Which radiographic angle, measured between the longitudinal axis of the talus and the first metatarsal on a weight-bearing lateral foot film, is normally approximately 0 degrees and increases in magnitude with progressive flatfoot deformity?

• A Calcaneal pitch angle
• B Kite angle
• C Talocalcaneal angle
• D Meary angle ✓

Explanation

Meary angle (talo-first metatarsal angle) is normally close to 0 degrees because the talar axis aligns with the first metatarsal shaft. In pes planus the talar axis plantarflexes relative to the first metatarsal, producing a convex-downward angle that quantifies arch collapse and guides severity grading. The calcaneal pitch decreases in flatfoot but measures heel height, not talar alignment, and Kite angle assesses hindfoot valgus in clubfoot.

Reference: Miller's Review of Orthopaedics, 8th ed.

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