8. Foot and Ankle MCQs

The Achilles tendon reflex (ankle reflex) is absent in a patient who has radicular back pain. Which of the following nerve roots is compressed:

A patient presents with a paracentral disc herniation at the L3-L4 level. Which of the following physical examination findings is most likely to be present?

A patient has an absent ankle jerk reflex, weakness in plantar flexion, and sensory loss over the lateral border of the foot. Which nerve root is most likely compressed?

A 32-year-old man develops left lower extremity discomfort following a basketball game. A magnetic resonance image of the lumbar spine reveals a posterolateral disk herniation at the level of L4/L5. All of the following conditions could be associated with this except:

When trying to distinguish sciatic radicular pain from pain following a hamstring strain, it is important to know that pain from a hamstring strain usually only involves the posterior aspect of thigh. Sciatic nerve pain may also be associated with:

During a routine neurologic examination for back pain, the patient exhibits an absent Achilles tendon reflex but normal patellar reflexes. Motor testing shows weakness in plantar flexion. Which nerve root is primarily involved?

A 35-year-old man presents with right lower extremity radiating pain. Examination reveals weakness in extensor hallucis longus (EHL) and numbness over the dorsum of the right foot. The Achilles and patellar reflexes are symmetric and intact. Which nerve root is most likely affected?

Which of the following physical examination findings is NOT considered one of Waddell's signs for nonorganic back pain?

A 45-year-old presents with back pain and leg weakness.

If imaging demonstrates a large L4-L5 paracentral disc extrusion, which physical exam finding is most likely?

What physical examination maneuvers listed below check the status of the L4 neurologic level:

When performing a physical examination, if running the pointed edge of a reflex hammer along the crest of a patient's tibia causes extension of the great toe while the remaining toes splay or plantarflex, this finding would indicate:

A 45-year-old man presents with sharp pain radiating down his right posterior thigh and calf to the plantar surface of his foot. On physical examination, he demonstrates a weakened Achilles tendon reflex and decreased sensation over the lateral aspect of his foot. Which nerve root is most likely compressed?

A 12-year-old boy presents with recurrent ankle sprains and rigid flatfeet. A lateral radiograph of the foot reveals an "anteater nose" sign. Which of the following coalitions is most likely present?

A 10-year-old active boy complains of posterior heel pain that worsens with soccer practice. Examination reveals point tenderness at the insertion of the Achilles tendon on the calcaneal apophysis. Radiographs are unremarkable. What is the most appropriate initial treatment?

A 14-year-old boy presents with a painful, rigid flatfoot and a history of recurrent ankle sprains.

Radiographs demonstrate a "C-sign" on the lateral view. Which of the following is the most likely diagnosis?

A 14-year-old boy presents with frequent ankle sprains and a rigid, painful flatfoot. Radiographs reveal a 'C sign' on the lateral view of the ankle. What is the most likely underlying diagnosis?

A newborn is brought in for consultation due to a foot deformity. The left foot is dorsiflexed at the ankle, and the dorsum of the foot is able to be placed against the tibia. Neurologic and vascular examination is normal. Recommended treatment includes:

A patient with confirmed active pulmonary tuberculosis develops an acute, sterile polyarthritis primarily affecting the knees and ankles. Joint aspirates show no evidence of direct mycobacterial invasion. What is the term for this specific reactive arthritis?