Diagnosis of Flat Feet
The diagnosis of flat feet is based on physical examination, patient history, and sometimes imaging tests. Since flat feet can be asymptomatic in many people, diagnosis is usually prompted by foot pain, abnormal gait, or posture-related issues.
Clinical Evaluation
A general practitioner, podiatrist, or orthopaedic specialist will begin with:
Medical history, including symptoms, previous injuries, and family history of foot problems
Questions about pain location, duration, and triggers
Observation of gait and foot posture while standing and walking
The examiner will check if:
The arch disappears when standing but reappears when sitting or on tiptoe (indicating flexible flat feet)
The arch is consistently absent, even when non-weight-bearing (rigid flat feet)
There is any swelling, tenderness, or ankle misalignment
Physical Tests
Heel raise test – checks posterior tibial tendon function by asking the patient to stand on tiptoe
Wet footprint test – reveals the shape of the arch by looking at the imprint left on paper
Range of motion assessments, particularly in the ankle and subtalar joint, help distinguish between flexible and rigid flat feet
Imaging Tests
If symptoms are severe or one-sided, or if surgery is being considered, doctors may order:
X-rays, to assess bone structure, alignment, and joint health
MRI scans, to evaluate soft tissue damage or tendon injuries, especially of the posterior tibial tendon
CT scans, in rare cases where bone fusion (tarsal coalition) or arthritis is suspected
Imaging is not always necessary in mild or uncomplicated cases.
Assessment of Children | Diagnosis of Flat Feet
Paediatric flat feet are often diagnosed during routine check-ups
In most children, flexible flat feet resolve by age 6
Persistent, painful, or rigid flat feet may require further investigation and referral to a specialist
Early diagnosis allows for appropriate intervention and can prevent complications, especially when flat feet are associated with biomechanical problems or progressive collapse.
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