Orthopedic case

By Hiwa

16/5/2023
 Case no.1

40-years-old female presented to consultant department with

chief complaint of Pain in her sole on the right foot for 4 days,
she said when she wake from sleep she cannot walk due to pain,
And she walks initially on his toes, she complain if only she
sleeps for a half hour when she wake up has pain, and also in the
end of day
 Case no.1

She also said the she had similar pain in her left foot 3 month ago
The patient has no history of fracture
No joint pain and stiffness
No Deformity
 Case no.1
Review of other systems

• CVS: normal HR, no palpitation

• RS: no shortness of breath, no cough
• CNS: nothing significant
• Urinary system: only frequent urination.
• GIT: no abdominal pain, no diarrhoea and constipation
 Case no.1
Past medical history
• Only history of Diabetes mellitus 7months ago after her sister death.
Past surgical history
no admission, no trauma
Family history

Nothing significant .
Social history
• No significant findings
Drug hx and allergy

Sitagliptin 50 mg and Metformin 1000 mg

Not known allergy for drugs

 Case no.1
Examination

• Patient has normal gait, normal turning.

• Look: No scar , no bruising, No psoriasis plaque, just has little swelling On right foot
• Feel : temperature on the affected side increased compared to the other foot,
• She has pulse rate of 86 on the posterior tibial And dorsalis pedis artery
• And also has little swelling and tenderness on the media side of sole of right foot
• Move: All movements are normal except dorsiflexion, she complain the pain increase with this
movement
• Passively dorsiflexion also increase tenderness on the affected side
 Anterior drawer test: negative
Thompson test : did not allow me to do
Morton test : negative
Peroneal test: negative
Posterior Tibial tendon: negative
Investigations
 Management

• Just Pain management, giving she methyl prednisolone injection

THANK YOU