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While I welcome the overall tenor of the article (conservative
treatment first, and surgery is reserved for failure of adequate
conservative care), the point about not examining the foot while the
patient is standing is mistaken.
The authors are correct that the deformity may look worse with
standing. However, since the bunion is generally more symptomatic while
standing, examining them under these circumstance will proved a much
better understanding of the source of their discomfort. Likewise, all
radiographs obtained should be made while standing.