Purpose or Case Report: To describe the prenatal imaging appearance of Congenital Vertical Talus (CVT) by US and MRI and detail the associated anomalies and outcome. The postnatal imaging appearance will also be discussed.
Methods & Materials: Using our radiology database, we performed a retrospective review of fetal US and MRI from 2006-2015. Cases of CVT were identified and associated findings as well as outcomes were assessed.
Results: 24 prenatal cases of CVT were identified. Both by US and MRI, CVT demonstrated a distinct appearance with a protuberant heel and dorsiflexion of the forefoot. This resulted in a convex contour of the plantar surface of the foot. In contrast, congenital talipes equinovarus (CTE) has a distinctive varus angulation to the foot, resulting in visualization of the tibia in the same plane. A significant number of concurrent anomalies were identified in the CVT cases, including brain and/or spinal anomalies (23/24, 96%), aneuploidy (5/24, 21%), and limb anomalies (13/24, 54%).
Conclusions: Congenital vertical talus has a distinct prenatal appearance that can be identified by US and MRI. It is associated with a high risk of additional fetal anomalies and there were no cases of isolated CVT in our series. It is important to distinguish CVT from CTE, which can often be an isolated finding. Identification of CVT through its classic dorsiflexion, convex plantar surface and prominent calcaneus should prompt a thorough search for additional anomalies prenatally. Fetal MRI is a helpful adjunct when this abnormality is present, particularly for identification of brain and spine malformations. Complete characterization of fetal anomalies allows for comprehensive family counseling.