Foot drop is a result of weakness of the foot dorsiflexors.

Possible causes include:

• common peroneal nerve lesion - the most common cause
• L5 radiculopathy
• sciatic nerve lesion
• superficial or deep peroneal nerve lesion
• other possible includes central nerve lesions (e.g. stroke) but other features are usually present

A common peroneal nerve lesion is the most common cause. This is often secondary to compression at the neck of the fibula. This may be caused by certain positions such as leg crossing, squatting or kneeling. Prolonged confinement, recent weight loss, Baker's cysts and plaster casts to the lower leg are also known to be precipitating factors.

Examination

• if the patient has an isolated peroneal neuropathy there will be weakness of foot dorsiflexion and eversion. Reflexes will be normal
• weakness of hip abduction is suggestive of a L5 radiculopathy

Bilateral symptoms, fasiculations or other abnormal neurological findings (e.g. hyperreflexia) are indications for specialist referral.

If the examination suggests an isolated peroneal neuropathy then conservative management is appropriate. Leg crossing, squatting and kneeling should be avoided. Symptoms typically improve over 2-3 months * ref: BMJ article

Charcot–Marie–Tooth (CMT)

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C‑M‑T → “CAVES, MUSCLES, TOES”

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C – Cavus feet

High‑arched feet (pes cavus) + hammer toes.

M – Muscle wasting (distal)