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Rocker bottom foot

A rocker bottom foot (also known as a congenital vertical talus) is a congenital anomaly of the foot. It is characterised by a prominent calcaneus (heel) and a convex rounded sole.


It results from a dorsal and lateral dislocation of the talonavicular joint 


Radiographic features

For assessment of the foot alignment abnormalities, it is important to perform weight bearing images or an equivalent in neonates (foot X ray):

  • fixed equinus: plantarflextion of the calcaneus 
  • vertical talus: plantarflextion of the talus- increased talocalcaneal angle​
  • irreducible dorsal sublaxation or dislocation of the navicular 
  • forefoot valgus: divergence of bases of the metatarsal heads on AP and superimposition of the metatarsal bones on the lateral view          
  • long axis of the talus passes plantar to metatarsal axis on lateral view and medial to the first metatarsal on AP view

The presence of a rocker bottom foot in an antenatal ultrasound scan is sometimes classified as a soft sign for aneuploidic anomalies 3.

Differential diagnosis

In the antental-neonatal period consider
In the adult period consider

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