CEREBROSPINALECTOMY
Student: "What are you looking at?" Me: "His shoes." Student: "Why the shoes?" Me: "One toe is scuffed down to the leather. The other one is new." Student: "So?" Me: "So the shoe told me in four seconds what the referral took four months to say." Send this to whoever taught you to look at the shoes.
EXPLAINED (ACCURACY-CHECKED)
Asymmetric wear on the toe of one shoe is a recognised bedside clue to a unilateral gait abnormality such as foot drop or leg circumduction, in which the foot scrapes the ground during the swing phase.
Established clinical examination teaching: asymmetric toe wear reflects a swing-phase gait abnormality (foot drop, circumduction).
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