EANS Case of the Month

Title: Flat Feet: A rare cause of myelopathy in a teenager

Author: J Tailor, DC Walsh

King’s College Hospital, London

Case history

A 15-year-old boy presents to the orthopaedic clinic for advice on his flat feet. His orthopaedic surgeon records a history of mild sensory alteration in the soles of his feet, associated with a gradual decline in mobility. This began 10 years ago with a sensation that his knees were always tending to turn in, and has resulted in a very gradual withdrawal from physical education and games. He has become a little socially withdrawn and has struggled with sports at school. He denies any sphincter disturbance and otherwise has been maturing normally. He has enjoyed a relatively normal childhood. He was a normal delivery at birth, has not had any childhood hospital admissions, no significant family history and does not take regular medications.

* 1. What features of the examination merit particular attention in this patient?