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What condition is shown in the photograph?
Name two other deformities associated with this condition.
What should be included in the examination?
Pes Cavus
Claw toes and cavovarus
Thorough examination of the peripheral nervous system is required.
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(See below for further details)
Pes cavus, otherwise known as hollow or high-arch foot, is due to imbalance of the intrinsic muscles of the foot leading to a high longitudinal arch. The toes are often clawed (hyperextension of the metatarsophalangeal joints and flexion of the interphalangeal joints). A specific cause is not always found, although peripheral neuropathies can present with pes cavus. Examples are Spina-bifida, muscular dystrophy, poliomyelitis, Charcot-Marie-Tooth disease. Investigations include family history, neurological examination, x-ray of the spine, EMG nerve conduction studies and myelogram. Treatment options range from soft-tissue release and tendon transfer in early cases, to calcaneal and metatarsal osteotomies in rigid deformity. Triple arthrodesis may be considered in severe deformity.