Ankle Diseases, Injuries and Treatments (Msq Drill 179)

1. Surgery is often the only treatment for Haglund's deformity. True or false?

True, surgery is the only treatment for resection of the prominence

False, RICE, heel lifts, PT, immobilization and modifying shoewear. surgery is seldom necessary.

2. Peroneal tendonitis is frequently misdiagnosed as:

Medial ankle sprain

Lateral ankle sprain

3. Is a medial ankle sprain common?

Yes

No

4. Can peroneal tendonitis becone cnronic?

Yes

No

5. Where would you feel tenderness in a patient with peroneal tendonitis?

Posterior to the lateral malleolus

Anterior to the lateral malleolus

Posterior to the medial malleolus

Anterior to the medial malleolus

6. Why would you perform an external rotation test or squeeze test on a patient. What are you suspecting?

Low ankle injury

High ankle injury

7. One should remember that in syndesmosis injuries there is usually an accompanying high ankle injury true or false?

True

False

8. You might order an x-ray in a patient with peroneal tendonitis to look for shelf like fractures around the lateral or medial malleolus. True or false?

Lateral malleolus

Medial malleolus

9. Can you order physical therapy for LCL sprains. True or false?

True

False

10. What is the largest tendon in the human body?

Tibialis anterior tendon

Tibialis posterior tendon

Achilles tendon

11. Overuse from athletic activities can cause achilles tendonitis. True or false?

True

False

12. The mechanism of injury usually determines the type of ankle fracture. True or false?

True

False

13. An achilles tendon should always be injected with a steroid. True or false?

True

False

You should NEVER inject the achilles tendon with steroids.

Explanation

You should NEVER inject the achilles tendon with steroids.

14. The most commonly injured ligament in ankle injuries is the:

Calcaneofibular ligament

Deltoid ligament

Anterior talofibular ligament

15. When you treat fractures you should use a c-arm. True or false?

True

False

16. Does a maisonneuve fracture usually involve syndesmotic injury?

Yes

No

17. Grade 1 – no laxity, can weight bear, mild injury

True or false?

True

False

18. What grade : gross instability, unable to weight bear

Grade 1

Grade 2

Grade 3

19. What grade is: laxity and abnormal motion on exam is present, weight bearing very difficult

Grade 1

Grade 2

Grade 3

20. Both posterior and anterior ankle impingements can occur. True or false?

True

False

21. In an x-ray of a talus in which treatment for avascular was carried out you observe a subchondral radioluscent band. Is this a negative or positive Hawkins sign?

Positive

Negative

22. Does the deltoid complex have a superficial and a deep layer?

Yes, it has two layers

No, it has one layer only

23. Can the calcaneal prominence that sticks out in Haglunds deformity cause problems with the bursa or achille's tendon?

Yes

No

24. In a bimalleolar fracture is the syndesmotic ligament is almost always torn. True or false?

True

False

they have to be treated with surgery.

Explanation

they have to be treated with surgery.

25. If conservative treatment fails is surgery an option for peroneal tnedonitis?

Yes

No

26. If you inject lidocaine in the peroneal tendon and the pain goes away, does this confirm the diagnosis?

Yes

No

27. What bone is affected in Haglund's deformity?

Talus

Tibia

Fibula

Calcaneus

Navicular

28. What population most commonly sufferes from Haglund's deformity?

Football athletes

Marathon runners

Tennis players

Women who wear high heels

29. The syndesmosis of the ankle is between which two bones?

Tibio-talar

Tibio-fibular

Subtala jjoint

30. Lateral collateral ligament sprains are graded by severity by what grading system?

Grade 1-5

Grade 0-4

Grade1-3

31. Medial ankle sprains are usually caused by ankle inversion or eversion?

Ankle eversion

Ankle inversion

32. Which is more serious, a high ankle sprain or a lateral ankle sprain?

High ankle sprain

Lateral ankle sprain

A high ankle sprain takes longer to heal.

Explanation

A high ankle sprain takes longer to heal.

33. Ankle syndesmosis injury is usually caused by:

Internal rotation injury

External rotation injury

34. Which of the following make up the syndesmosis?

Interosseous ligament

Interosseuos membrane

Anterior inferior tibio-fibular ligament

Posterior inferior tibio-fibular ligament

Submit

35. There is a difference of opinions on whether to RICE or surgically treat grade 3 sprains. True or false?

True

False

36. Would you use RICE and braces for grade 1 & 2 ankle sprains?

Yes

No

37. Deltoid ligament injury requires surgery 100% of the time. True or false?

True

False

It almost never required surgery even if associated with severe fracture dislocations.

Explanation

It almost never required surgery even if associated with severe fracture dislocations.

