Flat feet is a postural deformity in which the arches of the foot collapse, with the entire sole of the foot coming into complete or near-complete contact with the ground.
==Planning==
Flat feet can be diagnosed clinically, but projectional radiography ("X-ray") is helpful in uncertain cases. It can be used for severity grading, although this has little implication for treatment options.<ref name="indications" group="notenotes">Indications for non-surgical treatment is based on pain:*{{cite web|url=https://www.mayoclinic.org/diseases-conditions/flatfeet/diagnosis-treatment/drc-20372609|title=Flatfeet|website=Mayo Clinic|accessdate=2018-07-04}}Indications for surgery are failure of non-surgical treatment as well as a flexible rather than stiff arch:*{{cite journal|last1=Vulcano|first1=Ettore|last2=Deland|first2=Jonathan T.|last3=Ellis|first3=Scott J.|title=Approach and treatment of the adult acquired flatfoot deformity|journal=Current Reviews in Musculoskeletal Medicine|volume=6|issue=4|year=2013|pages=294–303|issn=1935-973X|doi=10.1007/s12178-013-9173-z}}*{{cite web|url=http://www.aofas.org/footcaremd/treatments/Pages/Flatfoot-Surgical-Correction.aspx|title=Flatfoot Surgical Correction|website=American Orthopaedic Foot & Ankle Society|accessdate=2018-07-04}}</ref> In children, X-ray may be taken in more severe cases of flat feet in order to determine the extent of the deformity.<ref>{{cite web|url=https://my.clevelandclinic.org/health/diseases/14483-flatfoot-in-children/diagnosis-and-tests|title=Flatfoot in Children: Diagnosis and Tests - How is pediatric flatfoot diagnosed?|website=Cleveland Clinic|accessdate=2018-07-09}}</ref>
==Diagnosis==
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File:Talonavicular coverage angle.jpg|Dorsoplantar [[projectional radiograph]] of the foot showing the measurement of the talonavicular coverage angle.
File:Calcaneal pitch.jpg|Weight-bearing lateral [[Projectional radiography|X-ray]] showing the measurement of [[calcaneal pitch]], which is an angle of the [[calcaneus]] and the inferior aspect of the foot, with different sources giving different reference points.<ref name="pitch" group="notenotes">Detailed explanations and references are located in the [[Calcaneal pitch]] article.</ref> A calcaneal pitch of less than 17° or 18° indicates flat feet.<ref name="uw-planus" />File:Talar-1st metatarsal angle (Meary's angle).jpg|Same lateral X-ray showing the measurement of Meary's angle, which is the angle between the long axis of the [[Talus bone|talus]] and [[first metatarsal bone]].<ref name="uw-planus" /> An angle greater than 4° convex downward is considered a flat foot.<ref name="uw-planus" /></gallery> ==Severity==Meary's angle angle 15° - 30° is considered "moderate" flat foot, and greater than 30° is considered "severe" flat foot.<ref name="uw-planus" /> ==Associated findings==<gallery mode="packed" heights=180px>File:Lateral X-ray of a flat foot an C-sign.jpg|Pediatric lateral X-ray of a flat foot with '''C-sign''', which is a bony bridge between the [[talus bone|talar]] dome and [[sustentaculum tali]], in combination with a prominent inferior border of the sustentaculum tali. This represents a talocalcaneal coalition, which is an abnormal connection between the talus and calcaneus, and is thought to cause the flat foot deformity in this case.<ref>{{cite journal|last1=Zhou|first1=Binghua|last2=Tang|first2=Kanglai|last3=Hardy|first3=Mark|title=Talocalcaneal coalition combined with flatfoot in children: diagnosis and treatment: a review|journal=Journal of Orthopaedic Surgery and Research|volume=9|issue=1|year=2014|issn=1749-799X|doi=10.1186/s13018-014-0129-9}} [https://creativecommons.org/licenses/by/4.0/ (CC BY 4.0)]</ref>
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==Report==
Presence {{Reporting}}Report presence or absence of flat feet. To put in simpler words, an abnormally laterally rotated talonavicular coverage angle can be described as "laterally pointed navicular bone", and an abnormally decreased calcaneal pitch and abnormally downward-convex Meary's angle can be described as "fallen arch".
Upon request, severity can be given (, as the value of Meary's angle angle 15° - 30° is considered or simply as "mild", "moderate flat foot, and greater than 30° " or "severe flat foot.<ref name="uw-planus" />), otherwise it is not relevantnecessary to report.<ref name="indications" group="notenotes"/> ==Notes=={{reflist|group="note"|refs=<ref name="pitch" group="note">Detailed explanations and references are located in the [[Calcaneal pitch]] article.</ref><ref name="indications" group="note">Indications for non-surgical treatment is based on pain:*{{cite web|url=https://www.mayoclinic.org/diseases-conditions/flatfeet/diagnosis-treatment/drc-20372609|title=Flatfeet|website=Mayo Clinic|accessdate=2018-07-04}}Indications for surgery are failure of non-surgical treatment as well as a flexible rather than stiff arch:*{{cite journal|last1=Vulcano|first1=Ettore|last2=Deland|first2=Jonathan T.|last3=Ellis|first3=Scott J.|title=Approach and treatment of the adult acquired flatfoot deformity|journal=Current Reviews in Musculoskeletal Medicine|volume=6|issue=4|year=2013|pages=294–303|issn=1935-973X|doi=10.1007/s12178-013-9173-z}}*{{cite web|url=http://www.aofas.org/footcaremd/treatments/Pages/Flatfoot-Surgical-Correction.aspx|title=Flatfoot Surgical Correction|website=American Orthopaedic Foot & Ankle Society|accessdate=2018-07-04}}</ref>}}