Rearfoot Alignment Radiographic Parameters

NewsBot · Jul 5, 2024

CURRENT LINES AND ANGLES USED IN PAEDIATRIC FOOT RADIOGRAPH: A SCOPING REVIEW OF LITERATURE
J Doski et al
Ann Ib Postgrad Med. 2024 Apr 30;22(1):51-61.

Objective: This article aimed to review the main currently described lines and angles and gather them in a single article and arrange them in a systematic way to facilitate the process of assessment of the pediatric foot for deformities.

Methods: The review was a scoping literature review. Electronic database websites such as PubMed, Europe PMC, Cochrane Library, and Google Scholar in addition to some books on anatomy and human movements biomechanics, diagnostic radiology, and orthopedics were searched for relevant articles for the topic of the present review. No statistical analysis was applied in this review.

Results: Data from thirty articles included in this review were arranged into different subheadings. In the anteroposterior view (AP), assessment of the hindfoot deviation was by the AP talo-calcaneal angle (Kite's angle); the forefoot and midfoot for abduction and adduction alignment was by the AP talo-first metatarsal angle, the talo-second metatarsal angle, the calcaneo-second metatarsal angle, the calcaneofifth metatarsal angle; the forefoot and midfoot rotation was by observing the normal proximal convergence of the metatarsal bones axes. In the lateral view, assessment of the hindfoot sagittal plane alignment was by the lateral tibio-calcaneal angle; hindfoot varus or valgus deviation by the lateral talo-calcaneal angle; talus bone alignment by talar declination angle and the tibio-talar angle; calcaneal bone alignment by the calcaneal inclination angle and the tibio-calcaneal angle, the midfoot and forefoot sagittal plane alignment for the plantar arch by the lateral talo-first metatarsal -Meary's- angle, the calcaneal inclination angle, and the lateral calcaneofirst metatarsal -Hibbs- angle; forefoot and midfoot rotational alignment by observing the overlap shadows of the metatarsals' shafts and drawing their axes.

Conclusion: Drawing certain lines and angles with a systematic approach to assess different regions of the foot in the radiographic films of children can facilitate the process of assessment of the foot (as a whole) for deformities.
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NewsBot · Jul 18, 2024

Pes planus intermetatarsal angle to measure flatfoot deformity on dorsoplantar radiographic imaging.
Giliyaru S, Gavvala SN, Saad A, Jenko N, Iyengar K, Nischal N, et al.
J Arthrosc Surg Sports Med. doi: 10.25259/JASSM_17_2024

Objectives:
Pes planus, or “flat foot,” is a common foot condition involving talus misalignment, calcaneus eversion, medial arch collapse, and forefoot abduction. It is a well-recognized cause of foot pain and can lead to disability in patients. Clinical diagnosis is supported by plain radiography. However, in patients presenting with foot pain, traditionally dorsoplantar (DP) and oblique radiographs are undertaken. Pes planus may be difficult to analyze and classify on predominant DP and oblique radiographs and often requires weight-bearing lateral foot radiographs to direct patient management. Our study introduces a novel angle for pes planus diagnosis on DP radiographs of the foot. The purpose of this study was to describe a new radiological pes planus intermetatarsal angle (PPIMA) for assessment of flatfoot DP imaging of the foot.

Materials and Methods:
We performed a retrospective cohort study on 114 consecutive patients presenting with foot pain referred to our foot and ankle clinic weight-bearing DP, oblique radiographs of the foot and lateral radiographs of the foot and ankle were undertaken. Demographic details and clinical indication were recorded, and radiological parameters of hallux valgus angle, calcaneal pitch and angle between the shaft of the first and fifth metatarsal PPIMA were measured by two consultant radiologists and a radiology trainee. Data were organized using Microsoft Excel, and statistical analysis was performed STATA (StataCorp LLC, College Station, TX, USA) using analysis of variance and post hoc analysis.

Results:
Thirty patients were excluded due to the presence of hallux valgus deformity. In our study, the cohort with normal foot alignment (n = 30, age 14–18) had an average PPIMA of 20.7°, pes cavus (n = 3, age 14–18) average PPIMA was 24.0, while the pes planus group (n = 51, age 14–18) had an average PPIMA of 20.0°. There was no statistically significant difference in PPIMA between the groups (P = 0.229).

