8. Foot and Ankle MCQs

A 12-year-old girl is suspected of having a calcaneonavicular coalition. Which specific radiographic view is considered most sensitive and specific for visualizing this pathology?

A 10-year-old boy presents with a rigid flatfoot and recurrent ankle sprains. Radiographs reveal an 'anteater sign'. What is the most likely diagnosis?

A 14-year-old male complains of medial hindfoot pain and frequent 'sprained ankles.' On examination, he has a rigid pes planovalgus foot with peroneal muscle spasm. A lateral radiograph demonstrates a 'C-sign.' This finding represents an osseous bridge between which two structures?

A 15-year-old patient with a symptomatic talocalcaneal coalition has failed 6 months of non-operative management. CT scan reveals that the coalition involves 60% of the posterior facet. What is the most appropriate surgical management?

Which radiographic projection is most sensitive for confirming the presence of a calcaneonavicular coalition in a pediatric patient?

A 10-year-old boy complains of frequent right ankle sprains and lateral foot pain. On examination, he has a rigid flatfoot with restricted subtalar motion. Radiographs show an elongation of the anterior process of the calcaneus, known as the 'anteater nose' sign. Which of the following is the most likely diagnosis?

A 14-year-old girl presents with deep medial hindfoot pain and a rigid flatfoot. A CT scan confirms a tarsal coalition. Which of the following anatomic locations is most commonly involved in this specific type of coalition?

A 13-year-old boy presents with a rigid valgus foot and recurrent ankle sprains. A lateral radiograph of the foot demonstrates a continuous rim of bone outlining the talar dome and extending inferiorly to the sustentaculum tali. This radiographic 'C-sign' is indicative of which of the following conditions?

A 14-year-old male presents with 'peroneal spastic flatfoot'. Examination reveals restricted subtalar motion and painful eversion. The peroneal muscle spasm is considered to be a secondary reflex mechanism. What is the underlying anatomic abnormality most likely causing this presentation?

A 13-year-old boy requires surgical intervention for a symptomatic talocalcaneal coalition after failing conservative treatment. Preoperative CT imaging is utilized to evaluate the joint. According to current literature, resection of the coalition is generally indicated if it involves less than what percentage of the posterior facet area?

A 12-year-old boy presents with recurrent ankle sprains and lateral foot pain. On examination, he has a rigid flatfoot with severely restricted subtalar motion and peroneal muscle spasm. A 45-degree internal oblique radiograph of the foot demonstrates an elongated anterior process of the calcaneus.

After a failed trial of short-leg casting, which of the following is the most appropriate next step in management?

A 14-year-old adolescent presents with medial hindfoot pain and a rigid flatfoot deformity. A lateral radiograph demonstrates a continuous bony bridge between the talus and calcaneus (C-sign).

Which anatomic facet is most commonly involved in this specific type of tarsal coalition?

In a 14-year-old patient with a symptomatic talocalcaneal coalition that has failed conservative management, which of the following is considered a relative contraindication to coalition resection and instead warrants primary subtalar arthrodesis?

A 32-year-old competitive runner presents with 6 months of worsening posteromedial ankle pain, exacerbated by push-off and toe-off activities. Clinical examination reveals pain with resisted plantarflexion and inversion. MRI shows tenosynovitis and thickening of the tendon sheath. Which tendon is most likely affected?

A 58-year-old patient with poorly controlled diabetes mellitus presents with a red, hot, swollen foot without breaks in the skin. Radiographs show periarticular osteopenia, debris, and fragmentation of the midfoot. According to the Eichenholtz classification, what stage does this represent and what is the best initial treatment?

A 55-year-old diabetic male presents with a swollen, warm, and erythematous left foot. Radiographs show periarticular debris, fragmentation of the navicular, and subluxation of the talonavicular joint. According to the Eichenholtz classification, what is the most appropriate initial management?

During a minimally invasive percutaneous repair of an acute Achilles tendon rupture, the surgeon places a suture 10 cm proximal to the calcaneal insertion. Which structure is at highest risk of iatrogenic injury at this level?

A 28-year-old athlete sustains an axial load to a plantarflexed foot. Weight-bearing radiographs demonstrate a 3mm diastasis between the medial and middle cuneiforms. What is the most appropriate initial management?

A 55-year-old male with poorly controlled diabetes mellitus presents with a severely swollen, erythematous, and warm left foot. He denies any recent trauma, systemic fevers, or pain. Radiographs reveal fragmentation and early subluxation of the navicular and cuneiforms without open wounds. What is the most appropriate initial management?

A 17-year-old female runner with a suspected stress fracture has bony edema on MRI, but no clear fracture line on radiographs. Her pain is present with weight bearing. Which of the following stress fracture locations carries the highest risk for fracture propagation and complications?