The Cavus Foot in Athletes: Fundamentals of Examination and Treatment

Anterior standing examination shows bilateral “peek a boo” heels and prominent first metatarsal head fat pads.

Posterior examination reveals hindfoot varus bilaterally.

Coleman block test reveals correction of hindfoot varus into anatomic heel valgus.

Standing lateral radiograph shows an increased distance between the inferior base of the fifth metatarsal and inferior medial cuneiform. A break in Meary's line and a posterior positioned fibula is also noted.

Standing AP radiograph of the feet showing metatarsal overlap due to hindfoot supination and relative forefoot pronation.

(A) AP radiograph displaying cortical hypertrophy consistent with fibular stress fracture. (B) Bone scan with increased uptake at the site of the fibular stress fracture.

(A) Radiograph of fifth metatarsal stress fracture. (B) Radiograph of intramedullary screw fixation of stress fracture.

(A) Subtle left cavus foot with visible “peek-a-boo” heel. (B) MRI confirming navicular stress fracture. (C) Radiograph displaying screw fixation of navicular stress fracture.

Peroneal tears are common with cavus feet particularly tears of the peroneus brevis.

Cavus foot with medial malleolus stress fracture.

Illustration showing the dorsal talar osteophyte common with ankle impingement.