Reliability of ultrasound for measurement of selected foot structures

NewsBot · Jun 24, 2013

Members do not see these Ads. Sign Up.
Reliability of ultrasound for measurement of selected foot structures
G. Crofts, S. Angin, K.J. Mickle, S. Hill, C.J. Nester
Gait & Posture; Article in Press

Background
Understanding the relationship between the lower leg muscles, foot structures and function is essential to explain how disease or injury may relate to changes in foot function and clinical pathology. The aim of this study was to investigate the inter-operator reliability of an ultrasound protocol to quantify features of: rear, mid and forefoot sections of the plantar fascia (PF); flexor hallucis brevis (FHB); flexor digitorum brevis (FDB); abductor hallucis (AbH); flexor digitorum longus (FDL); flexor hallucis longus (FHL); tibialis anterior (TA); and peroneus longus and brevis (PER).

Methods
A sample of 6 females and 4 males (mean age 29.1±7.2 years, mean BMI 25.5±4.8) was recruited from a university student and staff population. Scans were obtained using a portable Venue 40 musculoskeletal ultrasound system (GE Healthcare UK) with a 5–13MHz wideband linear array probe with a 12.7mm×47.1mm footprint by two operators in the same scanning session.

Results
Intraclass Correlation Coefficients (ICC) values for muscle thickness (ICC range 0.90–0.97), plantar fascia thickness (ICC range 0.94–0.98) and cross sectional muscle measurements (ICC range 0.91–0.98) revealed excellent inter-operator reliability. The limits of agreement, relative to structure size, ranged from 9.0% to 17.5% for muscle thickness, 11.0–18.0% for plantar fascia, and 11.0–26.0% for cross sectional area measurements.

Conclusions
The ultrasound protocol implemented in this work has been shown to be reliable. It therefore offers the opportunity to quantify the structures concerned and better understand their contributions to foot function.
Click to expand...

Highlights
•We measured soft tissue structures in the foot and lower leg using ultrasound.
•Inter-operator reliability was good for tissue thickness and cross sectional area.
•Variation in measures was less than expected changes in structure due to disease or ageing
Click to expand...

HansMassage · Jun 26, 2013

Would make very interesting comparison contralaterally where client developed club foot due to spinal injury probably at birth.

drsarbes · Jun 26, 2013

Can one of the research - statistic gurus on the Podiatry Arena please explain what this means.

"The limits of agreement, relative to structure size, ranged from 9.0% to 17.5% for muscle thickness, 11.0–18.0% for plantar fascia, and 11.0–26.0% for cross sectional area measurements."

Thank you

Steve

Simon Spooner · Jun 26, 2013

drsarbes said: ↑

Can one of the research - statistic gurus on the Podiatry Arena please explain what this means.

"The limits of agreement, relative to structure size, ranged from 9.0% to 17.5% for muscle thickness, 11.0–18.0% for plantar fascia, and 11.0–26.0% for cross sectional area measurements."

Thank you

Steve
Click to expand...

Steve, basically it means that for the two observers in the study, they could be 95% sure that their measurements were the same, within the percentiles reported. As they reported percentages it takes into account variations in the absolute size of the different tissues they were measuring. 26% difference seems a fair bit in my book. Hope that makes sense. Otherwise Google: "Bland and Altman limits of agreement".

NewsBot · Oct 6, 2019

Diagnostic accuracy of clinical tests to diagnose ultrasound-confirmed tibialis posterior tendinopathy in patients presenting with medial foot/ankle pain
M. Ross et al
October 2019Volume 22, Supplement 2, Page S25

Introduction: Tibialis posterior tendinopathy (TPT) is often diagnosed clinically based on presenting signs and symptoms, including pain around the medial aspect of the ankle and pain or difficulty with activities that load the tendon. There is a lack of data to support the validity of these clinical signs. The aim of this study was to determine the diagnostic utility of clinical assessment features in determining the presence of ultrasound-identified TPT.

Methods: TPT diagnosis was made by a physiotherapist based on medial foot/ankle pain, and one or more of the following signs: tenderness on palpation (TOP), swelling of the tendon, pain/difficulty with resisted tibialis posterior contraction, and pain/difficulty performing a single leg heel raise (SLHR). The reference standard, ultrasound-identified TPT, was defined as positive with the presence of one or more greyscale signs, or evidence of peritendinous fluid or colour on power Doppler. 2 x 2 contingency tables were developed to cross-tabulate results of each index test in isolation and for the overall clinical diagnosis (positive or negative TPT) and to calculate positive predictive value (PPV), negative predictive value (NPV) and likelihood ratios (LRs) and their confidence intervals.