38. What is the best test to diagnose avascular necrosis?

CT

MRI

Bone density scan

PET

39. There are two ways to treat an arthritic ankle.

Ankle replacement

Fusion

OMT

Submit

40. The most common fracture around the ankle is the

Bimalleolar fracture

Distal fibula fracture

Avulsion fracture of the distal fracture

Distal tibial fracture

41. What test would you use to check for peroneal tendonitis?

Xray

CT scan

MRI

42. Basically in Haglund's deformity there is a prominence of the calcaneus that sticks out in the anterior or posterior ankle?

43. What two tendons pass under the fibular retinaculum?

Peroneus longus tendon

Achilles tendon

Extensor digitorum brevis tendon

Peroneus brevis

Submit

44. What two tests can you do to test for LCL sprains?

Anterior draw sign

Talar tilt sign

Thompson test

Thomas test

Submit

45. Does absence of the Hawkin's signs suggest a high or low risk of avascular necrosis?

High risk

Low risk

46. You can treat a high ankle injury with RICE. When would you have to do an internal fixation?

If the tibia is fractured

If there is widening between the the distal tibia and fibula

If the fibula is fractured

47. The deltoid complex is on the lateral or medial side of the ankle?

Lateral

Medial

48. Which of the following make up the lateral collateral ligament?

Posterior talofibular ligament

Anterior talofibular ligament

Middle calcaneal fibular ligament

Anterior tibiofibular ligament

Submit

49. What types of fractures usually occur after a fall from a high level and are very difficult to fix?

Bimalleolar fracture

Distal tibial fracture

Pilon fracture

fx to the distal tibia

Explanation

fx to the distal tibia

50. Osteochondritis dessicans occurs mostlhy in the lateral or medial side of the ankle.

Lateral

Medial

51. Which malleolus is affected in a maisonneuve fracture?

Medial

Lateral

52. What nerve is compressed in tarsal tunnel syndrome?

Deep peroneal

Plantaris nerve

Tibial nerve

53. A maisonneuve fracture is a fracture of the _________ right below the knee.

Tibia

Fibula

54. Is the achilles tendon the most frequently ruptured tendon?

Yes

No

55. According to the Ottawa rules, everybody who walks into the emergency room complaining of lateral ankle pain should have an x-ray. True or false?

True

False

The Ottawa Rules essentially state that x-rays are necessary only for individuals with suspected ankle sprains who cannot bear weight on the injured leg and for individuals with tenderness over the bones (as opposed to the ligaments)

Explanation

The Ottawa Rules essentially state that x-rays are necessary only for individuals with suspected ankle sprains who cannot bear weight on the injured leg and for individuals with tenderness over the bones (as opposed to the ligaments)

56. Is decompression usually necessary in tarsal tunnel syndrome?

Yes

No

57. Which of the following actions might lead to peroneal tendonitis?

Inversion ankle injury (ATF)

Eversion ankle injury

Forceful contraction of the peroneal tendons on a dorsiflexed ankle

Forceful contraction of the posterior tibial tenson on a plantarflexed ankle

Submit

58. Why is the talus the bone that is affected the most by avascular necrosis?

Because of its relationship with the tibia

Because of its relationship with the calcaneus

Because it is the most central bone in the ankle

Because of limited collateral circulation

59. What part of the ankle is affected in a posterior impingement?

Distal fibula

Os trigonum

Distal tibia

Subtalar joint

60. How do you reduce the peroneal tendons before you immobilize the extremity?

Place in dorsiflexion with slight eversion below the knee

Plave in plantar flexin with slight evertsion below the knee

Placein plantar flexion in slight inversion below the knee

Place in dorsiflexion in slight inversion below the knee

61. Do both the anterior and posterior tibial tendons extend to the foot via the medial side or the lateral side?

Medial

Lateral

62. It will take about how many months for revasscularization of the talus?

5

12

24

36

48

63. Which of the following ligaments are located on the lateral side of the ankle?

Anterior talo-fibular

Calcaneal-fibular

Posterior talo-fibular

Posterior tibial-fibular

Anterior tibial-fibular

Submit

64. The ankle is a hinge joint that is made up of the following three joints:

Fibula

Calcaneus

Fibula

Talus

Submit

65. Which of the following is the most common bone affected with avascular necrosis in the ankle?

Tibia

Talus

Calcaneus

Fibula

66. Which of the following are symptoms of achilles tendonitis?

Mild pain after excersicing that graduallu worsens

Episodes of diffuse or localized pain, sometimes severe along the tendon during or a few hours after running

Morning tenderness or stiffness that gradually diminishes as the tendon warms up with use

Swelling

Tenderness at the end of the day from use during the day

Submit

67. The ankle mortise is made up the articulation of which of the following?

Distal tibia

Medial malleolus

Tibia

Distal fibula

Submit

68. What is the most common mechanism of injury seen in LCL sprains?

Ankle eversion

Ankle dorsiflexion

Ankle

Supination

Ankle inversion

69. What test is useful in diagnosing achilles related ankle pain?

Thomas

Thompson

Ober

Ankle Diseases, Injuries and Treatments (Msq Drill 179)

1. Surgery is often the only treatment for Haglund's deformity. True or false?

2.

