FETAL FEET IMAGING

1. Dr Arun Gupta
Director imaging
Dr Rakhee gupta
Dr Vinayak Mittal
Dr Ritesh Mahajan
ADVANCED USG LOUNGE
FETAL ANOMALY SERIES
FETAL FEET

2. ADVANCED USG LOUNGE
 SECOND GRAVIDA WITH POG of 15WKS 6DAYS
 ? LMP (Lactational Amenorrhoea).
 Uneventful first pregnancy .
 Present Sonogram findings are s/o Bilateral club
foot ( Talipes varus). Possibly isolated abnormality .
 Rest of the scan per se was normal .

3. NORMAL
FETAL FEET
THREE –D
RENDERED
IMAGES
squared angle
between
Long axis of foot
and leg.

4. TALIPES VARUS
INVERTED
PLANTAR FLEXED
MEDIALLY
DEVIATED FEET .
( BILATEEAL CLUB
FOOT WITH
ASSOCIATED
HINDFOOT VARUS )
.

5. Inward deviation of both the
fetal Feet is appreciated .
There is associated hindfoot
varus .
Rounding of the angle between
feet and leg is appreciated .
Long axis of the metatarsals are
visualized in the same plane as
leg .

6. FOLLOWING SPECTRUM
OF ABNORMALITIES CAN
BE ASSOCIATED WITH
CLASSIC TALIPES
•Hind foot equinus
( plantar flexion)
•Hind foor varus
( inward rotation)
•Forefoot adduction
•Forefoot cavus

7. INWARD ANGULATION
ROUNDING OF ANGLE BETWEEN LEG AND FEET
NO ATROPHY OF CALF MUSCLES APPRECIATED
( CAN BE SEEN IN ASSOCIATED MUSCULAR DYSTROPHIES)

8. GREY SCALE 2D
IMAGES OF THE
TALIPES VARUS
LONG AXIS OF
METATARSALS IS
APPRECIATED IN
SAME PLANE AS
ALONG THE LONG
AXIS OF THE LEG

9. NORMAL SPINE
NORMAL FACE
FETAL BIOMETRY ASSESSED.

10. CLASSICAL TALIPES
 Spectrum of abnormalities associated with variable
degree of contracture at ankle region /along with
tendon abnormalities .
 May be isolated or associated with neurological
defects ( spina bifida) , neuromuscular ( FADS)
,environmental factors( oligohydramnios, uterine
abnormalities , Early rupture of the membranes,
Fetal crowding due to multiple gestation).
 Two types :
 Talipes varus
 Talipes equinus

11. TALIPES VARUS ( CLUB FOOT)
 Occurs in 0.1 to 0.2% of population.
 Recurrence rate after birth of first child with club foot is 2% to
3% and if one parent is affected the recurrence risk is 3% to
4% .
 Majority are isolated deformations.
 Early amniocentesis is associated with increased risk of club
foot .
 Normal foot can also achieve extreme dorsiflexion / plantar
flexion and caution should be exercised while making isolated
diagnosis of club foot especially in late gestation.
 Congenital talipes equinovarus has spectrum ranging from :
 Postural talipes / Non rigid deformity
 Severe rigid deformity .

12. REFERENCE
DIAGNOSTIC
ULTRASOUND
FOURTH EDITION
Carol M. Rumack, MD, FACR
J. William Charboneau, MD, FACR
Deborah Levine, MD, FACR
Ultrasound of Congenital
Fetal AnomaliesDifferential
Diagnosis and Prognostic
Indicators
Dario Paladini MD
Head, Fetal Cardiology Unit
Department of Obstetrics and
GynecologyUniversity Federico II
of NaplesNaplesItaly
Paolo Volpe MD
Head, Fetal Medicine Unit
Department of Obstetrics and
GynecologyHospital Di Venere
Bari