Age-related differences in radiologic and clinical presentation of Charcot-Marie-Tooth foot deformity: Insights from WBCT and PROMIS analysis

BACKGROUND: This study compared pediatric and adult Charcot-Marie-Tooth (CMT) foot deformities using radiologic and clinical data and evaluated the relationship between age and deformity severity. METHODS: Sixty-eight CMT patients were retrospectively analyzed and divided into pediatric (< 18 years, n = 19) and adult (n = 49) groups. 3D measurements from foot weightbearing CT scans were obtained. Clinical outcomes were assessed using PROMIS scores. RESULTS: Adults showed significantly higher Meary's angle (10.9° vs. -5.9°, P = .002) and talonavicular angles (2.4° vs. -11.7°, P < .001) than pediatrics. Pediatric patients demonstrated higher Saltzman view angles (40.8° vs. 21.4°, P = .003). Adults showed higher PROMIS Pain Interference scores (58.8 vs. 52.6, P = .031). Age showed a positive correlation with sagittal Meary's angle, talonavicular angle, and Pain Interference score, and a negative correlation with the Saltzman view angle. CONCLUSION: The adult patients exhibited a higher arch and more pain interference, whereas the pediatric patients showed greater midfoot adduction and hindfoot varus. LEVEL OF EVIDENCE: Level IV.