Results: 52 individuals (42 female, age 46.2 (12.3), BMI 30.1 (7.6)) with medial foot/ankle pain participated. A positive clinical diagnosis of TPT was made in 31 participants and was confirmed by US imaging in 26 cases (PPV = 83.9 % (71.9–91.3)). Of 21 participants with a negative clinical diagnosis, 14 had signs of tendinopathy on US imaging (NPV = 33.3 % (20.9–48.62)). The clinical diagnosis had a positive LR (LR + ) of 1.56 (0.77–3.16) and negative LR (LR-) of 0.6 (0.32–1.14). Of the individual index tests, SLHR had the highest LR + (1.44 (0.7–2.95)), followed by TOP (1.2 (0.65-2.23)), swelling (1.14 (0.54–2.4)) and resisted contraction (0.96 (0.44–2.07)). SLHR had the lowest LR- (0.69 (0.37–1.26), followed by TOP (0.8 (0.4–1.58), swelling (0.9 (0.51–1.58)) and resisted contraction (1.03 (0.6–1.77)).

Conclusions: For individuals with medial ankle pain, the combination of ‘location of pain’ with at least 1 other index test has the greatest diagnostic utility. As SLHR had the highest LR + of the individual index tests, this suggests combining location of pain and positive SLHR test may be most beneficial to accurately detect ultrasound-confirmed TPT on clinical examination. Of note, the indices of diagnostic utility are small which questions the relationship between clinical symptoms and tendon pathology signs on US.
Click to expand...

NewsBot · Oct 13, 2019

Diagnostic Accuracy of Ultrasonography in Diagnosis of Metatarsal Bone Fracture; a Cross Sectional Study.
Ebrahimi M et al
Arch Acad EmergMed. 2019 Aug 17;7(1):e49. eCollection 2019.

INTRODUCTION:
Metatarsus is one of the most common sites in the sole of foot bones fractures. The aim of this study was to determine the diagnostic accuracy of ultrasound in diagnosis of metatarsal bone fractures following foot trauma.

METHODS:
This cross-sectional study was carried out on patients with blunt foot trauma admitted to emergency department of a hospital in Mashhad, Iran from January to September 2016. All patients were evaluated with bedside ultrasound for the presence of first to fifth metatarsal fractures and screening performance characteristics of ultrasonography in detection of metatarsal fractures were calculated considering foot radiography as the reference test.

RESULTS:
The study was conducted on 102 patients with a mean age of 35.14±14.32 years (56.8% male). The most common signs of trauma in physical examination were pain and tenderness (100%), swelling (96.1%), ecchymosis (14.7%) and deformity (1.9%). Sensitivity, specificity, and positive and negative likelihood ratio of ultrasonography in detection of metatarsal bone fracture were 96.7% (95% CI: 0.83-0.99), 84.5% (95% CI: 0.73-0.92), 73.1% (95% CI: 0.57-0.85), and 98.3% (95% CI: 0.91-0.99), respectively. The overall accuracy of ultrasonography was 0.906 (95% CI: 0.844 - 0.969) based on area under the receiver operating characteristic (ROC) curve.

CONCLUSION:
Considering the excellent diagnostic accuracy, ultrasonography can be used as an alternative means in diagnosis of metatarsal bone fractures.
Click to expand...

Reliability of ultrasound for measurement of selected foot structures

NewsBot The Admin that posts the news.

HansMassage Active Member

drsarbes Well-Known Member

Simon Spooner MVP

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

Reliability of self-identification of hallux valgus

Reliability and readability of clubfoot online resources

Reliability and Accuracy of Static Parameters Obtained From Ink and Pressure Platform Footprints

Reliability of a Qualitative Video Analysis for Running

Reliability of in shoe pressure systems

The reliability of the neutral measurement of the subtalar joint

Validity and Reliability of the Tri-axial Accelerometer of the iPod Touch

Share This Page

Reliability of ultrasound for measurement of selected foot structures

NewsBot The Admin that posts the news.

HansMassage Active Member

drsarbes Well-Known Member

Simon Spooner MVP

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

Reliability of self-identification of hallux valgus

Reliability and readability of clubfoot online resources

Reliability and Accuracy of Static Parameters Obtained From Ink and Pressure Platform Footprints

Reliability of a Qualitative Video Analysis for Running

Reliability of in shoe pressure systems

The reliability of the neutral measurement of the subtalar joint

Validity and Reliability of the Tri-axial Accelerometer of the iPod Touch

Share This Page

Useful Searches