The Cavovarus Foot in Hereditary Motor and Sensory Neuropathies.

Abstract

The cavovarus foot is a complex deformity involving a spectrum of changes to the hindfoot, midfoot, forefoot, and ankle. While cavovarus deformity can occur secondary to many congenital, neurological, or posttraumatic causes, the prototypical form is that of Charcot-Marie-Tooth (CMT) disease, the most common inherited neuropathy. The first known cases of cavovarus foot deformity were reported by Aran in the Archives Generales de Medicine in 18501. Professor Jean Martin Charcot and his student Pierre Marie coined the term “peroneal muscular atrophy” in 1886, with clinical descriptions of distal muscle weakness beginning in the legs and hands2. Howard Henry Tooth, in his Cambridge MD dissertation in the same year, wrote on “the peroneal type of progressive muscular atrophy” and provided illustrations of hindfoot varus and wasting of the peronei and foot extensors (Fig. 1)3. Charcot-Marie-Tooth disease has now become synonymous with the hereditary motor and sensory neuropathies (HMSNs), of which nearly fifty genetic subtypes have been described4. These neuropathies constitute a genetically and phenotypically heterogeneous group of peripheral nerve disorders that are …