|
XR foot AP
|
Insert Photo
|
|
XR foot lateral
|
Insert photo 2
|
|
XR foot oblique
|
insert photo 3
|
|
XR ankle lateral
|
Insert photo 4
|
|
XR ankle lateral
|
|
|
XR ankle mortise
|
|
|
Lower extremity physical exam
|
|
|
General/Constitutional WNL
|
|
|
Neuro
|
|
|
Additional Comments:
|
|
|
Neuro WNL
|
Neuro Abnormal
• • •
|
|
|
|
|
Vascular
|
|
|
Vascular WNL
|
Vascular Abnormal
• • •
|
|
Dermatologic
|
|
|
Derm Comments:
|
|
|
Derm: WNL
|
Normal post-op
|
|
ingrown- no infection
• • •
|
ingrown- infection
• • •
|
|
ingrown follow up
|
|
|
onychomycosis
• • •
|
Calluses
• • •
|
|
wound
• • •
|
Plantar verruca- laterality/location/size
|
|
Musculoskeletal
|
|
|
Additional Comments:
|
|
|
Gait/Biomechanical WNL
|
Gait Abnormal:
• • •
|
|
Orthopedic: WNL
|
|
|
Right/Left
|
bunion
• • •
|
|
plantar fasciitis/PTTD
• • •
|
Hammertoes
• • •
|
|
|
|
|
|
|
|
|
|
|
mild ttp
|
New Multiple Select
• • •
|
|
moderate ttp
|
severe ttp
|
|
|
Lymphatic WNL (popliteal nodes - )
|
