Tutorial B: Foot/Ankle Assessment Strategies Across Disciplines:
The Search for Common Ground
Chair: Robert Turner (Hospital for Special Surgery) Turnerr@hss.edu
Name: Affiliation/Institution: Email:
1. Robert Turner PT DPT OCS Hospital for Special Surgery Turnerr@hss.edu
2. Scott Ellis MD Hospital for Special Surgery Elliss@hss.edu
3. Jinsup Song, DPM, PhD Temple University JSONG@tuspm.temple.edu
Foot and Ankle assessment strategies across disciplines are highly variable by practioner as well as specialty field. Orthopedic assessments will be compared to podiatric and physical therapy assessments to illustrate commonalities as well as differences in each profession. Three common diagnoses (moderate 1st metatarsophalangeal joint osteoarthritis (MTPJ OA), adult acquired flatfoot deformity and hallux valgus) will be used as case examples of information gleaned from each discipline. We will compare and contrast specific assessment styles, treatment interventions and goals in an effort to elicit discussion from the participants. This workshop will highlight the necessity of an interdisciplinary approach to the totality of foot care to maximize treatment outcomes. Using prepared video assessments each speaker will offer their unique assessment strategies and discuss their treatment planning process for each diagnosis:
Scott Ellis MD will demonstrate and discuss his thought process and evaluation criteria from a Orthopedic Surgeon’s perspective. For hallux rigidus, the time and timing of surgical treatment is dictated by the presence or absence of pain and crepitus with mid-range of motion as well as the appearance of the MTP joint on plain radiographs and other imaging. For the adult acquired flatfoot deformity, the ability to perform a single heel raise, passive hindfoot range of motion, and the amount of progression of deformity dictate the timing and time of surgical intervention. MRI and weight-bearing CT scan have become essential tools as well.
Jinsup Song DPM, PhD. While Doctor of Podiatric Medicine are trained to manage foot and ankle pathologies using both surgical and conservative interventions, Dr. Song will demonstrate and discuss his thought process and evaluation criteria from a podiatric physician’s conservative perspective. In particular, decision process related to prescription of foot orthoses will be discussed.
Robert Turner PT DPT OCS will then discuss his thought process and evaluation criteria from a Doctor of Physical Therapy perspective. Utilizing functional testing, manual motion testing and palpation of the tissues of the foot and ankle, deficiencies will be noted and addressed with specific exercises prescribed for each case. Footwear patterns will be assessed and modified as needed for each case.