KEY FACTS
Terminology
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Clubfoot (talipes equinovarus)
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Foot is turned in at ankle (varus)
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Foot is pointed (equina)
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Rocker-bottom foot (congenital vertical talus)
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Back of foot is convex (like bottom of rocking chair)
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Toes are upturned
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Imaging
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Clubfoot: 2/3 bilateral
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Frontal tibia/fibula view best to show turned-in foot
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Plantar foot view shows short angulated foot
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2/3 are isolated: No other anomalies
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Key associations: Spina bifida, arthrogryposis, aneuploidy, oligohydramnios
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Rocker-bottom foot: 2/3 bilateral
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Sagittal view best to show morphology
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Rarely isolated
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Key associations: Aneuploidy (particularly trisomy 18), spine anomalies, arthrogryposis
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Clinical Issues
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Clubfoot is most common musculoskeletal anomaly
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1-3:1,000 newborns
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Prognosis depends on associated anomalies
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Most do not need surgical correction
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Rocker-bottom foot requires more significant intervention
Scanning Tips
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3D helps show severity
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Bone-rendered views are additive
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Beware of transient foot position
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Wait for feet to move away from uterus
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Avoid 3rd-trimester diagnosis if possible
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Higher false-positive rates
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Look carefully at spine, upper extremities, and fetal movement when lower extremity anomaly diagnosed