Evaluating the cavus foot

The cavus foot is a deformity characterized by abnormal elevation of the medial arch of the foot. Unique among foot deformities, cavus typically occurs secondary to a spinal cord or neuromuscular pathology, with two-thirds of patients having an underlying neurologic diagnosis. Thus, recognition of cavus foot and appropriate evaluation are essential in the primary care setting. Patients may present with unstable gait, frequent ankle sprains, or pain along the metatarsal heads or the lateral border of the foot. The diagnosis can be confirmed with a lateral weight-bearing radiograph, with several key measurements defining a pes cavus alignment. A thorough history and physical examination should be performed to look for possible secondary causes. The first step in the treatment of cavus deformity is to address the underlying cause. After that, a variety of treatment options are available to alleviate the pain and dysfunction caused by this deformity.