This finding represents the knees inability to maintain its dynamic integrity (position during movement) while under load. What we see is a collapsing medially (inward) of the involved knee representing poor control, weakness of the hip musculature, and/or poor foundational support from poorly controlled foot motion. This concept represents the importance of muscular control of one’s knee while under dynamic load. What we see at times is a “shimmy” in the knee while the patient attempts to control knee movements such as a single leg squat. This can represent poor muscular control and coordination of the knee, hip and foot musculature. Bunions areenlargements of the bone at the joints. They form in much thesame was as heel spurs. Causes may vary. Shoes that are too shortor too narrow that pinch and cause stress to the joints. The bonethen inflames and starts the cycle of putting on additionallayers of bone to mend the stress area (like a fracture). Pointedtoe shoes that squeeze the toes and stress on the joints and highheels that shift the weight to the ball of the foot are othercauses. Even nylon hose can contribute and cause the problem. At night after being held in this jelly mould, they are ina ball. Congenital vertical talus — In this condition, there is no arch because the foot bones are not aligned properly. In some cases, there is a reverse curve (rocker-bottom foot, in which the shape is like the bottom rails of a rocking chair) in place of the normal arch. Congenital vertical talus is a rare condition present at birth. It often is associated with a genetic disorder, such as Down syndrome, or other congenital disorders. The cause is unknown in up to half of cases. X-rays are always performed in a young child with rigid flatfeet and in an adult with acquired flatfeet due to trauma. Expected Duration A second type of flat foot is classed as "acquired" because the once-normal arch gradually falls and flattens. This happens when the connective structure of the foot weakens due to stress or injury. The primary support of the arch comes from the posterior tibial tendon which runs from the inside ankle to the arch. Inflammation or damage to this tendon - from injury, obesity, arthritis, diabetes or aging - can cause the arch to fall, resulting in flat feet. Pes planus can be a genetically inherited condition. If the flat feet are not causing any functional problems or pain, they are considered normal, and need not be addressed. Tarsal Coalition Rarer associations include lymphadenopathy and amyloidosis with deposition of serum amyloid A protein manifesting as proteinuria or malabsorption). Rheumatoid vasculitis may lead to nail fold infarcts in the periphery and leg ulceration. Renal involvement in rheumatoid disease is rare. Osteoporosis may occur as a result of the disease, immobility or corticosteroid therapy. There is an increased incidence of infections in patients with rheumatoid disease. Felty's syndrome (rheumatoid factor positive rheumatoid arthritis, splenomegaly and pancytopenia, most frequently neutropenia) may lead to recurrent bacterial infections, chronic leg ulcers and increased mortality. Yes, ugly orthopedic shoes. I know! I know! Orthopedic used to be synonymous with ugly. No more my bunion afflicted friend!