June 20, 2024

Pirani Score was given by Dr. Shafique Pirani who is a Clinical Professor at the Department of Orthopaedic Surgery, Division of Pediatric Orthopaedics, at the University of British Columbia. This Score is a simple and reliable system to determine the severity and monitor progress in the Assessment and Treatment of Clubfoot

Midfoot Score Sign

1. Medial Crease

2. Curved lateral border

Pirani Score Mid foot sign
Pirani score

3. Talar Head

Palpate talar head laterally with thumb

Gently abduct the foot to reduce navicular till resistance is felt

Assess how much talar head remains palpable

Pirani Score
Talar Head in Pirani Score

Hindfoot Sign in Pirani Score

1. Empty Heel sign

Gently extend ankle till resistance is felt

Palpate calcaneal tuberosity through fat pad at corner of the heel

  • Tuberosity immediately palpable: 0
  • Tuberosity felt only with deep palpation: 0.5
  • Tuberosity not palpable: 1

2. Posterior crease

  • Multiple creases: 0
  • Nonindentary solitary crease: 0.5
  • Single indentary crease:1
Posterior crease

3. Rigid Equinus

Gently extend the ankle till resistance is felt

Determine dorsiflexion angle from the lateral side

Pirani Score
Rigid equinus

See also: Congenital Talipus Equinovarus (CTEV)

See also: Congenital Vertical Talus (CVT)