Radiographic angles in hallux valgus: Comparison between protractor and iPhone measurements

Meng, Hong‐Zheng; Zhang, Wei‐Lin; Li, Xiu‐Cheng; Yang, Mon-Yuan

doi:10.1002/jor.22872

Cited by 13 publications

(7 citation statements)

References 16 publications

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“…Condon et al 8 and Meng et al 14 confirmed the high intra- and interobserver reliability for the measurement of the IM angle; however, they concluded that reliability can be improved using a sound technique and repeating the measurements at least twice. Hujazia et al 15 assessed the reliability of measuring HVI using a computerized measurement technique.…”

Section: Discussionmentioning

confidence: 98%

Reliability of the Radiographic Measurement of the Hallux Interphalangeal Angle

Khademi

Saragas

Ferrao

et al. 2020

Foot & Ankle Specialist

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Background The hallux valgus interphalangeus (HVI) deformity has a common association with hallux valgus and hallux rigidus. The HVI is formed by the angle between the long axes of the proximal and distal phalanges. The normal value for this angular deformity in the coronal plane is less than 10°. The aim of this study was to analyze the intra- and inter-observer reliability of measuring the interphalangeal angle by orthopaedic surgeons. This study is the first study to evaluate specifically the reliability and reproducibility of measuring the HVI angle. Methods Twenty-one X-ray prints of weightbearing feet constituted a set. Sixteen qualified orthopaedic surgeons were asked to measure the HVI angle of all 21 X-ray images in the set. Three randomized sets were sent to each evaluator at 4-week intervals. After all 3 sets were measured, data were retrieved and statistically analyzed to determine the inter- and intraobserver variability and reliability in the measurement of the HVI angle. Reproducibility of the HVI measurement was assessed using 3 categories, which included the ability to measure the same angle 3 times and achieve: 3° or less, 5° or less, and more than 5° variation. Results The intraobserver reliability was found to be 5° or less in 85.2% of participants and the interobserver reliability was 81.2%. The researcher did not find significant correlation between the surgeons’ level of experience with regard to the reliability of measuring the HVI angle. Conclusion The inter- and intraobserver reliabilities of measuring the HVI angle is 81.2% and 85.2%, respectively. The level of experience of the surgeon does not improve this reliability. Levels of Evidence Level II

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Section: Discussionmentioning

confidence: 98%

Reliability of the Radiographic Measurement of the Hallux Interphalangeal Angle

Khademi

Saragas

Ferrao

et al. 2020

Foot & Ankle Specialist

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“…The Hallux Angles software had been proven to be an accurate and reproducible method compared with the conventional PACS system [ 11 ]. Yang et al found that the Tiltmeter software in iPhone is superior to PACS in measuring time but with the same accuracy [ 13 ]. Mattos et al even showed that one iPhone app named iPinPoint could even be operated by non-experienced observers, which means patients may be able to self-screening such deformities [ 10 ].…”

Section: Discussionmentioning

confidence: 99%

“…In the past few years, computer-assisted image analysis software and smartphone applications have become widespread in daily use, in which the Picture archiving and communication systems (PACS) were considered as the gold standard. Some applications of iPhone have been developed and described to measure the angles of hallux valgus in previous researches [ 10 – 13 ]. In our previous study, we introduced a brand-new method of measuring the hallux valgus angles conveniently and rapidly with the intrinsic photograph-editing function of Android smartphones [ 14 ].…”

Section: Introductionmentioning

confidence: 99%

Reliability of different smartphones measuring the hallux valgus parameters in a new rapid method: a follow-up study

