A 40-year-old man was referred because he wished to be informed about the genetic nature of his disorder. He was diagnosed with Charcot–Marie–Tooth (CMT) disease. At 14 months of age, he started walking, but awkwardly due to a bilateral drop foot for which braces were prescribed. On first examination at age 2 years and 8 months, there was marked atrophy, hypotonia, and areflexia of the lower legs, and slight wasting of the thenar and hypothenar. At that time, nerve conduction studies showed normal motor conduction velocities of arm nerves. No motor unit action potentials could be recorded in the lower leg muscles on concentric needle examination.

A 24-year-old woman had difficulty with walking since early childhood. At age 18 months she was able to walk without support. She often stumbled and could not keep up with her peers in gym class. However, she still had been able to walk 5 km during a four-day walking event. Management included physiotherapy, and she had orthopaedic shoes. She underwent surgery at age eight years (tendon repositions of both feet). Family history was not available because she was adopted. Previous history includes bilateral congenital hip dysplasia and congenital hypothyroidism.

Foot and ankle examination begins with the patient standing. Then ask the patient to walk, observing the gait and the three rockers. If the diagnosis is pes planus or pes cavus, the relevant tests can be done at this point of the examination, a single leg tiptoe test or the Coleman block test, respectively. Inspection is then completed by asking the patient to sit and inspect the sole of the foot, between the toes and the shoes. Movements are performed in the joints from proximal to distal or distal to proximal, depending on the underlying pathology.

The chapter looks at a wide variety of pathology and the clinical examination findings related to these cases.