Ankle & Foot

 Introduce self, clarify patient identity

 Wash hands
 Explain the procedure
o “I’ve been asked to examine your ankles and feet – that will involve me having
a look and feel of them, and going through some movements. Is that OK?”
o “Before we start, do you have any pain at all?”
 Expose ankles and feet
 Gait inspection
o Looking for heel-strike, toe-off gait, toe position, shoes
 General inspection – look from behind
o Calf wasting, calcaneal tendon alignment, arches, joint swelling
o Then get patient to lie on bed – symmetry, nails, toe alignment, joint swelling,
calluses etc
 Palpation
o Temperature – back of hand, comparing each foot/ankle to each other and
rest of leg
o Palpate medial shins
o Pulses – dorsalis pedis, posterior tibial
o Palpate metatarsophalangeal joints looking for tenderness

o Palpate mid-foot, ankle and subtalar joints looking for tenderness

 Movements
 oPassively – dorsiflexion, plantarflexion, inversion, eversion
oActively – hold heel in left hand and forefoot in right hand
oBig toe plantar and dorsiflexion – active and passive
oMidtarsal joints – fix the forefoot and ask test inversion and eversion
 Special test
if time –
assess
Achilles by
squeezing
calf with pt
prone
 State would also
test the

neurovascular responses in
the lower limb
 Thank the patient

  Wash hands