Multiplanar Interactions in the Cavovarus Foot

Area of Science:

• Orthopedics
• Neurology
• Radiology

Background:

• Charcot-Marie-Tooth (CMT) disease is a leading cause of neurogenic cavus foot.
• Understanding the distinct foot morphology in CMT is crucial for diagnosis and treatment.

Purpose of the Study:

• To differentiate the morphologic characteristics of pes cavus in individuals with CMT, idiopathic cavus, and healthy controls.
• To quantify differences in arch height and foot alignment between these groups.

Main Methods:

• A case-control study involving 73 participants (18-65 years) with confirmed CMT, idiopathic cavus, or no foot conditions.
• Weightbearing computed tomography (WBCT) was used for morphologic assessment of foot structures.
• Statistical analysis included generalized linear models and Wilcoxon rank sum tests.

Main Results:

• 120 WBCT scans were analyzed, comparing medial longitudinal arch height, forefoot adduction/midfoot supination, and transverse tarsal arch angles.
• Individuals with CMT exhibited significantly greater medial longitudinal arch height compared to controls (P < .05).
• Forefoot adduction was three times greater in CMT, and the transverse arch plantar (TAP) angle was significantly more curved in CMT (94.2°) than in idiopathic (100.5°) or control (102.7°) groups.

Conclusions:

• Forefoot adduction and midfoot supination are more pronounced in CMT-associated pes cavus, indicating greater muscular imbalance.
• The medial longitudinal and transverse arches are more severely affected in CMT patients.
• The exaggerated transverse tarsal arch curvature in CMT may lead to increased foot stiffness.