The 'too many toes' sign is specifically seen in which condition?

• A Hallux rigidus with lateral weight transfer
• B Tarsal tunnel syndrome with intrinsic muscle wasting
• C Metatarsus adductus
• D Tibialis posterior tendon dysfunction causing progressive flatfoot ✓

Explanation

The 'too many toes' sign is a pathognomonic clinical finding in tibialis posterior tendon dysfunction (acquired adult flatfoot). When viewed from behind, more than the normal 1.5 toes visible lateral to the heel indicate hindfoot valgus and forefoot abduction characteristic of TPTD. The sign reflects collapse of the medial arch, excessive hindfoot valgus, and abduction of the forefoot. It can be graded; seeing 3 or more toes indicates significant deformity.

Reference: Maheshwari Essential Orthopaedics, 6th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.