Flat Foot

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[edit] Flat Foot

In this structural variation of the foot the foot arch at the inner aspect of the foot is flattened. This leads to foot arch pain and foot pain.
Sometimes this is falsely diagnosed in infants as they have a prominent fat pad in the medial longitudinal arch.

However, with tiptoeing the arch is normalizing showing that it was a false diagnosis of a "flat foot" and the infant really has a normal infant foot. This peculiarity and the associated wide-based gait and "foot pronation" normalizes itself at the age of 2.5 years (Ref.2). The child's foot changes its morphology and becomes more like the adult foot by the age of 8 years. Diagnostic tests usually are not needed as the diagnosis is based on the clinical examination. If beyond the age of 8 years there is a fallen medial (inside) longitudinal foot arch, then this flat foot needs to be treated with appropriate insoles or orthotics and this will usually take care of the foot pain (Ref. 1).

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References:

1. ABC of rheumatology, second edition, edited by Michael L. Snaith , M.D., BMJ Books, 1999. Chapter 5.

2. The Merck Manual, 7^th edition, by M. H. Beers et al., Whitehouse Station, N.J., 1999. Chapter 270.

3. Wheeless' Textbook of Orthopaedics: http://www.wheelessonline.com/

4. The Merck Manual, 7^th edition, by M. H. Beers et al., Whitehouse Station, N.J., 1999. Chapter 60, p.487.

5. Goldman: Cecil Textbook of Medicine, 21st ed.(©2000)W.B.Saunders

6. Ferri: Ferri's Clinical Advisor: Instant Diagnosis and Treatment, 2004 ed., Copyright © 2004 Mosby, Inc.

7. Rakel: Conn's Current Therapy 2004, 56th ed., Copyright © 2004 Elsevier