Foot drop

STARTFINISHCreated with SnapPresents with drop...Patient presents toMSK Physiotherapywith drop footSTARTFINISHCreated with SnapAssessmentSTARTFINISHCreated with SnapDifferential diagnosisSTARTFINISHCreated with SnapCNS• Displacement• Destruction (brain orpyramidal tracts)STARTFINISHCreated with SnapNeuromuscular...• Focal myopathies• Neuropathy(multifocalmotor)NOYESSTARTFINISHCreated with SnapIs diagnosisconfirmed/ referredwith this?STARTFINISHRefer to GPRefer back to GP forfurther investigationsand onward referralas appropriateSTARTFINISHPotential...STARTFINISHCreated with SnapPeripheral nerve• External comp• Internal comp• Direct trauma• Space occupyinglesion...NOYESYESSTARTFINISHCreated with SnapIs diagnosisconfirmed/referredwith this?NOYESSTARTFINISHCreated with SnapAre symptoms acute< 6/52?STARTFINISHDiscuss with GP orSenior clinician/APPspinal teamdepending onsuspected DxSTARTFINISHDiscuss NeurosurgeryDiscuss with on-callNeurosurgeon.STARTFINISHCreated with SnapNerve root with drop...• Compression: disc,stenosis, tumour,Neurinoma, rootavulsion, iatrogenic• Direct traumaYESNOSTARTFINISHCreated with SnapPositive signs ofCauda Equina oninitial Ax?STARTFINISHCreated with SnapFollow CES Pathway