Foot Deformity in Charcot Marie Tooth Disease According to Disease Severity

Abstract

ObjectiveTo investigate the characteristics of foot deformities in patients with Charcot-Marie-Tooth (CMT) disease compared with normal persons according to severity of disease.MethodSixty-two patients with CMT disease were recruited for this study. The normal control group was composed of 28 healthy people without any foot deformity. Patients were classified into a mild group and a moderate group according to the CMT neuropathy score. Ten typical radiological angles representing foot deformities such as pes equinus and pes varus were measured. The CMT group angles were compared with those of the normal control group, and those of the mild group were also compared with those of the moderate group.ResultsThe lateral (Lat.) talo-first metatarsal angle, anteroposterior talo-first metatarsal angle, Lat. calcaneal-first metatarsal angle, Lat. naviocuboid overlap, Lat. calcaneal pitch, Lat. tibiocalcaneal angle, and Lat. talocalcaneal angle in the CMT group showed a significant difference compared to the normal control group (p<0.05). These findings revealed CMT patients have pes cavus, forefoot adduction, midfoot supination and pes varus deformity. Compared to the mild group, the moderate group significantly showed an increased Lat. calcaneal pitch and decreased Lat. calcaneal-first metatarsal angle, Lat. tibiocalcaneal angle, Lat. talocalcaneal angle, and Lat. talo-first metatarsal angle (p<0.05). These findings revealed that the pes cavus deformity of CMT patients tend to be worse with disease severity.ConclusionThe characteristic equinovarus foot deformity patterns in CMT patients were revealed and these deformities tended to be worse with disease severity. Radiographic measures may be useful for the investigation of foot deformities in CMT patients.

Foot measures in patients with pes cavus with and without charcot–marie–tooth disease: A pilot study

“…While not serving as absolute cutoffs, ranges classically associated with pes cavus include a Meary's angle >4° (convex upward) or > 18° as well as a calcaneal pitch >30° . In their study correlating radiographic angles with CMT severity, Joo and colleagues found Meary's angle to decrease and the calcaneal pitch to increase in the moderately severe CMT subgroup as compared to mild CMT and controls …”

The Role of Orthotic Service in Modern Rehabilitation of Patients with Charcot-Marie-Tooth Disease

“…Many other foot deformities can arise as many patients are tested lately [4]. The study of So Young Joo et al confirms that the lateral talo-first metatarsal angle, anteroposterior talo-first metatarsal angle, lateral calcaneal-first metatarsal angle, lateral naviocuboid overlap, lateral calcaneal pitch, lateral tibiocalcaneal angle, and lateral talocalcaneal angle in the group of CMT patients showed a significant difference compared to the normal control group of healthy people [5].…”

Understanding Radiographic Measurements Used in Foot and Ankle Surgery

“…17 Objective measurements include increased Meary angle (apex superior) >4° to 5°, increased calcaneal pitch typically >30°, posterior subluxation of the fibula, and decreased Hibbs angle; on AP imaging, cavovarus deformity exemplifies increased talocalcaneal and talo-first metatarsal angles. 18,19 A cavovarus foot precorrection and postcorrection are demonstrated in Figure 13. Hindfoot alignment imaging would demonstrate worsening varus with an increased apparent moment arm medially.…”