Can imaging techniques of the tibialis posterior assist in evaluating the function of adult-onset acquired flat feet?

Question

Hello doctor,

I had an extra bone removed from each foot when I was a kid, specifically from the arch areas. As a result, I now have a hard lump located northeast of and below my ankle. This lump closely resembles an ankle itself. I experience chronic pain around the lump, extending up through and behind the ankle. The pain worsens with increased walking, to the point where it can be quite challenging to walk, particularly on stairs. Additionally, I have flat feet, but this lump only emerged later in my life and the flat-footedness has not been the primary cause of this heightened level of pain. At times, my ankle also swells. Moreover, there is a substantial bunion on top of the bone connected to my big toe, which not only causes increased discomfort but also seems to be growing. I am unsure if this is related, but there might be some connection to the protrusion at the back of my foot. I have had severe ankle sprains on a few occasions, including a particularly bad one as an adult. While these incidents might not be directly relevant due to the presence of the hard lump resembling an ankle, they are worth noting.

When my pain subsides, I have noticed that my arch tends to collapse even more than it did before. Conversely, when the pain intensifies, I tend to shift my weight to the left side of my foot if I am wearing shoes that allow for such adjustment. Sometimes, the pain becomes so severe that walking becomes a real struggle. Currently, I am taking medication for my heart, although I do not have any serious cardiac issues.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

It would have been more helpful for me to have access to clinical pictures and X-rays of the foot in order to make a more accurate diagnosis. I understand that you mentioned the accessory navicular bone, which is sometimes removed to alleviate midfoot pain and is also associated with flat feet. The condition you might be referring to is adult-onset acquired flat foot. To properly evaluate this, X-rays and ultrasound of the tibialis posterior, or an MRI (magnetic resonance imaging), would be necessary to assess its function. Additionally, a clinical examination would help determine if the heel valgus is correctable. In a worst-case scenario, a fusion of the heel bone might be considered.

Thanks and regards.