What first name or nickname would you like us to use?

2. Peroneal tendonitis is frequently misdiagnosed as:

3. Is a medial ankle sprain common?

4. Can peroneal tendonitis becone cnronic?

5. Where would you feel tenderness in a patient with peroneal tendonitis?

6. Why would you perform an external rotation test or squeeze test on a patient. What are you suspecting?

7. One should remember that in syndesmosis injuries there is usually an accompanying high ankle injury true or false?

8. You might order an x-ray in a patient with peroneal tendonitis to look for shelf like fractures around the lateral or medial malleolus. True or false?

9. Can you order physical therapy for LCL sprains. True or false?

10. What is the largest tendon in the human body?

11. Overuse from athletic activities can cause achilles tendonitis. True or false?

12. The mechanism of injury usually determines the type of ankle fracture. True or false?

13. An achilles tendon should always be injected with a steroid. True or false?

14. The most commonly injured ligament in ankle injuries is the:

15. When you treat fractures you should use a c-arm. True or false?

16. Does a maisonneuve fracture usually involve syndesmotic injury?

17. Grade 1 – no laxity, can weight bear, mild injuryTrue or false?

18. What grade : gross instability, unable to weight bear

19. What grade is: laxity and abnormal motion on exam is present, weight bearing very difficult

20. Both posterior and anterior ankle impingements can occur. True or false?

21. In an x-ray of a talus in which treatment for avascular was carried out you observe a subchondral radioluscent band. Is this a negative or positive Hawkins sign?

22. Does the deltoid complex have a superficial and a deep layer?

23. Can the calcaneal prominence that sticks out in Haglunds deformity cause problems with the bursa or achille's tendon?

24. In a bimalleolar fracture is the syndesmotic ligament is almost always torn. True or false?

25. If conservative treatment fails is surgery an option for peroneal tnedonitis?

26. If you inject lidocaine in the peroneal tendon and the pain goes away, does this confirm the diagnosis?

27. What bone is affected in Haglund's deformity?

28. What population most commonly sufferes from Haglund's deformity?

29. The syndesmosis of the ankle is between which two bones?

30. Lateral collateral ligament sprains are graded by severity by what grading system?

31. Medial ankle sprains are usually caused by ankle inversion or eversion?

32. Which is more serious, a high ankle sprain or a lateral ankle sprain?

33. Ankle syndesmosis injury is usually caused by:

34. Which of the following make up the syndesmosis?

35. There is a difference of opinions on whether to RICE or surgically treat grade 3 sprains. True or false?

36. Would you use RICE and braces for grade 1 & 2 ankle sprains?

37. Deltoid ligament injury requires surgery 100% of the time. True or false?

38. What is the best test to diagnose avascular necrosis?

39. There are two ways to treat an arthritic ankle.

40. The most common fracture around the ankle is the

41. What test would you use to check for peroneal tendonitis?

42. Basically in Haglund's deformity there is a prominence of the calcaneus that sticks out in the anterior or posterior ankle?

43. What two tendons pass under the fibular retinaculum?

44. What two tests can you do to test for LCL sprains?

45. Does absence of the Hawkin's signs suggest a high or low risk of avascular necrosis?

46. You can treat a high ankle injury with RICE. When would you have to do an internal fixation?

47. The deltoid complex is on the lateral or medial side of the ankle?

48. Which of the following make up the lateral collateral ligament?

49. What types of fractures usually occur after a fall from a high level and are very difficult to fix?

50. Osteochondritis dessicans occurs mostlhy in the lateral or medial side of the ankle.

51. Which malleolus is affected in a maisonneuve fracture?

52. What nerve is compressed in tarsal tunnel syndrome?

53. A maisonneuve fracture is a fracture of the _________ right below the knee.

54. Is the achilles tendon the most frequently ruptured tendon?

55. According to the Ottawa rules, everybody who walks into the emergency room complaining of lateral ankle pain should have an x-ray. True or false?

56. Is decompression usually necessary in tarsal tunnel syndrome?

57. Which of the following actions might lead to peroneal tendonitis?

58. Why is the talus the bone that is affected the most by avascular necrosis?

59. What part of the ankle is affected in a posterior impingement?

60. How do you reduce the peroneal tendons before you immobilize the extremity?

61. Do both the anterior and posterior tibial tendons extend to the foot via the medial side or the lateral side?

62. It will take about how many months for revasscularization of the talus?

63. Which of the following ligaments are located on the lateral side of the ankle?

64. The ankle is a hinge joint that is made up of the following three joints:

65. Which of the following is the most common bone affected with avascular necrosis in the ankle?

66. Which of the following are symptoms of achilles tendonitis?

67. The ankle mortise is made up the articulation of which of the following?

68. What is the most common mechanism of injury seen in LCL sprains?

69. What test is useful in diagnosing achilles related ankle pain?

17. Grade 1 – no laxity, can weight bear, mild injury

True or false?