Rearfoot / Ankle · Reconstructive · Neurology & Nerve · Advanced
Crutch Walker
Podiatric surgery residency interview case. Work through it the way you would at an interview: take the history, ask for the exam and imaging, then commit to a diagnosis and plan.
Chief complaint
"My left foot hurts so much I can't walk on it."
33-year-old female with cerebral palsy seen in the podiatry clinic.
History of present illness
Progressive, painful deformity of the left foot. She is unable to bear weight without crutches or a cane.
- Pain at the lateral hindfoot (sinus tarsi) and along the peroneal tendons
- Worsening over several years; now painful with any weight bearing
- Has used bracing in the past but can no longer tolerate an AFO because of pain and deformity
- Right foot is asymptomatic
Questions a strong candidate asks at this step
- Onset, progression, location of pain (sinus tarsi impingement vs medial)
- Functional status: ambulation, assistive devices, transfers
- Bracing history and tolerance
- Prior treatments, botulinum toxin injections, prior surgery
- Skin breakdown over the talar head
Present the rest of the case
Past history, exam, imaging, assessment, plan and discussion questions, with model answers, are in the interactive trainer. The diagnosis is kept there on purpose so you can practice committing to one.