MCQ – 67538

A 42-year-old man presents with difficulty in walking after sustaining an injury to the lateral aspect of his knee. On gait examination, he lifts his affected leg excessively high during the swing phase to prevent his toes from dragging on the ground. On neurological examination, there is weakness of ankle dorsiflexion and sensory loss over the dorsum of the foot.

Which of the following conditions best explains this gait abnormality?

Correct Answer » A Explanation

High steppage gait occurs due to weakness of ankle dorsiflexors. During the swing phase of walking, the patient cannot dorsiflex the foot, causing the toes to drag on the ground. To compensate, the patient exaggerates hip and knee flexion, producing a high stepping movement.
This pattern is classically seen in foot drop, most commonly due to common peroneal nerve palsy.
Frontal lobe stroke
→ Causes apraxic (magnetic) gait with difficulty initiating steps, not high stepping.
Tabes dorsalis
→ Causes sensory ataxic (stamping) gait, due to loss of proprioception.
Leprosy
→ Can cause peripheral neuropathy and even foot drop, but is not classically described as causing a specific gait pattern in exams.