Measuring hindfoot alignment in weight bearing CT: A novel clinical relevant measurement method

Burssens, Arne; Peeters, Jeroen; Buedts, Kristian; Leenders, T.; Vandeputte, Geoffroy

doi:10.1016/j.fas.2016.05.047

Cited by 15 publications

(30 citation statements)

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“…Nevertheless, different radiographic views are necessary for a detailed assessment of the posterior facet, which is a considerable drawback compared to CT scans. Although DRRs reconstructed out of a weight‐bearing CT scan dataset have shown to be more reliable in defining hindfoot malalignment compared to conventional radiographs, it is questionable if this novel imaging modality will replace X‐rays in the days to come . A detailed analysis of specific areas is possible using single CT images, but also the alignment can be assessed using DRRs.…”

Section: Discussionmentioning

confidence: 99%

Imaging of the subtalar joint: A novel approach to an old problem

Krähenbühl

Lenz

Lisonbee

et al. 2019

Journal Orthopaedic Research

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Evaluation of the subtalar joint using conventional radiographs is difficult. The purpose of this study was to assess how the posterior facet of the subtalar joint is projected on eight standard radiographic views of the foot and ankle. Weightbearing computed tomography (CT) scans of 27 volunteers without ankle pathology were performed. Eight standard views of the foot and ankle (antero‐posterior [AP] view, mortise view, subtalar view, four different Broden views) were reconstructed using digitally reconstructed radiographs (DRRs). The appearance of the posterior facet of the subtalar joint was assessed for each view. In addition, the position of the joint line was projected onto three‐dimensional (3‐D) models of the calcaneus. We found (i) on the AP view of the ankle joint, the posterior part of the posterior facet is visualized and appears convex (calcaneal side); (ii) on the mortise view of the ankle joint, a slightly more anterior part (compared to the AP view) is visualized and appears either convex or flat; (iii) on the subtalar view, the anterior part of the posterior facet is visualized and appears either convex, flat or concave; and (iv) using the Broden views, the posterior and anterior part of the posterior facet can be visualized. This study clarifies which parts of the posterior facet of the subtalar joint are visualized on eight standard views of the foot and ankle. © 2019 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res

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Section: Discussionmentioning

confidence: 99%

Imaging of the subtalar joint: A novel approach to an old problem

Krähenbühl

Lenz

Lisonbee

et al. 2019

Journal Orthopaedic Research

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“…That is to say, it allows a good clinical screening of hindfoot deformities, which is what we really wanted to do in our study. There is no doubt that radiological methods and CT scan methods published are more precise, but also more complex . In fact, they were designed for the preoperative planning of corrective surgical procedures to correct hindfoot malalignment.…”

Section: Methodsmentioning

confidence: 99%

“…There is no doubt that radiological methods and CT scan methods published are more precise, but also more complex. [13][14][15] In fact, they were designed for the preoperative planning of corrective surgical procedures to correct hindfoot malalignment. We assume that ideally, our study should have included some type of radiological measurement, although our intention was to describe a simple screening method to be used in clinical practice.…”

Section: Materials S and Me Thodsmentioning

confidence: 99%

Hindfoot malalignment in adults with haemophilic ankle arthropathy: The importance of early detection and orthotic treatment

et al. 2019

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Introduction Haemophilic arthropathy (osteoarthritis secondary to haemophilia) of the ankle may result in painful hindfoot malalignment. Purpose To analyse hindfoot alignment in subjects with haemophilic arthropathy of the ankle and evaluate the response (improvement of pain, function and alignment) to the orthotic treatment prescribed in patients with malalignment. Methods The study included 163 patients with haemophilia, all of them over 16 years of age. Hindfoot alignment and footprint were analysed in patients with and without haemophilic arthropathy of the ankle (as determined by the Pettersson score). Response to the use of an orthosis was evaluated at 6 months by means of the AOFAS Ankle‐Hindfoot Scale. Results Fifty‐six (59.5%) patients with haemophilic arthropathy presented with concomitant hindfoot malalignment. The most common abnormality was a valgus alignment combined with a neutral footprint. In 14 cases, valgus was associated with a pes planus or a pes cavus. Only 5 patients without haemophilic arthropathy (7.2%) presented with some form of malalignment. The differences between the groups were statistically significant. The probability of having malalignment increased with the degree of arthropathy. Patients with haemophilic arthropathy and malalignment were treated with an orthosis, with insoles as the most commonly used alternative (86%). Such treatment significantly improved patients’ pain and function‐related scores on the AOFAS Ankle‐Hindfoot Scale. Conclusion Given the high rates of valgus malalignment in subjects with haemophilic arthropathy of the ankle, and the good response rates obtained following individualised orthotic treatment, it seems reasonable to routinely evaluate hindfoot alignment in this group of patients.

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“…One of the major limitations is that the malalignment of patients in their study was assessed clinically and not radiographically . It has been demonstrated in several publications that the clinical assessment of hindfoot alignment is often incorrect and underestimates the underlying deformity (Figure ) . De Cesar Netto et al analysed clinical and radiographic alignment in 29 patients (30 feet) with adult‐acquired flatfoot deformity and demonstrated that clinical evaluation often underestimates the underlying flatfoot deformity by up to 15 degrees.…”

mentioning

confidence: 99%

“…In the last decade, weightbearing computed tomography (WBCT) has increased in use for preoperative and postoperative assessment of patients with hindfoot disorders . This novel imaging modality improves the assessment of joint alignment and degeneration under weightbearing conditions (Figures and ) …”

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confidence: 99%

Commentary on the paper: “Hindfoot malalignment in adults with haemophilic ankle arthropathy: The importance of early detection and orthotic treatment”

Barg

2019

Haemophilia

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Measuring hindfoot alignment in weight bearing CT: A novel clinical relevant measurement method

Cited by 15 publications

References 0 publications

Imaging of the subtalar joint: A novel approach to an old problem

Imaging of the subtalar joint: A novel approach to an old problem

Hindfoot malalignment in adults with haemophilic ankle arthropathy: The importance of early detection and orthotic treatment

Commentary on the paper: “Hindfoot malalignment in adults with haemophilic ankle arthropathy: The importance of early detection and orthotic treatment”

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