CFO Patient Assessment & Diagnosis 3 — Questions and Answers
Question 1: When documenting a patient's resting calcaneal stance position (RCSP), the orthotist finds the calcaneus is 5° everted relative to the floor. How is this correctly recorded?
- 5° valgus (everted) (Correct answer)
- 5° varus (inverted)
- 5° pronated
- 5° neutral
Correct answer: 5° valgus (everted)
RCSP is measured in degrees of valgus (eversion) or varus (inversion); a calcaneus angled outward from vertical is documented as valgus.
Question 2: A pediatric patient presents with in-toeing gait. On examination, the thigh-foot angle is −20°. This finding most likely indicates which condition?
- Internal tibial torsion (Correct answer)
- Femoral anteversion
- Metatarsus adductus
- Subtalar varus
Correct answer: Internal tibial torsion
The thigh-foot angle assesses tibial torsion; a negative value (internal rotation of the foot relative to the thigh) indicates internal tibial torsion.
Question 3: Which cardiovascular complication is a contraindication to aggressive orthotic intervention in diabetic patients and must be identified during the history-taking phase?
- Peripheral arterial disease with ABI < 0.5 (Correct answer)
- Controlled hypertension
- History of atrial fibrillation
- Stable coronary artery disease
Correct answer: Peripheral arterial disease with ABI < 0.5
A severely reduced ankle-brachial index (ABI < 0.5) indicates critical limb ischemia, making pressure-applying orthotic devices contraindicated without vascular team clearance.
Question 4: During assessment of spinal orthotic need, the fitter uses a plumb line dropped from the C7 spinous process. In a normal assessment, where should this line fall?
- Through the gluteal cleft to the midpoint between the feet (Correct answer)
- Anterior to the knees and posterior to the ankles
- At the level of the greater trochanters
- Behind the lumbar spine
Correct answer: Through the gluteal cleft to the midpoint between the feet
A vertical plumb line from C7 should pass through the gluteal fold and land equidistant between the feet, indicating balanced sagittal and coronal alignment.
Question 5: A patient's radiograph shows a Cobb angle of 32° in the thoracic spine. Which intervention is typically indicated at this angle range?
- Spinal orthosis (bracing) (Correct answer)
- Observation only
- Surgical referral
- Physical therapy exclusively
Correct answer: Spinal orthosis (bracing)
A Cobb angle between 25° and 40° in a skeletally immature patient generally warrants orthotic bracing to halt progression of scoliotic curvature.
Question 6: An orthotist is performing volumetric assessment of a patient's lower limb for edema monitoring. Which method is considered the gold standard for measuring limb volume?
- Water displacement volumetry (Correct answer)
- Sequential circumferential measurements
- Bioelectrical impedance analysis
- Perometry (infrared scanning)
Correct answer: Water displacement volumetry
Water displacement volumetry is the gold standard for measuring limb volume, as it directly measures the volume of fluid displaced by the immersed limb.
Question 7: When assessing range of motion for a patient requiring a knee orthosis, the fitter notes a 10° knee flexion contracture. How should this be documented?
- Extension limited to −10° (10° flexion contracture) (Correct answer)
- Flexion of 10°
- Extension of 170°
- Hyperextension deficit of 10°
Correct answer: Extension limited to −10° (10° flexion contracture)
A flexion contracture means the knee cannot fully extend; it is documented as a negative extension value (e.g., −10°) indicating the degree short of full extension (0°).
CFO Patient Assessment & Diagnosis 3
When documenting a patient's resting calcaneal stance position (RCSP), the orthotist finds the calcaneus is 5° everted relative to the floor.
How is this correctly recorded?