Wang

Zhang

Liang

et al. 2022

BMC Musculoskelet Disord

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Objective This study aimed to further compare the abilities to measure hallux valgus parameters in different smartphones using the intrinsic photograph-editing function. Methods We retrospectively reviewed 61 patients (100 feet) of hallux valgus without medical or surgical interventions at our department. The radiographic parameters were assessed and measured via the Picture archiving and communication systems (PACS), iPhone, and Android. The accuracy, reliability, and the time-taken were compared and analyzed between each two methods. Results The mean value of measured hallux valgus parameters were as follow: hallux valgus angle (HVA): 33.71 ± 7.25°; the first and second intermetatarsal angle (IMA): 12.84 ± 3.62° in PACS; HVA: 33.59 ± 7.18° and IMA: 12.80 ± 3.65° in Android; HVA: 33.63 ± 7.23° and IMA: 12.87 ± 3.60° in iPhone. No significant difference was found among the average results measured by PACS, Android and iPhone (F = 0.008, P = 0.992 in HVA; F = 0.009, P = 0.991 in IMA). For measurements by PACS, Android smartphone, and iPhone, the variability of HVA (F = 0.061, P = 1.000) and IMA (F = 0.133, P = 1.000) was similar. The intraclass correlation coefficients (ICCs) of the mean results of four times measurements of HVA and IMA as follows: PACS vs Android: 0.995 (0.993–0.997) and 0.982 (0.973–0.988); PACS vs iPhone:0.997 (0.995–0.998) and 0.974 (0.962–0.982); Android vs iPhone:0.997 (0.995–0.998) and 0.981 (0.971–0.987). The interobserver and intraobserver reliability was very good for Android smartphones and iPhone in measuring hallux valgus parameters. The mean time of measurement by PACS, Android smartphone, and iPhone were 25.34 ± 1.18 s, 20.10 ± 0.92 s, and 19.92 ± 0.99 s respectively. The measurement time of smartphones is significantly faster than that of PACS by about 5 seconds (P = 0.000). The measurement time of iPhone was slightly faster than that of Android smartphone, while no significant difference was found (P = 0.24). Conclusion It is more convenient and faster to use smartphones when compared with PACS, at the same level of accuracy. Furthermore, the abilities of different smartphone platforms are proven to be of no significant difference.

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“…The iPhone Hallux Angles app was proven to be a reliable method to measure HVA and IMA when compared to PACS [ 6 ]. The Tiltmeter software for iPhones is precise and less time-consuming than traditional measurements with protractors [ 7 ]. One app named iPinPoint is suggested to be reliable for the measurement of HVA and IMA, even for nonexperienced users [ 8 ].…”

Section: Discussionmentioning

confidence: 99%

A novel rapid measurement of hallux valgus parameters using the built-in photo edit function of smartphones

Huang

Wang

Lü

et al. 2021

BMC Musculoskelet Disord

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Objective The objective of this study was to assess the accuracy and reliability of and time taken by a novel method using the built-in photo-edit function of smartphones compared with PACS in measuring hallux valgus parameters. Methods Seventy patients (124 ft) admitted to our hospital with a diagnosis of hallux valgus without previous surgical procedures were retrospectively reviewed. The foot radiographs of all the patients were extracted from PACS. The hallux valgus angle (HVA) and the first and second intermetatarsal angles (IMAs) were measured by PACS and by this novel method using the built-in photo-edit function of a smartphone. The results of these two methods were compared, and the accuracy and reliability were assessed between these two methods. Results The average parameters measured by PACS were as follows: HVA average: 37.43 ± 9.61°; IMA average: 13.37 ± 4.01°. The average parameters measured by smartphones were as follows: HVA average: 37.09 ± 9.52° and IMA average: 13.49 ± 3.91°. When compared by the independent-samples T test, the average parameters between PACS and smartphones were not significantly different (HVA PACS vs HVA smartphones: P = 0.776; IMA PACS vs IMA smartphones: P = 0.816). The variability of the HVA (F = 0.166, P = 0.992) and IMA (F = 0.215, P = 0.982) measurements was similar for the PACS and smartphones. The ICCs of the average parameters of four measurements of HVA and IMA between PACS and smartphones were 0.995 (0.991–0.997) and 0.970 (0.958–0.979), indicating that the two methods were highly correlated. For the smartphone measurement, the interobserver and intraobserver reliability was very good for HVA and IMA. The average measurement time of PACS was 25.41 ± 0.86 s, and the average measurement time of smartphones was 20.29 ± 1.22 s. The smartphone time was significantly faster than that of PACS by approximately 5 s (P<0.001). Conclusion This novel method using the built-in photo-edit function of smartphones is accurate, reliable, convenient and time-saving in measuring the angles of hallux valgus.

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Radiographic angles in hallux valgus: Comparison between protractor and iPhone measurements

Cited by 13 publications

References 16 publications

Reliability of the Radiographic Measurement of the Hallux Interphalangeal Angle

Reliability of the Radiographic Measurement of the Hallux Interphalangeal Angle

Reliability of different smartphones measuring the hallux valgus parameters in a new rapid method: a follow-up study

A novel rapid measurement of hallux valgus parameters using the built-in photo edit function of smartphones

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