[Diagnostic procedures for painful foot]

The diagnostic process in case of painful foot must always begin with a first clinical phase that is the most important. The history, conditions of happening and the clinical examination are essentials to orient appropriately the secondary examinations, if necessary, and establish a proper diagnosis. After the taking of the history, the clinical examination of the foot, bilateral and comparative, should begin with an evaluation of the entire musculoskeletal system for systemic and general conditions which can affect the foot and ankle. The function and structure of the foot may be evaluated using observation, palpation and manipulation of the different joints. The foot, and the patient's shoes, should be evaluated during unloaded and loaded conditions with gait observation. The location of the pain must be accurately precised: hindfoot pain (inferior, posterior, lateral, medial, anterior), middle foot pain or forefoot pain (medial with the first ray pathology or lateral). This first clinical assesment, with a basic radiography and sometimes an ultrasosonography study are able to diagnose the most frequent pathologies. Other additional examinations could be more rarely neccessary and must always be oriented by the knowledge of the foot pathology and the first obligatory clinical evaluation.