achilles tendonitis

- abnormal outward thoracic curvature

- sharply angulated may represent tuberculosis of the spine or metastatic cancer

- gentler form accompanies aging and osteoporosis

Kyphosis

- exaggerated inward curving of the thoracic spine

Lordosis

- lateral curvature of the spine

- screening done by palpating and observing the spine while pt is bent at hips

Scoliosis

- one of the most common conditions for which pts seek medical care

- difficult to identify cause on physical exam

Back pain

- most common cause of low back pain

- between lower lumber vertebrae these are the ones that are most commonly injured because they support the weight of the entire body

- soft inner core (nucleus pulposis) escapes outer ring

- most vulnerable where nerves pass through canal (sciatica)

- subacute pain may linger down the back of leg (electric or burning quality)

Lumbar disk herniation

- valuable maneuver to assess compression of the sciatic nerve or one of its trunks

- pt lies supine and examiner passively flexes the leg at the hip, raising it fully extended from the ankle

- 40-60 degrees of elevation produces pain if positive

Straight Leg Raising Test for Sciatica

- common deformity of spine characterized by anterior displacement of one vertebra on another

- usually involves 4th or 5th lumbar

- center of gravity is in front of lumbar spine and can contribute to this

- occurs if abnormalities are present within facet joints, articular processes, or neural arch

- low back pain is most common symptom

- radiculopathy may also occur w/ compression of nerve roots

Spondylolisthesis

- formed by the articulation of the ileum w/ the sacrum

- lie beneath the sacrum dimples of the lower back

- assessed for tenderness by fist percussion

- arthritic involvement of SI joints may produce pain

Sacroiliac joints