Dawaa Reference

chronic

Congenital musculoskeletal anomaly

Treatment options, dosing, cautions and Egyptian brands from the shipped Dawaa Reference card.

Evidence status

Checked against the sources named below

Sources3 sources

Clubfoot - StatPearls (NCBI Bookshelf NBK551574) - https://www.ncbi.nlm.nih.gov/books/NBK551574/ · ICPC-3 (WONCA International Classification of Primary Care, 3rd edition) class LD55 - condition scope only, no dose · No dose - referral pathway, no medicine given in primary care

Verified against2 documents
  • No dose - referral pathway, no medicine given in primary care
  • Congenital musculoskeletal anomaly - disease-level clinical article (congenital-musculoskeletal-anomaly-clinical.txt)

Verified date2026-08

Presentation reference

Is it this?

Reference only, to read alongside your own examination.

Signs — what you find (4)

  • The hindfoot points outward and downward while the forefoot turns outward and bends upward at the midfoot
  • The sole of the foot becomes convex, giving a rocker-bottom appearance
  • Deep skin creases appear over the outer, upper part of the foot
  • The head of the talus bone can be felt as a bony bump on the inner sole of the midfoot [skin nodule]

Tests (6)

  • Standing X-rays are used once a child can bear weight, and neutral-position X-rays are used in infants
  • Diagnosis at birth can be difficult because several foot bones are not yet ossified
  • Forced dorsiflexion and plantar flexion X-ray views are needed to confirm the diagnosis and to rule out a calcaneovalgus or oblique talus foot
  • The classic finding is an increased talus-to-heel-bone angle, with the talus lying vertical and parallel to the shinbone on the side-view X-ray
  • On forced upward bending the shin-to-heel angle decreases and the talus misaligns with the navicular bone, while forced downward bending misaligns it with the first metatarsal
  • A full neurologic exam of the spine and limbs should be done to check for associated abnormalities

If not this — what else fits (3)

  • Vertical talus displaces the talonavicular joint medially and downward, unlike a related deformity where the same joint shifts laterally and upward
  • In calcaneovalgus foot, a palpable gap between the talar neck and navicular bone closes with forced downward bending, unlike vertical talus
  • Clubfoot and posterior medial bowing of the tibia are also on the differential for this foot deformity

SourceStatPearls "Congenital Vertical Talus" - disease-level clinical article

Presentation findings are traced to the source above.

1

NO DRUG THERAPY IN PRIMARY CARE (RECOGNITION & REFERRAL)

1st line
Adult dose and duration

Broad grouping of congenital skeletal deformities (clubfoot, bow leg, craniofacial malformation, foot deformities) usually identified at birth or in infancy; management is bracing/casting or surgical, not pharmacologic, so the GP's role is early recognition and prompt referral. - Refer

Paediatric dose

Children follow the same pathway: recognise and refer. No primary-care medicine is implied.

Dose source

No dose - referral pathway, no medicine given in primary care

Why

Broad grouping of congenital skeletal deformities (clubfoot, bow leg, craniofacial malformation, foot deformities) usually identified at birth or in infancy; management is bracing/casting or surgical, not pharmacologic, so the GP's role is early recognition and prompt referral.

Cautions
  • Associated syndromic features or other congenital anomalies; clubfoot needs referral early in infancy for best results with corrective casting.
  • No medicine is prescribed for this in primary care - this entry is for recognition and referral. Anything given is decided by the service it is referred to.
  • RED FLAG - Children with congenital vertical talus require prompt evaluation and treatment to prevent permanent bony deformities (rocker-bottom foot) and significant long-term disability.

Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy.