Radiographic angular measurements of the foot and ankle in weight-bearing: A literature review

Carrara, Claudio; Caravaggi, Paolo; Belvedere, Claudio; Leardini, Alberto

doi:10.1016/j.fas.2019.07.008

Cited by 39 publications

(33 citation statements)

References 46 publications

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“…Low ICC's were most likely caused by over-projection in case of the first metatarsal bone (MT1) and difficulties determining the anatomical long-axis of bones, such as the talus and calcaneus. Our 2D geometric parameters were in agreement with those of other studies reporting parameters of healthy individuals [17,21,23,24,29,30]. Regarding the comparison of geometric parameters for left and right feet our results are in agreement with Tomas et al who found no significant difference between left and right in AP and LL weight-bearing radiographs [17].…”

Section: Discussionsupporting

confidence: 93%

“…These simulated X-rays were used for geometrical measurements on the foot anatomy. In literature, several well-known angle and height measurements are described to determine the stability of the foot and ankle [4,[21][22][23][24][25][26]. Angles between bones were defined by manually drawn anatomical axis lines through the center of the body structures in 2D sagittal and/or axial view of the foot (Fig.…”

Section: Measurements -2dmentioning

confidence: 99%

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Geometric 3D analyses of the foot and ankle using weight-bearing and non weight-bearing cone-beam CT images: The new standard?

Broos

Berardo

Dobbe

et al. 2021

European Journal of Radiology

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We hypothesize that three-dimensional (3D) geometric analyses in weight bearing CT-images of the foot and ankle are more reproducible compared to two-dimensional (2D) analyses. Therefore, we compared 2D and 3D analyses on bones of weight-bearing and non weight-bearing cone-beam CT images of healthy volunteers. Methods: Twenty healthy volunteers (10 male, 10 female, mean age 37.5 years) underwent weight-bearing and non weight-bearing cone-beam CT imaging of both feet. Clinically relevant height and angle measurements were performed in 2D and 3D (for example: cuboid height, calcaneal pitch, talo-calcaneal angle, Meary's angle, intermetatarsal angle). Three-dimensional measurements were obtained using automated software. Intraobserver and inter-observer agreement were evaluated for all 2D measurements. Results: Overall intraclass correlation coefficients (ICC's) were higher than 0.750 for most 2D measurements, ranging from 0.352 to 0.995. Calcaneal pitch, angle between the first metatarsal (MT1) and proximal phalange 1, between the fifth metatarsal (MT5) and the calcaneus and heights of the sesamoid bones, navicular, cuboid and talus decreased during weight-bearing in both 2D and 3D results (p < 0.01). Meary's angle was not statistically different in 2D (p = 0.627) and 3D (p = 0.765). Higher coefficients of variation in 2D geometric analysis parameters (0.27 versus 0.16) indicate that 3D analyses are more precise compared to 2D (p < 0.01). Results of left and right feet are comparable for 2D and 3D analyses. Conclusion: Although 2D and 3D geometrical analyses are fundamentally different, automated 3D analyses are more reproducible and precise compared to 2D analyses. In addition, 3D evaluation better demonstrates differences in bone configurations between weight-bearing and non weight-bearing conditions, which may be of value to demonstrate pathology.

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Section: Discussionsupporting

confidence: 93%

Section: Measurements -2dmentioning

confidence: 99%

Geometric 3D analyses of the foot and ankle using weight-bearing and non weight-bearing cone-beam CT images: The new standard?

Broos

Berardo

Dobbe

et al. 2021

European Journal of Radiology

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“…We selected 12 studies assessing radiographic patterns of normal ankles, and identified a total of 15 possible radiographic measurements (6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17) .…”

Section: Resultsmentioning

confidence: 99%

“…• Lateral distal tibial angle, anteroposterior distal tibial angle or Anterior distal tibial angle (7,8,14,16) ;…”

Section: Lateral Viewmentioning

confidence: 99%

Study of the radiographic parameters of normal ankles

et al. 2020

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Objective: The authors carried out a bibliographic search for the radiographic parameters used to determine tibiotalar joint alignment, and suggest a set of parameters that constitute the minimum radiographic evaluation sufficient for the proper assessment of tibiotalar alignment. Methods: The search was conducted between May 2019 and January 2020 on the online platforms PudMed and Google Scholar with the following terms, used separately or jointly: “ankle arthritis, radiographic measurement, ankle alignment, alignment, anterior ankle instability, X-ray, and ankle injury”. Results: We selected twelve studies evaluating radiographic patterns of normal ankles, and identified a total of 15 radiographic measurements. Conclusion: The authors believe that a minimum radiographic assessment of tibiotalar alignment should include the following parameters on the anteroposterior radiograph: the distal tibial articular angle, the talar tilt and talus center migration. On the lateral radiograph, it should include: lateral distal tibial angle and lateral talar station. Level of Evidence V; Diagnostic Study; Expert Opinion.

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“…11,16,[40][41][42] These include single-bone absolute orientation, interbone relative alignments, distances, arch angles, and also morphological aspects of the single bones. A recent literature review 43 surveyed the most popular of these foot and ankle radiographic measures, although they are still based on weight-bearing radiographic images. That comprehensive review includes a careful aggregation of similar conceptual measures and relevant diagrammatic representations.…”

Section: Discussionmentioning

confidence: 99%

Weight-bearing CT Technology in Musculoskeletal Pathologies of the Lower Limbs: Techniques, Initial Applications, and Preliminary Combinations with Gait-Analysis Measurements at the Istituto Ortopedico Rizzoli

Leardini

Durante

Belvedere

et al. 2019

Semin Musculoskelet Radiol

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Musculoskeletal radiology has been mostly limited by the option between imaging under load but in two dimensions (i.e., radiographs) and three-dimensional (3D) scans but in unloaded conditions (i.e., computed tomography [CT] and magnetic resonance imaging in a supine position). Cone-beam technology is now also a way to image the extremities with 3D and weight-bearing CT. This article discusses the initial experience over a few studies in progress at an orthopaedic center. The custom design of total ankle replacements, the patellofemoral alignment after medial ligament reconstruction, the overall architecture of the foot bones in the diabetic foot, and the radiographic assessment of the rearfoot after subtalar fusion for correction of severe flat foot have all taken advantage of the 3D and weight-bearing feature of relevant CT scans. To further support these novel assessments, techniques have been developed to obtain 3D models of the bones from the scans and to merge these with state-of-the-art gait analyses.

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Radiographic angular measurements of the foot and ankle in weight-bearing: A literature review

Cited by 39 publications

References 46 publications

Geometric 3D analyses of the foot and ankle using weight-bearing and non weight-bearing cone-beam CT images: The new standard?

Geometric 3D analyses of the foot and ankle using weight-bearing and non weight-bearing cone-beam CT images: The new standard?

Study of the radiographic parameters of normal ankles

Weight-bearing CT Technology in Musculoskeletal Pathologies of the Lower Limbs: Techniques, Initial Applications, and Preliminary Combinations with Gait-Analysis Measurements at the Istituto Ortopedico Rizzoli

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