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Musculoskeletal
Diagnosis
Non-Trauma
Congenital and Developmental Abnormalities
Lower Extremity
Pes Planus (Flatfoot)
Pes Planus (Flatfoot)
Kara G. Gill, MD; B. J. Manaster, MD, PhD, FACR
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KEY FACTS

  • Terminology

    • Imaging

      • Pathology

        TERMINOLOGY

        • Synonyms

          • Pes planus, pes valgus, congenital hypermobile flatfoot, talipes calcaneovalgus, compensated talipes equinus collapsing pes planovalgus

        • Definitions

          • Group of foot disorders having flattened longitudinal arch in common; may have several contributing factors
          • Clinically, foot is recognized as having some or all of following
            • Everted heel
            • Abduction of forefoot on hindfoot
            • Collapse of medial column
            • Flexibility of foot with reducibility of deformity

        IMAGING

        • Imaging Recommendations

          • Radiographic Findings

            • MR Findings

              • Ultrasonographic Findings

                DIFFERENTIAL DIAGNOSIS

                  PATHOLOGY

                  • General Features

                    CLINICAL ISSUES

                    • Presentation

                      • Demographics

                        • Natural History & Prognosis

                          • Treatment

                            Selected References

                            1. Flores DV et al: Adult acquired flatfoot deformity: anatomy, biomechanics, staging, and imaging findings. Radiographics. 39(5):1437-60, 2019
                            2. Ford SE et al: Pediatric flatfoot: pearls and pitfalls. Foot Ankle Clin. 22(3):643-56, 2017
                            3. Arnoldner MA et al: Imaging of posterior tibial tendon dysfunction-comparison of high-resolution ultrasound and 3T MRI. Eur J Radiol. 84(9):1777-81, 2015
                            4. Erol K et al: An important cause of pes planus: the posterior tibial tendon dysfunction. Clin Pract. 5(1):699, 2015
                            5. Meyr AJ et al: Descriptive quantitative analysis of rearfoot alignment radiographic parameters. J Foot Ankle Surg. 54(5):860-71, 2015
                            6. Shah NS et al: 2013 Subtalar arthroereisis survey: the current practice patterns of members of the AOFAS. Foot Ankle Spec. 8(3):180-5, 2015
                            7. Toullec E: Adult flatfoot. Orthop Traumatol Surg Res. 101(1 Suppl):S11-7, 2015
                            8. Blitz NM et al: Flexible pediatric and adolescent pes planovalgus: conservative and surgical treatment options. Clin Podiatr Med Surg. 27(1):59-77, 2010
                            9. Blitz NM: Pediatric & adolescent flatfoot reconstruction in combination with middle facet talocalcaneal coalition resection. Clin Podiatr Med Surg. 27(1):119-33, 2010
                            10. Chen YC et al: Effects of foot orthoses on gait patterns of flat feet patients. Clin Biomech (Bristol, Avon). 25(3):265-70, 2010
                            11. Ellis SJ et al: Plantar pressures in patients with and without lateral foot pain after lateral column lengthening. J Bone Joint Surg Am. 92(1):81-91, 2010
                            12. Arangio GA et al: A biomechanical analysis of posterior tibial tendon dysfunction, medial displacement calcaneal osteotomy and flexor digitorum longus transfer in adult acquired flat foot. Clin Biomech (Bristol, Avon). 2009 May;24(4):385-90. Epub 2009 Mar 9. Erratum in: Clin Biomech (Bristol, Avon). 24(6):530, 2009
                            13. Fujii T et al: The influence of flatfoot deformity on the gliding resistance of tendons about the ankle. Foot Ankle Int. 30(11):1107-10, 2009
                            14. Hirano T et al: Effects of foot orthoses on the work of friction of the posterior tibial tendon. Clin Biomech (Bristol, Avon). 24(9):776-80, 2009
                            15. Jerosch J et al: The stop screw technique--a simple and reliable method in treating flexible flatfoot in children. Foot Ankle Surg. 15(4):174-8, 2009
                            16. Koning PM et al: Subtalar arthroereisis for pediatric flexible pes planovalgus: fifteen years experience with the cone-shaped implant. J Am Podiatr Med Assoc. 99(5):447-53, 2009
                            17. Kulig K et al: Effect of eccentric exercise program for early tibialis posterior tendinopathy. Foot Ankle Int. 30(9):877-85, 2009
                            18. Jacobs AM: Soft tissue procedures for the stabilization of medial arch pathology in the management of flexible flatfoot deformity. Clin Podiatr Med Surg. 24(4):657-65, vii-viii, 2007
                            19. Scher DM et al: Extensive implant reaction in failed subtalar joint arthroereisis: report of two cases. HSS J. 3(2):177-81, 2007
                            Related Anatomy
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                            Related Differential Diagnoses
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                            References
                            Tables

