Validity and Reliability of Hallux Valgus Angle Measured on Digital Photographs

Nix, Sheree; Russell, Trevor; Vicenzino, Bill; Smith, Michelle D.

doi:10.2519/jospt.2012.3841

Cited by 48 publications

(50 citation statements)

References 34 publications

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“…Statistical power may be further improved by performing association analysis with ordinal51 52 or continuous53 measurement of HV. However, in the current study, not all of the participating studies had such measurements.…”

Section: Discussionmentioning

confidence: 99%

Genome-wide association meta-analyses to identify common genetic variants associated with hallux valgus in Caucasian and African Americans

et al. 2015

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Objective Hallux valgus (HV) affects ~36% of Caucasian adults. Although considered highly heritable, the underlying genetic determinants are unclear. We conducted the first genome-wide association study (GWAS) aimed to identify genetic variants associated with HV. Methods HV was assessed in 3 Caucasian cohorts (n=2,263, n=915, and n=1,231 participants, respectively). In each cohort, a GWAS was conducted using 2.5M imputed single nucleotide polymorphisms (SNPs). Mixed-effect regression with the additive genetic model adjusted for age, sex, weight and within-family correlations was used for both sex-specific and combined analyses. To combine GWAS results across cohorts, fixed-effect inverse-variance meta-analyses were used. Following meta-analyses, top-associated findings were also examined in an African American cohort (n=327). Results The proportion of HV variance explained by genome-wide genotyped SNPs was 50% in men and 48% in women. A higher proportion of genetic determinants of HV was sex-specific. The most significantly associated SNP in men was rs9675316 located on chr17q23-a24 near the AXIN2 gene (p=5.46×10−7); the most significantly associated SNP in women was rs7996797 located on chr13q14.1-q14.2 near the ESD gene (p=7.21×10−7). Genome-wide significant SNP-by-sex interaction was found for SNP rs1563374 located on chr11p15.1 near the MRGPRX3 gene (interaction p-value =4.1×10−9). The association signals diminished when combining men and women. Conclusion Findings suggest that the potential pathophysiological mechanisms of HV are complex and strongly underlined by sex-specific interactions. The identified genetic variants imply contribution of biological pathways observed in osteoarthritis as well as new pathways, influencing skeletal development and inflammation.

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Section: Discussionmentioning

confidence: 99%

Genome-wide association meta-analyses to identify common genetic variants associated with hallux valgus in Caucasian and African Americans

et al. 2015

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“…A significant limitation of both methods is that a precise measurement of the deviation in degrees compared to radiological measurements is not possible. Nix reported measurements of hallux valgus by using standardized digital photographs [17]. Compared to clinical scales a more incremental measurement of the deviation is possible.…”

Section: Introductionmentioning

confidence: 99%

The hallux valgus angle of the margo medialis pedis as an alternative to the measurement of the metatarsophalangeal hallux valgus angle

Klein¹,

Kinz

Zembsch

et al. 2014

BMC Musculoskelet Disord

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BackgroundCurrently, the metatarsophalangeal angle (hallux valgus angle) is measured based on radiographic images. However, using X-ray examinations for epidemiological or screening purposes would be unethical, especially in children. For this reason it is discussed to measure the hallux valgus angle of the margo medialis pedis (medial border of the foot) documented on foot outline drawings or foot scans. As a first step on the way to prove the validity of those approaches this study assesses the hallux valgus angle measured on the margo medialis pedis based on the same x-ray pictures as the metatarsophalangeal hallux valgus.MethodsRadiographic images of the foot were obtained from patients with symptomatic hallux valgus malformation. Twelve sets of contact copies of the 63 originals were made, and were marked and measured according to three different methods, each one performed by two observers and with two repeated measurements. Thus, data sets from 756 individual assessments were entered into the multifactorial statistical analysis.Comparisons were made between the angle of the margo medialis pedis and the metatarsophalangeal angle, which was determined by two different methods. To determine the inter- and intraobserver reliability of the different methods, each assessment was conducted by two independent experts and repeated after a period of several weeks.ResultsThe correlations between the hallux valgus angles determined by the three different methods were all above r = 0.89 (p < 0.001) and thus highly significant. The values obtained by measuring the margo medialis pedis angle, however, were on average 4.8 degrees smaller than the metatarsophalangeal angles. No significant differences were found between the observers. No systematic deviations for any observer between repeated measurements were detected.ConclusionsMeasurements of the radiographic hallux angle of the margo medialis pedis are reliable and show high correlation with the metatarsophalangeal angle. Because the hallux valgus angles based on margo medialis pedis measurements were slightly but statistically significantly smaller, these measurements should be considered conservative estimates of the metatarsophalangeal angle. Significant differences between hallux valgus angles based on radiographic and non-radiographic material are unlikely. However this question has to be treated in a second stage in detail.

