A patient is referred with a diagnosis of HAV deformity. What sign might your worn shoe evaluation reveal?

In the case of a patient with a diagnosis of Hallux Abducto Valgus (HAV) deformity, the evaluation of worn shoes will often reveal a narrow toe box as a significant sign. This is because individuals with HAV typically experience lateral deviation of the big toe, leading them to seek shoes that accommodate the deformity. However, the shape of the shoe's toe box remains a critical factor.

When shoes have a narrow toe box, they may not provide adequate space for the affected toe, which can exacerbate pain and discomfort associated with the deformity. Thus, people might continually wear such shoes despite the fit being less than ideal, which ultimately contributes to worsening of the condition.

This pattern of wear is reflective of the specific challenges faced by those with HAV. The other characteristics typically seen in footwear, such as a wedge type sole, an infare last, or a low heel, do not directly relate to the typical adaptations that a person with HAV would make in their choice of footwear, making the narrow toe box the most relevant sign in this context.