Reliability of Standard Foot Radiographic Measurements

Abstract

Fifty standing dorsoplantar and lateral foot radiographs were obtained on a consecutive series of patients seen in an orthopaedic foot and ankle clinic. These radiographs were duplicated, and eight common foot measurements were made on each pair by six experienced examiners. Measurements were made in two ways: first by a subjective visual assessment, and second by quantitative evaluation made according to strictly defined criteria. All measurements were made under controlled, ideal conditions with similar high quality goniometers. The results demonstrated overall greater reliability in the quantitative methods than the non-quantitative methods. For each of the quantitative techniques, a cumulated frequency distribution of differences between examiners was calculated. The approximate 95% bounds for these measures were: hallux-metatarsophalangeal angle = 6 degrees, first intermetatarsal angle = 4 degrees, metatarsophalangeal-5 angle = 11 degrees, fourth intermetatarsal angle = 4 degrees, AP talocalcaneal angle = 20 degrees, lateral talocalcaneal angle = 12 degrees, sesamoid station = 2 grades, and forefoot width = 5 mm. Physicians using these parameters to make decisions regarding patient care and clinical outcomes need to keep in mind these potential errors in making foot radiographic measurements.

Reproducibility of foot structure measurements in neuropathic diabetic patients using magnetic resonance imaging

“…Saltzman et al (21) determined the interobserver variability of radiographic foot measurements in nondiabetic subjects and found a 95% limit for the MTP joint angle of 6°, which is higher than the limit in the present study (Ͻ3.0°). Using CT, Commean et al (22) assessed the intraobserver reliability of foot structure measurements in the diabetic patient, including MTP joint angle and plantar soft-tissue thickness.…”

Does Alignment in the Hindfoot Radiograph Influence Dynamic Foot-floor Pressures in Ankle and Tibiotalocalcaneal Fusion?

“…The inaccuracy of visual judgment also has been reported by others [1,36,38,44]. Although the reliability of clinical measurement is improved by using a goniometer and a weightbearing position, clinical approaches are less reliable than a radiographic approach [5,13,38].…”

“…Fifth, visual judgment was made by three different observers as patients were seen for followups. Because visual judgment is inaccurate [1,36,38,44], a certain variance must be assumed which may have reduced the correlation of visual with radiographic alignment. Sixth, measurements were made with the patients in bare feet.…”

Tradução e validação do questionário FAOS - FOOT and ankle outcome score para língua portuguesa

“…It is estimated that one ankle sprain occurs among each 10,000 individuals everyday. 9 Appropriate treatments evaluated in an effectively and comparable manner can reduce medical and social costs and favor an earlier return to sports and professional activities. The purpose of this study was to translate and validate the FAOS questionnaire specifically designed for ankle function and symptoms into Portuguese and correlate it to the SF-36 quality of life questionnaire.…”