                            Tables

                            KEY FACTS

                            • Terminology

                              • Imaging

                                • Pathology

                                  TERMINOLOGY

                                  • Synonyms

                                    • Pes planus, pes valgus, congenital hypermobile flatfoot, talipes calcaneovalgus, compensated talipes equinus collapsing pes planovalgus

                                  • Definitions

                                    • Group of foot disorders having flattened longitudinal arch in common; may have several contributing factors
                                    • Clinically, foot is recognized as having some or all of following
                                      • Everted heel
                                      • Abduction of forefoot on hindfoot
                                      • Collapse of medial column
                                      • Flexibility of foot with reducibility of deformity

                                  IMAGING

                                  • Imaging Recommendations

                                    • Radiographic Findings

                                      • MR Findings

                                        • Ultrasonographic Findings

                                          DIFFERENTIAL DIAGNOSIS

                                            PATHOLOGY

                                            • General Features

                                              CLINICAL ISSUES

                                              • Presentation

                                                • Demographics

                                                  • Natural History & Prognosis

                                                    • Treatment

                                                      Selected References

                                                      1. Flores DV et al: Adult acquired flatfoot deformity: anatomy, biomechanics, staging, and imaging findings. Radiographics. 39(5):1437-60, 2019
                                                      2. Ford SE et al: Pediatric flatfoot: pearls and pitfalls. Foot Ankle Clin. 22(3):643-56, 2017
                                                      3. Arnoldner MA et al: Imaging of posterior tibial tendon dysfunction-comparison of high-resolution ultrasound and 3T MRI. Eur J Radiol. 84(9):1777-81, 2015
                                                      4. Erol K et al: An important cause of pes planus: the posterior tibial tendon dysfunction. Clin Pract. 5(1):699, 2015
                                                      5. Meyr AJ et al: Descriptive quantitative analysis of rearfoot alignment radiographic parameters. J Foot Ankle Surg. 54(5):860-71, 2015
                                                      6. Shah NS et al: 2013 Subtalar arthroereisis survey: the current practice patterns of members of the AOFAS. Foot Ankle Spec. 8(3):180-5, 2015
                                                      7. Toullec E: Adult flatfoot. Orthop Traumatol Surg Res. 101(1 Suppl):S11-7, 2015
                                                      8. Blitz NM et al: Flexible pediatric and adolescent pes planovalgus: conservative and surgical treatment options. Clin Podiatr Med Surg. 27(1):59-77, 2010
                                                      9. Blitz NM: Pediatric & adolescent flatfoot reconstruction in combination with middle facet talocalcaneal coalition resection. Clin Podiatr Med Surg. 27(1):119-33, 2010
                                                      10. Chen YC et al: Effects of foot orthoses on gait patterns of flat feet patients. Clin Biomech (Bristol, Avon). 25(3):265-70, 2010
                                                      11. Ellis SJ et al: Plantar pressures in patients with and without lateral foot pain after lateral column lengthening. J Bone Joint Surg Am. 92(1):81-91, 2010
                                                      12. Arangio GA et al: A biomechanical analysis of posterior tibial tendon dysfunction, medial displacement calcaneal osteotomy and flexor digitorum longus transfer in adult acquired flat foot. Clin Biomech (Bristol, Avon). 2009 May;24(4):385-90. Epub 2009 Mar 9. Erratum in: Clin Biomech (Bristol, Avon). 24(6):530, 2009
                                                      13. Fujii T et al: The influence of flatfoot deformity on the gliding resistance of tendons about the ankle. Foot Ankle Int. 30(11):1107-10, 2009
                                                      14. Hirano T et al: Effects of foot orthoses on the work of friction of the posterior tibial tendon. Clin Biomech (Bristol, Avon). 24(9):776-80, 2009
                                                      15. Jerosch J et al: The stop screw technique--a simple and reliable method in treating flexible flatfoot in children. Foot Ankle Surg. 15(4):174-8, 2009
                                                      16. Koning PM et al: Subtalar arthroereisis for pediatric flexible pes planovalgus: fifteen years experience with the cone-shaped implant. J Am Podiatr Med Assoc. 99(5):447-53, 2009
                                                      17. Kulig K et al: Effect of eccentric exercise program for early tibialis posterior tendinopathy. Foot Ankle Int. 30(9):877-85, 2009
                                                      18. Jacobs AM: Soft tissue procedures for the stabilization of medial arch pathology in the management of flexible flatfoot deformity. Clin Podiatr Med Surg. 24(4):657-65, vii-viii, 2007
                                                      19. Scher DM et al: Extensive implant reaction in failed subtalar joint arthroereisis: report of two cases. HSS J. 3(2):177-81, 2007