Deformity is usually the presenting feature of pes cavus. Often there is a family history of the condition. The patient may complain of pain over the metatarsal heads, or over the toes where the shoe pressure is greatest. There may be callosities formed at these sites. There may be an increased angle between the first metatarsal and the tarsus, and there may be a varus deformity of the heel.
At first the deformity is mobile, later it becomes fixed: sub-talar movements become decreased or absent.
This condition may be associated with peroneal muscular atrophy and Friedreich's ataxia, and these conditions must be excluded as aetiological factors.
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