A newborn is noted to have both feet pointing downward and inward with a convex sole, and the deformity is rigid and irreducible on manipulation. Radiographs show the talus aligned vertically with the long axis of the tibia and the navicular dislocated dorsally onto the talar neck. The diagnosis is:

• A Congenital talipes equinovarus
• B Calcaneovalgus foot
• C Congenital vertical talus ✓
• D Skewfoot

Explanation

Congenital vertical talus produces a rigid flatfoot with rocker-bottom sole, hindfoot equinus, and forefoot abduction and dorsiflexion. The forced plantarflexion lateral radiograph confirms the diagnosis when the talus stays vertical and the first metatarsal axis remains dorsiflexed relative to it. Clubfoot shows hindfoot varus rather than valgus, calcaneovalgus is a flexible positional deformity with the foot in dorsiflexion, and skewfoot is a Z-shaped forefoot adduction with hindfoot valgus in older children.

Reference: Tachdjian's Pediatric Orthopaedics, 5th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.