Calcaneal pitch

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Author: Mikael Häggström [notes 1]

Calcaneal pitch.jpg

The calcaneal pitch is an angle used mainly in the diagnosis and severity grading at X-ray of flat feet in adults and X-ray of pes cavus.


Calcaneal pitch is an angle of the calcaneus and the inferior aspect of the foot, with different sources giving different reference points. The first line making up the angle is defined as either:

  • The calcaneal inclination axis, extending from the calcaneus by the inferior portion of the calcaneocuboid joint to the inferior border of the calcaneus.[1]
  • Tangential to the inferior distal border of the calcaneus.[2]

The second line is defined as extending from either of the two above to either of the following:


Calcaneal pitch is increased in pes cavus, with cutoffs ranging from 20° to 32°.[5] A calcaneal pitch of less than 17° or 18° indicates flat feet.[6]


  1. For a full list of contributors, see article history. Creators of images are attributed at the image description pages, seen by clicking on the images. See Radlines:Authorship for details.


  1. 1.0 1.1 Sinacore, David R; Gutekunst, David J; Hastings, Mary K; Strube, Michael J; Bohnert, Kathryn L; Prior, Fred W; Johnson, Jeffrey E (2013). "Neuropathic midfoot deformity: associations with ankle and subtalar joint motion ". Journal of Foot and Ankle Research 6 (1). doi:10.1186/1757-1146-6-11. ISSN 1757-1146. 
  2. Page 486 in: Julia R. Crim, B. J. Manaster, Zehava Sadka Rosenberg (2017). Imaging Anatomy: Knee, Ankle, Foot (2 ed.). Elsevier Health Sciences. ISBN 9780323529556. 
  3. Calcaneal pitch angle segment in: Sam W. Wiesel (2015). Operative Techniques in Orthopaedic Surgery (2 ed.). Lippincott Williams & Wilkins. ISBN 9781496314680. 
  4. Bourdet, C.; Seringe, R.; Adamsbaum, C.; Glorion, C.; Wicart, P. (2013). "Flatfoot in children and adolescents. Analysis of imaging findings and therapeutic implications ". Orthopaedics & Traumatology: Surgery & Research 99 (1): 80–87. doi:10.1016/j.otsr.2012.10.008. ISSN 18770568. 
  5. . Pes Cavus. University of Washington, Department of Radiology. Last modified: 2016/08/14
  6. . Pes Planus. University of Washington, Department of Radiology. Last modified: 2016/08/14