Symptom Finder - Leg, foot and Toe Pain
Leg, Foot, and Toe Pain
No doubt the reader does not need instruction in performing inspection and palpation of the lower extremities for cellulitis, hematoma, or other mass lesions. The author also does not think it is necessary to discuss the examination of the bones and joints for inflammation or fracture
dislocations.
However, the physician should not forget to perform a test for Homan sign to rule out thrombophlebitis and palpate for diminished pulses, not
just the dorsalis pedis and tibial pulses, but also the popliteal and femoral pulses. Also, listen for bruits over the femoral arteries to detect significant occlusion of the femoral arteries or terminal aorta (Leriche syndrome).
One thing that many clinicians neglect to do is measure the calves. Often, this is the only way to detect unilateral swelling (in thrombophlebitis) or atrophy (in a herniated lumbar disc syndrome). A clinician should keep a tape measure on his or her person or in his or her bag at all times.
One should perform a straight leg raising test to rule out radiculopathy and external rotation of the hip joint (Patrick test) to rule out hip
pathology. Finally, a good sensory examination does not just help diagnose radiculopathy or polyneuropathy but also rules out tarsal tunnel syndrome or Morton neuroma.
No doubt the reader does not need instruction in performing inspection and palpation of the lower extremities for cellulitis, hematoma, or other mass lesions. The author also does not think it is necessary to discuss the examination of the bones and joints for inflammation or fracture
dislocations.
However, the physician should not forget to perform a test for Homan sign to rule out thrombophlebitis and palpate for diminished pulses, not
just the dorsalis pedis and tibial pulses, but also the popliteal and femoral pulses. Also, listen for bruits over the femoral arteries to detect significant occlusion of the femoral arteries or terminal aorta (Leriche syndrome).
One thing that many clinicians neglect to do is measure the calves. Often, this is the only way to detect unilateral swelling (in thrombophlebitis) or atrophy (in a herniated lumbar disc syndrome). A clinician should keep a tape measure on his or her person or in his or her bag at all times.
One should perform a straight leg raising test to rule out radiculopathy and external rotation of the hip joint (Patrick test) to rule out hip
pathology. Finally, a good sensory examination does not just help diagnose radiculopathy or polyneuropathy but also rules out tarsal tunnel syndrome or Morton neuroma.
