In stage 3 PTTD, deformities become more severe and
fixed. Significant loss of subtalar joint motion and contracture
of the posterior muscle group usually occur at this
stage. Lateral symptoms predominate. The patient is unable
to perform a single heel-raise test and the rearfoot remains
everted with a double heel-raise test (Fig 3). A forefoot
varus is often noted. Radiographs of stage 3 PTTD show
continued increase in angular deformities and may show
degenerative changes within the rearfoot. MRI and ultrasound
studies reveal similar findings to those in stage 2