Flatfoot, Acquired (Pes Planus), Bilateral

Mild acquired flatfoot bilaterally: With symptoms correctable by arch supports, without significant objective findings on examination.

Moderate acquired flatfoot bilaterally: With marked pronation, and inward displacement and sagging of the longitudinal arch, pain on manipulation and use, callosity formation, and/or use of orthotics.

Unilateral

Severe acquired flatfoot bilaterally: With objective evidence of marked deformity (pronation, abduction, etc.), pain on manipulation, indication of swelling on use, characteristic skin lesions (callosity), and/or marked inward displacement and sagging of the longitudinal arch on weightbearing X-ray.

Pronounced acquired flatfoot bilaterally: With marked pronation, extreme tenderness of plantar surfaces, marked inward displacement of the astragalus, and/or os calcis findings; no improvement with orthotic use; chronic inflammatory changes noted.