Stress Reactions of the Third Metatarsal of the Left Foot - Essay Example

Stress Reactions

Introduction

I would start by introducing myself to the patient by telling them my name and role in that particular setting. The introduction involves the sharing of important pieces of information about all the parties involved. It boosts the patient's confidence to describe their conditions and feelings to the healthcare provider . I would then confirm the patient's details, including name and date of birth. I would then explain to the patient what the assessment would entail. I would then seek the permission of the patient to proceed with the processes. I would then expose the patient’s legs and feet. I would then ask them to stand to check for any abnormalities in the feet . I would then wash my hands. Before staring the physical examination, I would ask the patient if they are experiencing any distress in the feet.

Physical Examination

Look

This part of the physical examination would involve the checking of factors such as clinical signs of pathology, equipment, or objects relating to a foot injury, and gait. It would also involve the checking of any signs of other health conditions. For example, overweight is a significant predisposing factor for various joint problems . Symptoms such as wasting muscles would suggest adverse events such as injury to the lower motor neuron and malfunctioning joints. The failure of the nerves and joints cause disuse atrophy in the muscles. Length of the legs is a significant factor to consider when making the assessment . That would help in identifying factors that could cause adverse events. The height of steps can also be used as an indicator of health or lack of the same.

Expected outcomes

Under normal conditions, the person should walk smoothly and with the normal gait cycle. Under pathological conditions, the expected outcomes would include the presence of walking aids that suggest impaired movement. Past prescriptions would help healthcare providers learn more about the patient's medical history. Factors such as scars would suggest past events such as foot surgery . Gait-related factors such as limping and relatively slow turning could also indicate some form of pathology. As a podiatrist, I would check for signs of abnormalities in heel strike and toe-off. Stepping gait that is higher than usual could indicate pathological conditions such as foot drop. The latter occurs mainly due to the malfunctioning of the fibular nerve.

Closer Look

A closer assessment would also be necessary for the patient. I would ask the patient to stand and turn at 90° so that I could check for abnormalities from all the sides. Different signs could indicate pathology or normalcy when the feet are viewed from different sides. I would ask the patient to tip-toe and then walk on their heels. Such events would enable the healthcare provider to identify various elements of pathology.

Expected Outcomes

From the anterior view, the foot with pathological conditions would show signs such as bruising, scars, psoriasis plaques, and swelling. The scars would enable the healthcare provider to know the patient’s history of adverse events such as joint trauma and surgery . Bruising could indicate health problems such as hemophilia or create some possibility that the patient could be on anti-coagulants. Swellings can suggest underlying health conditions such as septic arthritis. Psoriasis plaques have a close relation with psoriatic arthritis. From the lateral view, the affected foot would show signs such as an abnormally raised foot arch or a flat arch . From the posterior view, one would expect to see signs such as heel misalignment and scars. On the walking part, patients with health conditions such as arthritis or muscle damage around the legs and feet would walk with difficulty or fail to do so completely.

Feeling

This step involves checking for various factors that can be felt in a patient using relatively simple techniques. I would ask the patient to lay on the clinical examination couch for the same . I would begin by checking the temperature around the foot and comparing it with that of the ankle.

Expected Outcomes

A pathological condition would be associated with a significantly high temperature around the affected area. Septic arthritis is one of the most common health conditions associated with a significant rise in temperature around the foot joints. The disorder is also associated with swelling and tenderness at the joints and the surrounding tissues.

I would check the pulse rate at the posterior part of the medial malleolus. I would then compare the rates for the right and left foot. I would also check the pulse rate of the dorsalis pedis . I could do that by palpating the dorsum of the area around the second and the third cuneiforms.

Expected Outcome

An abnormal pulse rate would indicate a pathological condition.

I would gently squeeze the metatarsophalangeal joints and observing the patient for signs of the discomfort. I would palpate the area around the ankle and all the other joints of both the right and left feet.

Expected Outcomes

Tenderness, irregularity of bones, and swelling would indicate a pathological condition.

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Move

Joint movement is an essential element of the assessment. I would start by assessing the patient's perceived normal foot for comparison. I would ask the patient to move the feet voluntarily. They could dorsiflex, plantarflex, or rotate the feet . That would give me a chance t observe important elements such as signs if discomfort and range of flexion. I would then ask the patient to repeat the movements passively to confirm the essential aspects of abnormality.

Expected Outcomes

Factors such as distress and restrictions in the range of movement would indicate pathological conditions. Factors such as crepitus would indicate pathological conditions such as osteoarthritis.

Simmonds’ Test

I would also conduct the Simmonds’ test to check the functioning of the calcaneal tendon. It is done by pressing the calf. The contraction of the gastrocnemius in response to the compression would cause movement of the calcaneal tendon as well . That causes plantarflexion under normal circumstances.

Expected Outcomes

For a healthy tendon, the foot will plantarflex. The foot does not move in the case of an injured tendon. The lack of movement under pathological conditions could be as a result of injury or malfunction of the calcaneal tendon.

Conceptual Maps

Left Foot

Right Foot

Other methods that can be used in the Diagnosis

X-Rays

If the physical examination shows that the patient has stress reactions, I would recommend the use of other testing methods to confirm. X-rays have been used in the exercise for a significantly long time with positive outcomes . They are used to check the state of bones and other dense structures. One fact is that stress reactions are usually too tiny to be seen for the first time. Therefore, if the X-ray test gives negative results, I would recommend for repeat tests after several weeks . That is when the affected area starts to heal.

Expected Outcome

A callus tissue around the affected area of the third metatarsal would be the most significant outcome for a patient with a stress reaction. The tissue mostly develops around the bruised area in the bone.

Bone Scans

A bone scan can also be conducted on the patient to confirm the stress reactions. The method will be appropriate in case the X-rays give negative results. I would inject a tracer into the patient's bloodstream . The substance would move through the bloodstream to the affected point along the third metatarsal.

Expected outcome: the most significant event would be the presence of a dark area along the bone.

Magnetic Resonance Imaging

The use of magnetic resonance imaging would also be appropriate for the exercise. That would be appropriate if I wanted more detailed results. The method involves several factors that make the imaging clearer compared to the other test methods . Such factors include computers, radio waves, and a magnet. Another significant advantage of using the approach is that patients are not exposed to radiation . That minimizes the risk of developing complications associated with various radiations. The method also distinguishes between stress reactions and soft tissue damage.

Expected outcomes: the images would show swelling or very tiny cracks on the affected parts of the third metatarsal.