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“…This tool might be considered as a non-invasive technique in order to measure the HV deformity degree using a standardized photograph set, divided into I degree (no HV), II degree (mild HV), III degree (moderate HV), and IV degree (severe HV). This scale showed an excellent inter-examiner repeatability (κ = 0.86) [29]. Also, excellent inter-examiner reliability and validity were shown for the HV angle between photographic measures and radiographs.…”

Section: Hv Deformity Degreesmentioning

confidence: 72%

“…A total sample of 100 subjects with different HV deformity degrees was recruited by a consecutive convenience sampling method in an outpatient clinic from March to November 2019 [4][5][6][7]. Inclusion criteria comprised subjects older than 18 years old, being healthy subjects for the control group classified as I degree-no HV presence (n = 25), as well as patients with HV deformity for cases groups, such as II degree-mild HV (n = 25), III degree-moderate HV (n = 25), and IV degree-severe HV (n = 25) [28,29].…”

Section: Samplementioning

confidence: 99%

Kinesiophobia and Pain Intensity Are Increased by a Greater Hallux Valgus Deformity Degree- Kinesiophobia and Pain Intensity in Hallux Valgus

Palomo‐López

Becerro-de-Bengoa-Vallejo

Iglesias

et al. 2020

IJERPH

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Background: Hallux valgus (HV) has been previously associated with psychological disorders. Thus, the purposes of this study were to associate kinesiophobia and pain intensity with HV deformity degrees, as well as predict kinesiophobia and pain intensity based on HV deformity and demographic features. Methods: A cross-sectional study was carried out recruiting 100 subjects, who were divided into HV deformity degrees, such as I-no HV (n = 25), II-mild (n = 25), III-moderate (n = 25), and IV-severe (n = 25) HV. Kinesiophobia total and domains (activity avoidance and harm) scores and levels were self-reported by the Tampa Scale of Kinesiophobia (TSK-11). Pain intensity was self-reported by the numeric rating scale (NRS). Results: Statistically significant differences (p < 0.01; η2 = 0.132–0.850) were shown for between-groups comparison of kinesiophobia total and domain scores (activity avoidance and harm) and levels, as well as pain intensity among HV deformity degrees. Post hoc comparisons showed statistically significant differences with a large effect size (p < 0.05; d = 0.85–4.41), showing higher kinesiophobia symptoms and levels and pain intensity associated with greater HV deformity degrees, especially for III-moderate and/or IV-severe HV deformity degrees versus I-no HV and/or II-mild deformity degrees. Both statistically significant prediction models (p < 0.05) for kinesiophobia (R2 = 0.300) and pain intensity (R2 = 0.815) were predicted by greater HV deformity degree and age. Conclusions: Greater kinesiophobia symptoms and levels and pain were associated with higher HV deformity degrees, especially severe and/or moderate HV with respect to no and/or mild HV. The kinesiophobia and pain intensity were predicted by greater HV deformity degree and age.

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Validity and Reliability of Hallux Valgus Angle Measured on Digital Photographs

Cited by 48 publications

References 34 publications

Genome-wide association meta-analyses to identify common genetic variants associated with hallux valgus in Caucasian and African Americans

Genome-wide association meta-analyses to identify common genetic variants associated with hallux valgus in Caucasian and African Americans

The hallux valgus angle of the margo medialis pedis as an alternative to the measurement of the metatarsophalangeal hallux valgus angle

Kinesiophobia and Pain Intensity Are Increased by a Greater Hallux Valgus Deformity Degree- Kinesiophobia and Pain Intensity in Hallux Valgus

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