Foot and ankle history and clinical examination: A guide to everyday practice

Table 8 Examination techniques of performing the foot and ankle special tests[2,3,9,10]

Name of the test	Purpose of the test	Manoeuvre
Silfverskiold test	Differentiate between a tight gastrocnemius and a tight soleus muscle	The leg hangs loosely off the table - knee flexed Dorsiflex the ankle to the maximum Patient should then extend their knee Repeat the ankle dorsiflexion (Figure 10) If there was more ankle dorsiflexion with the knee flexed then there is gastrocnemius tightness
Thompson’s test	Achilles’ tendon rupture	Patient lies is prone on the bed or kneel on a chair The examiner gently squeeze the gastrocsoleus muscle (calf) If the tendon is intact, then the foot passively plantar flexes when the calf is squeezed
Test for tarsal tunnel syndrome	Compressions of the posterior tibial nerve underneath the flexor retinaculum at the tarsal tunnel	Tap inferior to the inferior to the medial malleolus to produce Tinel’s sign
Test for flat foot	Differentiate between flexible vs rigid	Ask patient to stand on tiptoes If the medial arch forms and heel going into varus then it is flexible flat foot Beware of rupture tibialis posterior tendon or tarsal coalition
Test for stress fractures	Stress fractures	Place a tuning fork onto the painful area If it increases the pain, then it is positive Other test: One spot tenderness on palpation with finger
Babinski’s response	Upper motor neuron disease	Scratch the lateral border of the sole of the foot A positive response is dorsiflexion of the great toe
Oppenheim’s test	Upper motor neuron disease	Run a knuckle or fingernail up the anterior tibial surface A positive response is dorsiflexion of the great toe
Mulder's test	Morton’s neuroma	A mass felt or audible Click is elicited by palpating (grasping) the forefoot (web space) with the index finger and thumb of the examiner