Club Foot

Question 1

Describe the ultrasound findings associated with club foot.

Answer 1

• Angulated foot noted in coronal view and sagittal view

- Short and angulated in plantar foot view

Question 2

How do you counsel the patient if club foot is seen on ultrasound?

Answer 2

• 2/3 are bilateral
• 2/3 are isolated
• 2% associated with aneuploidy
• Prognosis depends on associated anomalies
• Prognosis unchanged if unilateral or bilateral
• Most grow up to wear normal shoes and live active lives

Question 3

What genetic conditions are associated with club foot?

Answer 3

• T13
• T18
• Triploidy
• 22q11
• VACTRL - Vetebral, anorectal atresia, cardia, tracheoesophageal fistula, renal abnormalities, limd dysplasia
• Muscular dystrophy like myotonic dystrophy

-Skeletal dysplasia
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Chances of genetic problem are as follow: 
-CF + anomaly - 10-30% 
-CF alone - 2% 
-Familial CF - 20%

Question 4

What is the likelihood of associated anomalies in the setting of club foot?

Answer 4

1/3 are associated with anomalies.

• Spina bifida is most commonly associated
• 4% of isolated club foot are born with minor anomalies such as polydactyly, hip dislocation, hypospadius

Question 5

What additional evaluation do you perform if a club foot is identified?

Answer 5

• Detailed anatomy with 3D views
• Fetal echocardiogram
• Amniocentesis if other anomalies found (10-30% will have genetic problem with other anomalies found)

Question 6

What is the likelihood of identifying a genetic condition in a fetus with club foot?

Answer 6

2% if CF alone
20% if familial CF
10-30% if CF with anomalies