APMLE APMLE Biomechanics and Orthopedics 2 — Questions and Answers
Question 1: On a lateral weight-bearing radiograph, which angle is used to assess the sagittal plane relationship of the talus to the calcaneus?
- Lateral talocalcaneal angle (Correct answer)
- Meary's angle
- Calcaneal inclination angle
- Hibbs angle
Correct answer: Lateral talocalcaneal angle
The lateral talocalcaneal angle measures the sagittal relationship between the talus and calcaneus, normally 25–50°.
Question 2: What is Meary's angle used to assess on a lateral weight-bearing radiograph?
- Talo-first metatarsal angle assessing foot arch (Correct answer)
- Hallux valgus deformity
- Tibial sesamoid position
- Ankle dorsiflexion
Correct answer: Talo-first metatarsal angle assessing foot arch
Meary's angle (talo-first metatarsal angle) assesses the medial longitudinal arch; a normal value is 0° with deviations indicating flatfoot or cavus.
Question 3: Which classification system is commonly used to grade adult-acquired flatfoot deformity based on posterior tibial tendon dysfunction?
- Johnson and Strom classification (Correct answer)
- Lauge-Hansen classification
- Essex-Lopresti classification
- Hawkins classification
Correct answer: Johnson and Strom classification
The Johnson and Strom classification (Stages I–IV) grades adult-acquired flatfoot deformity based on the severity of posterior tibial tendon dysfunction.
Question 4: What does a positive too-many-toes sign indicate?
- Abduction of the forefoot seen from behind due to flatfoot deformity (Correct answer)
- Hallux valgus deformity
- Digital contracture
- Metatarsalgia
Correct answer: Abduction of the forefoot seen from behind due to flatfoot deformity
The too-many-toes sign is seen when more than 1–2 toes are visible lateral to the heel from behind, indicating forefoot abduction in flatfoot deformity.
Question 5: Which orthotic design is most appropriate for a patient with a rigid forefoot valgus deformity?
- Forefoot valgus post (Correct answer)
- Forefoot varus post
- Heel lift
- Metatarsal pad
Correct answer: Forefoot valgus post
A forefoot valgus post is applied to the orthotic to accommodate a rigid forefoot valgus deformity and prevent excessive supination compensation.
Question 6: What is the normal calcaneal inclination angle on a lateral weight-bearing radiograph?
- 18–20° (Correct answer)
- 5–10°
- 30–35°
- 45–50°
Correct answer: 18–20°
The normal calcaneal inclination angle is approximately 18–20°; a decreased angle indicates flatfoot and an increased angle indicates cavus.
APMLE APMLE Biomechanics and Orthopedics 2
On a lateral weight-bearing radiograph, which angle is used to assess the sagittal plane relationship of the talus to the calcaneus?