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Image A
3%
85/3262
Image B
15%
486/3262
Image C
66%
2165/3262
Image D
5%
177/3262
Image E
10%
332/3262
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Charcot-Marie-Tooth disease (CMT), or Hereditary Motor Sensory Neuropathy, is a demyelinating disorder of the peripheral nervous system. Manifestations in the foot include pes cavovarus, claw toes, and frequent ankle sprains. The cause of the foot deformities in CMT is an imbalance of distal musculature, with the peroneus brevis and tibialis anterior being relatively overpowered by the peroneus longus. The paper by Alexander et al. discussed the difficulties reconstructing cavovaus feet of CMT, with special focus on muscle imbalance causing the deformity. Paulos et al studied over twenty patients with CMT who underwent plantar tissue releases and tendon transfers. With at least two year follow up, 85% were found to have acceptable results. Other described techniques include osteotomies as well. Image C shows a high arched foot of a person with CMT. Incorrect Answers: Image A shows an accessory navicular. Image B shows a calcaneonavicular coalition. Image D shows a foot without pathology Image E shows a ball-and-socket ankle, which can be associated with fibular hemimelia. While other radiographic choices could represent a patient with frequent ankle spains, none of them except a patient with CMT would have abnormal nerve conduction studies.
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