Conclusion:
Our study introduces a practical diagnostic tool for pes planus on DP foot imaging. The PPIMA is not a reliable indicator for the evaluation of foot alignment.
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NewsBot · Aug 14, 2024

Deep learning-based automated angle measurement for flatfoot diagnosis in weight-bearing lateral radiographs
Won-Jun Noh et al
Sci Rep. 2024 Aug 8;14(1):18411

This study aimed to develop and evaluate a deep learning-based system for the automatic measurement of angles (specifically, Meary's angle and calcaneal pitch) in weight-bearing lateral radiographs of the foot for flatfoot diagnosis. We utilized 3960 lateral radiographs, either from the left or right foot, sourced from a pool of 4000 patients to construct and evaluate a deep learning-based model. These radiographs were captured between June and November 2021, and patients who had undergone total ankle replacement surgery or ankle arthrodesis surgery were excluded. Various methods, including correlation analysis, Bland-Altman plots, and paired T-tests, were employed to assess the concordance between the angles automatically measured using the system and those assessed by clinical experts. The evaluation dataset comprised 150 weight-bearing radiographs from 150 patients. In all test cases, the angles automatically computed using the deep learning-based system were in good agreement with the reference standards (Meary's angle: Pearson correlation coefficient (PCC) = 0.964, intraclass correlation coefficient (ICC) = 0.963, concordance correlation coefficient (CCC) = 0.963, p-value = 0.632, mean absolute error (MAE) = 1.59°; calcaneal pitch: PCC = 0.988, ICC = 0.987, CCC = 0.987, p-value = 0.055, MAE = 0.63°). The average time required for angle measurement using only the CPU to execute the deep learning-based system was 11 ± 1 s. The deep learning-based automatic angle measurement system, a tool for diagnosing flatfoot, demonstrated comparable accuracy and reliability with the results obtained by medical professionals for patients without internal fixation devices.
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NewsBot · Sep 4, 2024

Hindfoot Alignment in Pediatrics: The Relationship Between Hindfoot Moment Arm and Hindfoot Alignment Angle
Pascual-Leone, Nicolas MD; Bram, Joshua T. MD; Cororaton, Agnes D. MS; Hillstrom, Howard J. PhD; Mintz, Douglas N. MD; Widmann, Roger F. MD; Ellis, Scott J. MD; Scher, David M. MD
Journal of Pediatric Orthopaedics ():10.1097/BPO.0000000000002803, August 27, 2024. | DOI: 10.1097/BPO.0000000000002803

Background:
Various measurements are used to evaluate hindfoot alignment and determine appropriate treatment, though the best tool is not known. Few studies have examined the relationship between these measurements in pediatric patients. This study sought to compare Hindfoot Moment Arm (HMA) and Hindfoot Alignment Angle (HAA) in evaluation of pediatric hindfoot deformity.

Methods:
This was a retrospective cohort study of pediatric patients by age: school-aged (7 to 10 years old), preadolescents (11 to 14), and adolescents (15 to 18). A total of 10 males and 10 females were randomly selected for each cohort from patients with available hindfoot radiographs. HMA and HAA were measured by 2 independent reviewers. Pearson correlation of HMA and HAA was performed by age cohort. Multivariable linear regression was used to investigate the association of HMA and HAA adjusting for age, sex, height, and weight.

Results:
Sixty participants were analyzed. Interrater reliability was found to be excellent for HMA and HAA (ICC=0.996 and 0.992, respectively). HMA was 8.7±9.4 mm in school age, 5.7±6.7 mm in preadolescents, and 2.5±13.0 mm among adolescents (P=0.153). HAA was 6.3±9.7 degrees in school age, 6.7±8.6 degrees in preadolescents, and 6.0±14.5 degrees among adolescents (P=0.983). The Pearson correlation coefficient was 0.78 (CI: 0.51-0.91) for school-aged, 0.92 (CI: 0.81-0.97) for preadolescents, and 0.86 (CI: 0.67-0.94) for adolescents. Using multivariable regression, each degree increase in HAA, increased HMA by 0.77 mm. Age, height, and weight were not found to be independent predictors of HMA.

Conclusions:
HMA and HAA were both found to be reliable measurements across all age cohorts. When comparing across age cohorts, neither HMA nor HAA differed significantly (P=0.153 and 0.983, respectively). Furthermore, Pearson correlation demonstrated a linear relationship between HMA and HAA. When evaluating hindfoot deformity, surgeons may assess hindfoot alignment via either HMA or HAA regardless of patient age. The authors support the use of HMA for clinical and academic purposes as HMA is considerably simpler to measure.
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Rearfoot Alignment Radiographic Parameters

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Rearfoot Alignment Radiographic Parameters

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

Rearfoot Alignment and First Metatarsal Rotation

Rearfoot alignment and plantar fasciitis

Impact of rearfoot alignment on hallux valgus surgery outcomes

Talar neutral position and forefoot/rearfoot alignment

Rearfoot alignment and medial longitudinal arch configurations of runners with symptoms and historie

New measurements of rearfoot, forefoot and shank-forefoot alignment in athletes

Rearfoot alignment and jones fracture

Share This Page

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