Calcaneal inclination angle

Last revised by Mohammad Taghi Niknejad on 25 Feb 2024

The calcaneal inclination angle, also known as the calcaneal pitch, is useful in assessing medial arch height. 


This angle is formed on a weight-bearing lateral foot radiograph between the calcaneal inclination axis (i.e. most inferior part of the calcaneus) and the supporting horizontal surface 1.


This measurement reflects the height of the foot framework but is affected by abnormal pronation or supination of the foot.

Median calcaneal inclination angles have been published in various adult populations ranging between 18° +/- 5° 5 and 20.5° +/- 1° 6 with a large range (8-30°) of normal in one series 5. Normal ranges of between 10-25° 3 and 20-30° 2 have been proposed.

A significant difference between the calcaneal inclination angle between patients with adult flatfoot disease and normal patients has been demonstrated 4. A cut-off of ≤19° has been shown to have 90% sensitivity and 85% specificity for diagnosing symptomatic pes planus/flatfoot but should be interpreted in the context of other measurements and findings 7

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