Australian Doctor Australian Doctor 3rd November 2017 | Page 17

PULL-OUT SECTION COMPLETE HOW TO TREAT QUIZZES ONLINE www.howtotreat.com.au Lleyton Hewitt continued to play high- level professional tennis with a fusion of his great toe for hallux rigidus. INSIDE Forefoot pain Midfoot pain Heel pain Case studies THE AUTHORS DR ROBBIE RAY orthopaedic surgeon, Edinburgh, UK. DR ANDREW WINES orthopaedic surgeon, Sydney and Dubbo, NSW. Foot pain Introduction MUSCULOSKELETAL problems account for around 10% of presen- tations to the GP in Australia every year. 1 A large study of UK general practice found 10% of musculoskel- etal presentations were due to foot and ankle problems and the major- ity of these were chronic and non- traumatic in origin. 2 Persistent foot pain can lead to significant diagnostic challenges. There are multiple causes of pain in each region of the foot and investi- gation and management will vary depending on the underlying condi- tion. Having a baseline understanding of the common foot pathologies seen in the general population and by taking a thorough history and a focussed examination, many of the common causes of foot pain can be elucidated. Appropriate investiga- tions can be undertaken and many conditions can be initially managed in the community. When specialist referral is required, initial diagnosis and appropriate investigations allow for correct triaging of patients to the most beneficial service, whether this is orthotics, physiotherapy, rheuma- tology or an orthopaedic specialist. This How to Treat provides infor- mation on the most common foot and ankle conditions. An overview of each condition is offered, with www.australiandoctor.com.au tips for history and examination, appropriate investigations and man- agement options. As this article is aimed at the review and manage- ment of patients in general practice, the main focus will be on man- agement in the community rather than a thorough review of surgical options. The author’s own opinion on current trends in surgical options is given for each condition. cont’d next page Copyright © 2017 Australian Doctor All rights reserved. No part of this publication may be reproduced, distributed, or transmitted in any form or by any means without the prior written permission of the publisher. For permission requests, email: [email protected] 3 November 2017 | Australian Doctor | 17