Flat Foot, In-Toeing and Normal Variants – Board-Style Questions

What this deck covers

flat foot, in-toeing and normal variants in 18 board-style clinical cases with worked explanations. Each case gives you a clinical vignette, four options, the correct answer, and an explanation of why each of the other three is wrong, with the guideline or textbook it follows named on the answer.

Board-style teaching questions for paediatricians and trainees preparing for paediatric board, MRCPCH and licensing examinations. Written from published guidelines and standard paediatric textbooks, with the source named on every answer.

The 18 cases, in order

1. Up on the toes
2. Pulling on the big toe
3. What to buy
4. The foot that will not change
5. A bridge that should not be there
6. Sore under the strap
7. A curved little foot
8. What the parents do at home
9. When to send on
10. Where the rotation sits
11. Higher up the limb
12. How the child sits
13. Measuring the twist
14. How it ends
15. Bandy at eighteen months
16. One leg unlike the other
17. Knees that touch
18. Always on the toes

Diagnoses and management options tested

Across the 18 cases you are asked to choose between options such as: The inner border remains on the floor on tiptoe, The arch rises as the great toe is lifted, They are needed daily until the arch forms, The involvement of one foot rather than both feet, A bar of bone or cartilage joining two hindfoot bones, Inflammation of the growth plate at the heel, The heel turning outwards with the arch collapsed, Surgery on the forefoot before he takes his first steps, Pain, stiffness, or one side differing from the other, An inward twist of the thigh bone, The forefoot, which is curved towards the midline, Sitting on one hip with both legs to the same side, The angle between the thigh and the foot in this position, It remains unchanged and needs an operation in adolescence.

Clinical pearls from this deck

• Arch back on tiptoe: the foot is flexible.
• Lift the great toe and the arch should rise.
• Inserts treat pain, never the shape of the foot.
• Flat on tiptoe with a stiff hindfoot: a rigid foot.
• Rigid foot with spasm in adolescence: a coalition.
• Tender bump on the inner border: an extra ossicle.

Work through the deck once for recognition, then again a week later to test yourself — each question gives the answer and explains why every other option fails.

More from this system: all MSK and orthopaedics case decks · pediatric reference values.