← Full lesson and references Paired practice cardsSt Emlyn’s · FRCEM

One learner performs. One learner checks the key steps and gives feedback. Then swap roles. This is a practice aid, not an official mark scheme.

Candidate

Ankle and foot examination

FRCEM · Paired examination practice

Your task

Examine the ankle and foot. Summarise the findings and explain the next steps for the presentation.

Starting information

Practise with a consenting partner or a suitable teaching model.

Suggested practice time: 5–7 minutes. This is a practice suggestion, not an official examination timing.

St Emlyn’s · FRCEM · Practice aid, not an official mark schemeCandidate card

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Examiner / observer

Ankle and foot examination

Tick the actions you observe. Discuss any step that was not needed for this examination; unchecked boxes are not a score.

Examiner / observer · 1 of 3

Ankle and foot examination

Preparation · History and inspection

Provide a couch, chair and safe walking space. Use a comfortable consenting partner; agree which tests will be described rather than performed if pain, injury or practical limits intervene.

St Emlyn’s · FRCEM · Practice aid, not an official mark schemeObserver 1 of 3

Examiner / observer · 2 of 3

Ankle and foot examination

Palpation and movement · Forefoot

Palpation and movement

Compares warmth, swelling, tenderness and crepitus, assessing relevant foot/ankle bones and proximal fibula.

Assesses relevant ligament tenderness and selects syndesmotic testing for a clinical question.

Compares active, safe gentle passive and resisted dorsiflexion, plantarflexion, inversion and eversion with heel support.

Assesses toe movement where indicated and stops when pain or suspected injury limits examination.

Achilles tendon

For Simmonds–Thompson, positions prone with feet free, squeezes the calf and compares plantarflexion.

Recognises that reduced/absent plantarflexion supports Achilles rupture and preserved voluntary plantarflexion does not exclude it. Key step

Forefoot

For possible Morton’s neuroma, gently compresses the forefoot and relevant plantar web space, identifying usual pain/paraesthesia and any click.

St Emlyn’s · FRCEM · Practice aid, not an official mark schemeObserver 2 of 3

Examiner / observer · 3 of 3

Ankle and foot examination

Trauma assessment · Finish

Trauma assessment

After trauma, assesses malleoli, navicular, fifth-metatarsal base, midfoot and proximal fibula as appropriate.

Treats plantar bruising as concerning for Lisfranc injury and recognises that Ottawa rules do not exclude every tendon, ligament or midfoot injury. Key step

Completion

Selects relevant knee assessment and documents neurovascular findings, pain limits and further care; does not add routine rectal examination.

Finish

Thanks the patient.

Restores comfort and offers help with dressing where needed.

Ask the candidate

What injuries remain possible despite reassuring findings? Preserved plantarflexion does not exclude Achilles rupture, and Ottawa rules are not an exclusion test for all important injuries.

How would you present your examination? Describes location, function, neurovascular findings, test limits and the reason for protection, imaging, review or referral.

Feedback

What went well:

One thing to improve:

Try again focusing on:

St Emlyn’s · FRCEM · Practice aid, not an official mark schemeObserver 3 of 3

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