Pes cavus
| Pes cavus | |
|---|---|
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| High arch in foot of a person with a hereditary neuropathy | |
| Classification and external resources | |
| Specialty | medical genetics |
| ICD-10 | Q66.7 |
| ICD-9-CM | 754.71 |
| DiseasesDB | 24563 |
| MedlinePlus | 001261 |
| eMedicine | orthoped/539 |
Pes cavus (in medical terminology, also high instep, high arch, talipes cavus, cavoid foot, and supinated foot type) is a human foot type in which the sole of the foot is distinctly hollow when bearing weight. That is, there is a fixed plantar flexion of the foot. A high arch is the opposite of a flat foot and is somewhat less common.
The term pes cavus is Latin for "hollow foot" and is synonymous with the terms talipes cavus, cavoid foot, high-arched foot, and supinated foot type. Pes cavus is a multiplanar foot deformity characterised by an abnormally high medial longitudinal arch. Pes cavus commonly features a varus (inverted) hindfoot, a plantarflexed position of the first metatarsal, an adducted forefoot, and dorsal contracture of the toes. Despite numerous anecdotal reports and hypothetical descriptions, very little rigorous scientific data exist on the assessment or treatment of pes cavus.
The term pes cavus encompasses a broad spectrum of foot deformities. Three main types of pes cavus are regularly described in the literature: pes cavovarus, pes calcaneocavus, and ‘pure’ pes cavus. The three types of pes cavus can be distinguished by their aetiology, clinical signs and radiological appearance.
Pes cavovarus, the most common type of pes cavus, is seen primarily in neuromuscular disorders such as Charcot-Marie-Tooth disease and, in cases of unknown aetiology, is conventionally termed ‘idiopathic’. Pes cavovarus presents with the calcaneus in varus, the first metatarsal plantarflexed, and a claw-toe deformity. Radiological analysis of pes cavus in Charcot-Marie-Tooth disease shows the forefoot is typically plantarflexed in relation to the rearfoot.
In the pes calcaneocavus foot, which is seen primarily following paralysis of the triceps surae due to poliomyelitis, the calcaneus is dorsiflexed and the forefoot is plantarflexed. Radiological analysis of pes calcaneocavus reveals a large talo-calcaneal angle.
In ‘pure’ pes cavus, the calcaneus is neither dorsiflexed nor in varus and is highly arched due to a plantarflexed position of the forefoot on the rearfoot.
A combination of any or all of these elements can also be seen in a ‘combined’ type of pes cavus that may be further categorized as flexible or rigid.
Despite various presentations and descriptions of pes cavus, not all incarnations are characterised by an abnormally high medial longitudinal arch, gait disturbances, and resultant foot pathology.
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Wikipedia