Abnormal bone pathology may promote hindfoot deformity in Charcot-Marie-Tooth disease
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CHARLOTTE, N.C. — Hindfoot deformity in patients with Charcot-Marie-Tooth disease may be due to a combination of muscular imbalances and changes of the underlying bony deformity, according to results presented here.
Max P. Michalski, MD, and colleagues compared 27 weight-bearing CTs in 21 patients with Charcot-Marie-Tooth disease with 20 healthy patients with no history of foot or ankle problems. Calcaneal measurements included the radius of curvature and the angle between the posterior tuberosity and posterior facet in the sagittal plane, while talar measurements included axial and sagittal declination between the body and neck, as well as coronal rotation of the talar head relative to the body. Researchers performed a surface-mesh model analysis that compared the average measures of the Charcot-Marie-Tooth group with the control group using CT analysis software (Disior Bonelogic).
“We found a significant difference in the radius of curvature of the calcaneus,” Michalski said in his presentation at the American Orthopaedic Foot & Ankle Annual Meeting. “Of note, two of the [Charcot-Marie-Tooth] CMT patients had nearly straight calcanea. So while there was a significant difference, it is not present in all feet.”
Michalski noted most patients with Charcot-Marie Tooth disease had more of a C-shaped calcaneus compared with the control group. He added the two groups had a significant difference in the sagittal plane.
“For the talar results, coronal rotation of the head of the talus relative to the body was smaller in the CMT population,” Michalski said. “This would indicate the head sits in a more horizontal position.”
Surface-mesh model analysis showed the navicular tuberosity, medial talar head, sustentaculum tali and anterior process of the calcaneus had the largest differences in morphology.
“Additionally, we found an enlargement in the central posterior tuberosity, as well as the navicular at the central lateral talar head-neck joint,” Michalski said.
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Michalski MP, et al. Use of weight-bearing computed tomography in the evaluation of abnormal hindfoot morphology in Charcot-Marie-Tooth patients. Presented at: American Orthopaedic Foot & Ankle Society Annual Meeting. Sept. 22-25, 2021; Charlotte, N.C.
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