Review Question - QID 211198

All of the above answers have been associated with the cavovarus foot with the exception of hallux valgus, which is instead classically associated with pes planovalgus.

Cavovarus deformity leads to progressive lateral overload of the foot, resulting in characteristic lateral ankle instability, peroneal tendon pathology, fifth metatarsal stress fracture, and metatarsalgia with painful plantar calluses. Additionally, a result of the cavus, the effective shortening of the plantar fascia and Achilles tendon contracture have been associated with the development of plantar fasciitis. Treatment involves recognition and correction of the underlying cavovarus deformity in order to effectively address the resulting pathologies.

Younger et al. review the pathophysiology behind the adult cavovarus foot deformity. The authors discuss the muscular imbalances which result in progression of the deformity and pathologies that arise as a result of the foot position. The article specifically highlights the lateral overload arising from the deformity and the associated clinical and radiographic manifestations.

Chilvers et al. present a review of the subtle cavus foot and the association with lateral foot overload. The authors describe the etiology and treatment of the various manifestations and underscore the importance of treating the underlying malalignment. Without addressing the cavovarus, the related pathologies associated with lateral overload will continue to progress or recur.

Figure A is an AP radiograph of both feet in a patient with bilateral cavovarus foot deformity showing lateral metatarsal overlap and talonavicular overcoverage. Figure B is a weight-bearing lateral radiograph of a cavovarus foot as referenced by increased lateral talo-first metatarsal angle and a double talar dome sign.

Incorrect Answers:
Answers 1,2,4, and 5: These are all pathologies that may result directly from cavovarus foot deformity.