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Indian J Radiol Imaging. 2019 Oct-Dec;29(4):364-371. doi: 10.4103/ijri.IJRI_288_19. Epub 2019 Dec 31.

Role of the weight-bearing cone-beam CT in evaluation of flatfoot deformity.

Author information

Department of Radiodiagnosis, Jankharia Imaging Centre, 383 S V P Road, Bhaveshwar Vihar, Mumbai, Maharashtra, India.
Department of Orthopaedics, Breach Candy Hospital Trust, 60 A Bhulabhai Desai Road, Girgaon, Mumbai, Maharashtra, India.
Department of Orthopaedics, Sir H N Reliance Foundation Hospital, Raja Rammohan Roy Rd, Prarthana Samaj, Khetwadi, Girgaon, Mumbai, Maharashtra, India.



Till date, weight-bearing radiographs have been the cornerstone for planning surgeries on flatfoot. The technique, however, has limitations due to the superimposition of the bones and the lack of reproducibility. Weight-bearing CT with its unique design overcomes these limitations and enables cross-sectional imaging of the foot to be done in the natural weight-bearing position. In this paper, we report our initial experience in weight-bearing cross-sectional imaging of the foot for assessment of flatfoot deformity.

Materials and Methods:

Around 19 known cases of flatfoot were scanned on the weight-bearing CT. Each foot was then assessed for the various angles and also for the presence/absence of extra-articular talocalcaneal impingement and subfibular impingement. Other associated abnormalities like secondary osteoarthritic changes, were also noted.


The Meary, as well as the calcaneal angles, were abnormal, in all but one separate foot. Forefoot abduction was seen in 7 of the 19 feet. The hind foot valgus angle was greater than 10° in all patients. Extra-articular talocalcaneal impingement was seen in 13 of 19 feet. Secondary osteoarthritic changes were seen in 14 feet.


Weight-bearing CT scan is a very useful technique for evaluation of flatfoot and associated complications. It overcomes the limitations of the radiographs by providing multiplanar three-dimensional assessment of the foot in the natural weight-bearing position and at the same time being easily reproducible and consistent for the measurements around the foot. The definite advantage over the conventional cross-sectional scanners is the weight-bearing capability.


Extremity CT; flatfoot; pes planus; weight-bearing CT

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