Pes Cavus and Hereditary Neuropathies: When a Relationship Should Be Suspected

SLR - September 2011 - Kelsey L. Harvey

Reference: Piazza, S., Ricci G., Calderazzo Ienco, E., Carlesi, C., Volpi, L., Siciliano, G., Mancuso, M.  Pes cavus and hereditary neuropathies: when a relationship should be suspected.  Journal of Orthopaedic Traumatology. 2010, 11:195-201.

Scientific Literature Review

Reviewed by:  Kelsey L. Harvey, DPM
Residency Program:  St. John Hospital and Medical Center

Podiatric Relevance: 
Hereditary peripheral neuropathies should be suspected in those patients presenting with bilateral foot deformities (such as pes cavus, hammertoe deformities, and ankle instability), family history and/or gait impairment with signs of neurological impairment such as distal muscle hypotrophy.  

Methods: 
This article reviews the hereditary peripheral neuropathies in which pes cavus plays a key role as a “spy sign.”  The hereditary peripheral neuropathies reviewed are Charcot-Marie-Tooth, Dejerine-Sottas neuropathy, congenital hypomyelinating neuropathy, hereditary neuropathy with liability to pressure palsies and distal hereditary motor neuropathies.

Results: 
Clinical data suggestive of hereditary peripheral neuropathy are represented by evidence of: bilateral pes cavus and/or gait impairment, distal muscle hypotrophy of limbs, and sensorial and/or motor dysfunction.

Conclusions:  
When one or more signs of hereditary peripheral neuropathy are present, the patient should receive a thorough neurological evaluation to exclude or confirm the presence of involvement of peripheral nerves, especially in the early stages of the disease when other signs may not be present or evident.