Sandal gap deformity
Dr Yuranga Weerakkody ◉ et al.
A sandal gap deformity, also known as hallux varus, is an imaging observation in antenatal ultrasound (typically second trimester) where there is an expanded first interspace, i.e. the gap between the great toe of the foot from the rest of the toes (likened to the gap caused by a sandal).
While it can be a normal variant (especially when it is the only finding) it is also sometimes considered a soft marker for other fetal anomalies.
Pathology
Associations
Recognized associations include
- Down syndrome 1-3,4
Differential diagnosis
For an unusually wide gap between the 1st and 2nd toe on antenatal ultrasound consider
- a deformity due to an amniotic band
- spectrum of ectrodactyly
Related Radiopaedia articles
Ultrasound - obstetric
- ultrasound (introduction)
- obstetric ultrasound
- first trimester and early pregnancy
- ectopic pregnancy
- multiple gestations
- subchorionic hematoma
- failed early pregnancy
-
second trimester
- fetal biometry
- fetal morphology assessment
- fetal echocardiography views
- nonvisualisation of the fetal stomach
-
soft markers
- nuchal fold thickness
- ventriculomegaly
- absent nasal bone
- choroid plexus cysts
- enlarged cisterna magna
- shortened fetal long bones
- echogenic intracardiac focus (EIF)
- echogenic fetal bowel
- aberrant right sublavian artery
- fetal pyelectasis / fetal renal pelvic dilatation
- single umbilical artery
- sandal gap toes
- amnioreduction
- Doppler ultrasound
- nuchal translucency
- 11-13 weeks antenatal scan
- chorionic villus sampling (CVS) and amniocentesis
- placenta
- other
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