General inspection:

• Gait as patient enters room- is there pain, deformity, joints involved.
• Visible rashes (psoriasis, vasculitic skin rash), erythema (gout, cellulitis, septic arthritis) bruising (corticosteroid use, injury), swelling (injury, gout, arthropathy) pallor, red eye (iritis/scleritis in spondyloarthrits or CTD), Cushingoid facies

Examination of the Foot and Ankle:

• Examine in a sequential manner depending on the patient’s presenting complaint.
• Inspection (Look):

Palpation (feel):

• Assess temperature over forefoot, midfoot and ankle.
• Check peripheral pulse
• Tenderness (squeeze metatarsophalangeal joint by compressing the first and fifth metatarsal heads between thumb and forefinger for synovitis in RA).
• Palpate the ankle, mid foot and subtalar joints for swelling (bony due to arthritis, soft tissue in synovitis) and tenderness. Check for tenderness over ankle joint line, the medial ankle (deltoid sprain, tarsal tunnel syndrome, fracture) or lateral ankle (lateral ligament injury or pain behind the ankle (Achilles tendinitis). Check for tender areas on the feet (fore foot- Morton’s neuroma, gout; hind foot or mid foot pain in OA, RA). Heel tenderness can be observed in plantar fasciitis.
• Palpate Achilles tendon for nodules, tendinitis, and previous rupture.
• Palpate the interphalangeal joints