Diagnosing Clubfoot in Children

Clubfoot is a condition that causes the tendons, ligaments, and bones in a baby’s foot to develop abnormally, resulting in feet that twist inward and downward. Clubfoot is almost always diagnosed during a prenatal ultrasound—a technique that uses high-frequency sound waves to create images of babies in the womb. Clubfoot can also be diagnosed by a doctor immediately after a baby is born. Typically, clubfoot affects both feet, though some babies are born with only one clubfoot.

Most of the time, the cause of clubfoot is unknown, though research suggests that genetics play a role in its development. Rarely, clubfoot is a symptom of a broader musculoskeletal disorder, such as spina bifida, arthrogryposis, or another condition. In most instances, clubfoot is not caused by any actions taken by a pregnant woman, and the condition cannot be prevented. However, clubfoot may develop as a result of drug or alcohol abuse during pregnancy or because of an infection, virus, or disease.

The New York Ponseti Clubfoot Center at the Center for Children, part of Hassenfeld Children’s Hospital at NYU Langone, is staffed by clubfoot specialists including orthopedic physicians and surgeons, neurologists, pediatricians, nurses, social workers, and brace specialists. This collaborative approach provides infants with the support and care they need to grow up to lead active lives.

Because of the prevalence of ultrasound exams during pregnancy and the high number of births that take place in hospitals, most children are diagnosed with clubfoot before or shortly after birth. Our doctors have the experience and training to treat clubfoot in people of any age.

Early Diagnosis

Clubfoot develops during the first trimester of pregnancy, but signs of the condition may not be visible in an ultrasound image until later in pregnancy. Although treatment for clubfoot cannot begin before a baby is born, an early diagnosis allows parents to prepare for the baby’s arrival. Our doctors are available for prenatal consultations, during which they can help you and your family to plan for treatment after your baby is born.

If a diagnosis is not made prenatally, clubfoot is typically visible in newborns. Doctors can confirm the diagnosis in a physical examination immediately after birth. Treatment should begin as early as possible after diagnosis—ideally, within the first three weeks of life.

Physical Examination

Your child’s doctor assesses the shape and position of your infant’s foot during a physical examination immediately after birth. During the exam, the doctor uses his or her hands to move each foot back and forth. This enables your child’s doctor to feel how the bones are positioned and to test the tightness of connective tissue, which attaches muscle to bone.

Tendons and ligaments are connective tissues that span the length of the foot. If a tendon is too short, it can pull muscles or bones into abnormal positions. Newborns have very flexible tendons that can be gradually stretched and repositioned, which is why early diagnosis is so important to the successful treatment of clubfoot.

If left untreated, clubfoot can worsen as the child’s bones grow. Many people with clubfoot who were not treated as babies have difficulty walking or, if clubfoot is severe, can’t walk at all.

X-rays

Occasionally, doctors use X-rays to get a closer look at how the bones of the foot are positioned. X-ray imaging is painless and administered onsite.