Inspection

The first part of the foot examination involves inspection:

• examine weight-bearing posture:
  • the pattern of weight distribution can be gauged by coating the soles in ink and asking the patient to stand on a sheet of paper
• examine gait
• ankles, legs and back must also be examined
• inspect sole and between toes
• note:
  • colouration
  • condition of the skin: colour, callus formation, ulceration, infection, trophic changes along legs
  • nails: deformed, ingrowing, elevated, rough texture
  • swelling
  • masses: calcaneal prominence, ganglia, exostoses, fibrous tissue on sole - Dupuytren's contracture
  • bunions, especially over metatarsophalngeal joint
    
    
• deformity:
  • compare both sides
  • specifically look for pes cavus and planus, hammer toes, mallet toes, intoeing, eversion and inversion, genu valgum and varum, splaying - broadening - of the foot
    
    
• inspect the patient's shoe: wear is normally medially at the ball of the foot and posterolateral at the heel