Clubfoot (talipes equinovarus)

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  Foot is turned in at ankle (varus)

  
  
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  Foot is pointed (equina)

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

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

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

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

Rocker-bottom foot requires more significant intervention

3D helps show severity

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  Bone-rendered views are additive

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

  
  

Look carefully at spine, upper extremities, and fetal movement when lower extremity anomaly diagnosed