From the Guidelines
The term for when a doctor examines the foot to supplement x-rays is a "clinical foot examination" or "podiatric physical examination." This hands-on assessment involves the doctor visually inspecting the foot, palpating (touching) to check for tenderness or abnormalities, assessing range of motion, evaluating gait (how a person walks), and testing neurological responses. While x-rays provide valuable information about bone structure, they cannot show soft tissue problems like ligament tears, nerve damage, or circulation issues. The clinical examination is essential because it provides information about pain locations, functional limitations, and soft tissue conditions that imaging alone cannot detect, as supported by the Ottawa rules for acute trauma to the foot 1. Doctors typically perform this examination before ordering x-rays, but also use it afterward to correlate physical findings with radiographic results, creating a more complete diagnostic picture that guides treatment decisions. Key aspects of the clinical foot examination include:
- Visually inspecting the foot for signs of injury or abnormality
- Palpating to check for tenderness or abnormalities
- Assessing range of motion and evaluating gait
- Testing neurological responses to identify potential nerve damage The Ottawa rules, which have a sensitivity of 99% and a median specificity of 26% for combined evaluation of the ankle and midfoot 1, highlight the importance of a thorough clinical examination in conjunction with imaging studies. By combining the results of the clinical foot examination with x-ray findings, doctors can make more accurate diagnoses and develop effective treatment plans, ultimately improving patient outcomes in terms of morbidity, mortality, and quality of life.
From the Research
Foot Examination
- The term for when a doctor examines the foot to supplement x-rays is a physical examination or clinical examination of the foot and ankle 2.
- This examination is thorough and focused on inspection, palpation, range of motion, and appropriate special tests when applicable 2.
- The examination assesses the entirety of patient disorders that present as they can be multifactorial in cause, including disorders of bones, joints, muscles, neurovasculature, and surrounding soft tissue structures 2.
Diagnostic Considerations
- A broad differential diagnosis should include disorders of bones, joints, muscles, neurovasculature, and surrounding soft tissue structures 2.
- The examination is used to diagnose and manage various foot and ankle disorders, including mechanical, inflammatory, infectious, and tumoral diseases 3.
- It is also used to evaluate and treat conditions such as bunions, hammertoes, and clawtoes 4, 5, 6.