Rocker bottom foot

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A rocker bottom foot (also known as a congenital vertical talus) is a congenital anomaly of the foot.It It is characterised by a prominent ~~calcaneus (heel)~~calcaneus/heel and a convex rounded sole.

Pathology

It results from a dorsal and lateral dislocation of the talonavicular joint

Associations

aneuploidic syndromic
non aneuploidic non syndromic
- spina bifida
- arthrogryposis

Radiographic features

For ~~assessment~~ assessment of the foot alignment abnormalities, it is important to perform ~~weight~~ weight bearing images or an equivalent in neonates (~~~~foot X ray~~)~~:

fixed equinus: plantarflextion of the calcaneus
vertical talus:~~plantarflextion~~ plantarflextion of the talus (increased talocalcaneal angle)
irreducible dorsal ~~sublaxation~~ sublaxation or dislocation of the navicular
forefoot valgus:~~divergence~~ divergence of bases of the metatarsal heads on AP and superimposition of the metatarsal bones on the lateral view
long axis of the talus passes plantar to metatarsal axis ~~on lateral~~ on lateral view and medial to the first metatarsal on AP AP view

The presence of a rocker bottom foot in an antenatal ultrasound scan is sometimes classified as a soft sign for aneuploidic anomalies³.

Differential diagnosis

In the ~~antental-neonatal~~antenatal/neonatal period consider

clubfoot.

In the adult period consider

acquired rocker bottom deformity occurring secondary to a
- underyling neuromuscular disorder(s)
- diabetic foot (Charcot joint) ²

-<p>A <strong>rocker bottom foot</strong> (also known as a <strong>congenital vertical talus</strong>) is a congenital anomaly of the foot. <span style="line-height:13.8666658401489px">It is characterised by a prominent calcaneus (heel) and a convex rounded sole.</span></p><h4>Pathology</h4><p>It results from a dorsal and lateral dislocation of the talonavicular joint </p><h5>Associations</h5><ul>
+<p>A <strong>rocker bottom foot</strong> (also known as a <strong>congenital vertical talus</strong>) is a congenital anomaly of the foot. It is characterised by a prominent <a title="Calcaneus" href="/articles/calcaneus">calcaneus</a>/heel and a convex rounded sole.</p><h4>Pathology</h4><p>It results from a dorsal and lateral dislocation of the talonavicular joint </p><h5>Associations</h5><ul>
-</ul><h4>Radiographic features</h4><p>For assessment of the foot alignment abnormalities, it is important to perform weight bearing images or an equivalent in neonates (<a title="Foot radiograph (an approach)" href="/articles/foot-radiograph-an-approach">foot X ray</a>):</p><ul>
~~-<li><span style="line-height:13.8666658401489px">fixed equinus: plantarflextion of the calcaneus </span></li>~~
~~-<li>~~
~~-<span style="line-height:13.8666658401489px">vertical talus: </span>plantarflextion of the talus- increased <a title="" href="/articles/">talocalcaneal angle</a>~~
+</ul><h4>Radiographic features</h4><p>For assessment of the foot alignment abnormalities, it is important to perform weight bearing images or an equivalent in neonates:</p><ul>
+<li>fixed equinus: plantarflextion of the calcaneus </li>
+<li>vertical talus: plantarflextion of the talus (increased <a href="/articles/">talocalcaneal angle)</a>
~~-<li>irreducible dorsal sublaxation or dislocation of the navicular </li>~~
~~-<li>~~
-<span style="line-height:13.8666658401489px">forefoot valgus: </span>divergence of bases of the metatarsal heads on AP and superimposition of the metatarsal bones on the lateral view </li>
~~-<li>long axis of the talus passes plantar to metatarsal axis on lateral view and medial to the first metatarsal on AP view</li>~~
-</ul><p>The presence of a rocker bottom foot in an antenatal ultrasound scan is sometimes classified as a <a href="/articles/antenatal-soft-markers-on-ultrasound">soft sign</a> for aneuploidic anomalies <sup>3</sup>.</p><h4>Differential diagnosis</h4><h6>In the antental-neonatal period consider</h6><ul><li><a href="/articles/congenital-talipes-equinovarus">clubfoot</a></li></ul><h6>In the adult period consider</h6><ul><li>acquired rocker bottom deformity occurring secondary to a <ul>
+<li>irreducible dorsal sublaxation or dislocation of the navicular </li>
+<li>forefoot valgus: divergence of bases of the metatarsal heads on AP and superimposition of the metatarsal bones on the lateral view</li>
+<li>long axis of the talus passes plantar to metatarsal axis on lateral view and medial to the first metatarsal on AP view</li>
+</ul><p>The presence of a rocker bottom foot in an antenatal ultrasound scan is sometimes classified as a <a href="/articles/antenatal-soft-markers-on-ultrasound">soft sign</a> for aneuploidic anomalies <sup>3</sup>.</p><h4>Differential diagnosis</h4><p>In the antenatal/neonatal period consider <a href="/articles/congenital-talipes-equinovarus">clubfoot.</a></p><p>In the adult period consider acquired rocker bottom deformity occurring secondary to</p><ul>
~~-</ul>~~
~~-</li></ul>~~
+</ul>

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