Curbside Consultation of the Foot and Ankle: An Essential Guide for Primary Care Providers

Foot and ankle problems are common in primary care, accounting for a significant portion of patient visits. Curbside Consultations provide an efficient way for primary care providers to obtain expert advice from specialists without the need for a formal referral process. This article provides a comprehensive guide to curbside consultations of foot and ankle conditions, covering common presentations, differential diagnoses, and management strategies.

Curbside Consultation of the Foot and Ankle: 49 Clinical Questions

by Donatella Mutolo

4 out of 5

Language	:	English
File size	:	11230 KB
Text-to-Speech	:	Enabled
Screen Reader	:	Supported
Enhanced typesetting	:	Enabled
Print length	:	288 pages
X-Ray for textbooks	:	Enabled

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Common Foot and Ankle Presentations

1. Pain: Pain is the most common presenting symptom of foot and ankle problems. It can range from mild discomfort to severe, debilitating pain. The location, character, and duration of pain can help narrow down the differential diagnosis.
2. Swelling: Swelling can be caused by inflammation, infection, or trauma. It can be localized to a specific area or affect the entire foot or ankle.
3. Deformity: Deformities can be congenital or acquired. They can affect the shape, alignment, and function of the foot or ankle.
4. Skin changes: Skin changes can include redness, swelling, itching, and scaling. They can be caused by a variety of conditions, including infections, allergies, and systemic diseases.
5. Neurological symptoms: Neurological symptoms can include numbness, tingling, and weakness. They can be caused by nerve damage or compression.

Differential Diagnoses

The differential diagnosis of foot and ankle problems can be extensive, depending on the presentation. Some of the most common conditions include:

• Arthritis: Arthritis is a condition that causes inflammation of the joints. It can affect the joints of the foot and ankle, leading to pain, stiffness, and swelling.
• Bursitis: Bursitis is a condition that causes inflammation of the bursae, which are fluid-filled sacs that cushion the joints. It can affect the bursae of the foot and ankle, leading to pain, swelling, and tenderness.
• Tendonitis: Tendonitis is a condition that causes inflammation of the tendons, which are the tough, fibrous cords that connect muscles to bones. It can affect the tendons of the foot and ankle, leading to pain, swelling, and tenderness.
• Plantar fasciitis: Plantar fasciitis is a condition that causes inflammation of the plantar fascia, which is a thick band of tissue that runs along the bottom of the foot. It can lead to pain, stiffness, and tenderness in the heel and arch of the foot.
• Heel spurs: Heel spurs are bony growths that develop on the heel bone. They can cause pain, swelling, and tenderness, especially when walking or standing.
• Bunions: Bunions are bony bumps that develop on the side of the big toe. They can cause pain, swelling, and deformity of the toe.
• Hammertoes: Hammertoes are toes that are bent at the middle joint. They can cause pain, swelling, and difficulty wearing shoes.
• Ingrown toenails: Ingrown toenails are nails that have grown into the surrounding skin. They can cause pain, swelling, and infection.
• Athlete's foot: Athlete's foot is a fungal infection of the skin of the feet. It can cause itching, burning, and scaling.

Management Strategies

The management of foot and ankle problems depends on the underlying condition. Some common management strategies include:

1. Rest: Resting the affected foot or ankle can help to reduce pain and inflammation.
2. Ice: Applying ice to the affected area can help to reduce pain and swelling.
3. Compression: Wrapping the affected area with an elastic bandage can help to reduce swelling.
4. Elevation: Elevating the affected foot or ankle above the level of the heart can help to reduce swelling.
5. Medication: Over-the-counter or prescription medications can be used to reduce pain and inflammation.
6. Physical therapy: Physical therapy can help to improve range of motion, strength, and function of the affected foot or ankle.
7. Injections: Injections of corticosteroids or other medications can be used to reduce pain and inflammation.
8. Surgery: Surgery may be necessary to correct deformities or repair damaged tissues.

When to Refer to a Specialist

Primary care providers should consider referring patients to a foot and ankle specialist if:

• The patient has severe pain, swelling, or deformity.
• The patient has not responded to conservative treatment.
• The patient has a complex or underlying medical condition that may be affecting the foot or ankle.
• The patient requires surgery.

Curbside consultations are an effective way for primary care providers to obtain expert advice on foot and ankle problems. By understanding the common presentations, differential diagnoses, and management strategies, primary care providers can provide appropriate care for their patients and when necessary, refer them to a specialist for further evaluation and treatment.

Curbside Consultation of the Foot and Ankle: 49 Clinical Questions

by Donatella Mutolo

4 out of 5

Language	:	English
File size	:	11230 KB
Text-to-Speech	:	Enabled
Screen Reader	:	Supported
Enhanced typesetting	:	Enabled
Print length	:	288 pages
X-Ray for textbooks	:	Enabled

FREE