Flat Feet and Related Orthopedic Concerns

Q: Flat Feet and Related Orthopedic Concerns

Hello, Lai： <br>1. <br>Indeed, there are many factors that can affect the interpretation, but there is a standardized method for taking X-rays of flat feet. <br>Public hospitals (those involved in military service physical examinations) tend to be more reliable. <br>However, the

Flatfoot and related issues?

Hello Dr.
Li,
1.
I would like to ask if the measurement of the arch in flat feet can vary due to the physician's technique (such as drawing lines).
Additionally, can both standing X-rays and lateral X-rays be used to assess the arch? During a previous health check, my arch measurement was 160 degrees, but when I had it checked at the hospital recently, it was 167 degrees.
This difference seems quite significant.
2.
I went to the hospital for an examination due to difficulty squatting.
After the examination, the physician provided a report stating that there is fibrosis of the gluteus maximus, with abduction at 60 degrees, adduction at 10 degrees, and hip flexion at 110 degrees.
There is no indentation in both buttocks, and there is a suspicion of frog leg deformity, but the objective values are not significant, and an MRI of the gluteal muscles is recommended.
Based on the above examination, can we determine if there is a frog leg deformity? I have consulted several hospitals, and some physicians say it is a frog leg deformity while others say it is not, as I do not experience any popping sounds in my hip bones.
Is a popping sound necessary for a diagnosis of frog leg deformity? How should a diagnosis of frog leg deformity be confirmed, and is an MRI useful?
3.
I am unable to bring my fingers together completely; is this considered normal?
Thank you for your response!

Lai, 20~29 year old female. Ask Date: 2011/09/25

Dr. Li Wenlin reply Orthopedics

Hello, Lai:
1.
Indeed, there are many factors that can affect the interpretation, but there is a standardized method for taking X-rays of flat feet.
Public hospitals (those involved in military service physical examinations) tend to be more reliable.
However, the standard for the flat foot angle has been revised multiple times, and the current standard is 168 degrees.

2.
Based on your hip joint range of motion, if you can flex to 110 degrees, it is not frog leg position.
Frog leg position does not require MRI examination; only severe cases need special treatment (surgery).
Additionally, difficulty in squatting is often caused by tightness in the gastrocnemius muscle rather than fibrosis of the gluteus maximus.

3.
The inability to bring the fingers together can be normal in some cases and indicative of a problem in others; a consultation is necessary to determine the cause.
You can consult an orthopedic physician at a medical center, and I believe your issues can be resolved! Wishing you all the best!

Reply Date: 2011/09/25

More Info

Understanding flat feet, or pes planus, is essential for addressing various orthopedic concerns. Flat feet occur when the arches of the feet collapse, causing the entire sole to come into contact with the ground. This condition can lead to discomfort and pain in the feet, ankles, knees, and even the hips and lower back due to altered biomechanics during walking and standing.

1. Measurement Variability: The measurement of the arch height can indeed vary based on the method used, including the technique employed by the physician. When measuring the arch, the use of a line drawn on the foot can introduce some variability. Additionally, the position of the foot during the X-ray (standing vs. lateral) can affect the results. Standing X-rays typically show the foot in a weight-bearing position, which may reveal more about the functional aspects of the arch compared to non-weight-bearing positions. If you received different measurements (160 degrees vs. 167 degrees), this could be attributed to differences in the measurement technique, the position of the foot, or even slight variations in the foot's condition at the time of each measurement.

2. Hip and Gluteal Concerns: Regarding your hip examination, the findings of gluteal fibrosis and the range of motion measurements suggest some limitations in hip function. The term "frog leg" typically refers to a position where the legs are abducted and externally rotated, resembling a frog's posture. The absence of a "catching" or "snapping" sound does not rule out the diagnosis of frog leg positioning. Diagnosis often relies on a combination of clinical examination, imaging studies, and the patient's reported symptoms. An MRI can provide detailed images of the soft tissues, including muscles and tendons, which may help confirm the presence of fibrosis or other abnormalities in the gluteal region. However, the diagnosis should be made by a qualified healthcare professional based on a comprehensive evaluation.

3. Finger Mobility: The inability to bring your fingers together may not necessarily be abnormal, as individual anatomical variations exist. However, if this limitation is accompanied by pain, discomfort, or functional impairment, it may warrant further investigation. Conditions such as joint stiffness, tendon issues, or even neurological concerns could contribute to this limitation. A thorough assessment by a hand specialist or orthopedic surgeon may provide more insight into whether this is a normal variation or indicative of an underlying issue.

In summary, flat feet can lead to a range of orthopedic concerns, and understanding the nuances of measurement and diagnosis is crucial. If you have persistent symptoms or concerns, it is advisable to consult with a specialist who can provide tailored recommendations based on your specific situation. Treatment options for flat feet may include orthotics, physical therapy, and in some cases, surgical intervention, depending on the severity of the condition and its impact on your daily life.

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