Static Rearfoot Alignment

Lamm, Bradley M.; Mendicino, Robert W.; Catanzariti, Alan R.; Hillstrom, Howard J.

doi:10.7547/0950026

Cited by 73 publications

(27 citation statements)

References 10 publications

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“…To record the long axial view, the film cassette was lying flat on the floor [15]. Volunteers stood on the cassette and were asked to hold their ankle in 10° of dorsal flexion, which was verified by a goniometer.…”

Section: Methodsmentioning

confidence: 99%

“…Two other radiographic projections have been described to overcome this problem: the hindfoot alignment view [11–14] (Fig. 1) and the long axial view [15–17] (Fig. 2).…”

Section: Introductionmentioning

confidence: 99%

“…2). Measurements of hindfoot alignment on both views have been compared by Lamm et al [15], who reported a significant correlation between both methods in a bilateral weight-bearing stance. However, the reliability of both views has not yet been compared.…”

Section: Introductionmentioning

confidence: 99%

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Measuring hindfoot alignment radiographically: the long axial view is more reliable than the hindfoot alignment view

et al. 2010

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BackgroundHindfoot malalignment is a recognized cause of foot and ankle disability. For preoperative planning and clinical follow-up, reliable radiographic assessment of hindfoot alignment is important. The long axial radiographic view and the hindfoot alignment view are commonly used for this purpose. However, their comparative reliabilities are unknown. As hindfoot varus or valgus malalignment is most pronounced during mid-stance of gait, a unilateral weight-bearing stance, in comparison with a bilateral stance, could increase measurement reliability. The purpose of this study was to compare the intra- and interobserver reliability of hindfoot alignment measurements of both radiographic views in bilateral and unilateral stance.Materials and methodsA hindfoot alignment view and a long axial view were acquired from 18 healthy volunteers in bilateral and unilateral weight-bearing stances. Hindfoot alignment was defined as the angular deviation between the tibial anatomical axis and the calcaneus longitudinal axis from the radiographs. Repeat measurements of hindfoot alignment were performed by nine orthopaedic examiners.ResultsMeasurements from the hindfoot alignment view gave intra- and interclass correlation coefficients (CCs) of 0.72 and 0.58, respectively, for bilateral stance and 0.91 and 0.49, respectively, for unilateral stance. The long axial view showed, respectively, intra- and interclass CCs of 0.93 and 0.79 for bilateral stance and 0.91 and 0.58 for unilateral stance.ConclusionThe long axial view is more reliable than the hindfoot alignment view or the angular measurement of hindfoot alignment. Although intra-observer reliability is good/excellent for both methods, only the long axial view leads to good interobserver reliability. A unilateral weight-bearing stance does not lead to greater reliability of measurement.

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Section: Methodsmentioning

confidence: 99%

“…Two other radiographic projections have been described to overcome this problem: the hindfoot alignment view [11–14] (Fig. 1) and the long axial view [15–17] (Fig. 2).…”

Section: Introductionmentioning

confidence: 99%

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Measuring hindfoot alignment radiographically: the long axial view is more reliable than the hindfoot alignment view

et al. 2010

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“…RCSP can be evaluated using various methods, but a composite measure that includes malleolar valgus index (MVI), rearfoot alignment view, and long leg calcaneal axial view has shown high accuracy (r = 0.814) [144]. MVI is a static measurement taken with a flatbed computer scan of the plantar foot [144, 145]. MVI is calculated by dividing the distance between the center of the transmalleolar width to the foot bisection at the heel multiplied by 100.…”

Section: Ankle Painmentioning

confidence: 99%

“…Rearfoot alignment in terms of rearfoot varus/valgus is discussed in the section on Static Structure and Alignment of the Foot (Figure 1) [146]; however, different cut-off angles are also used [147, 148]. The long leg calcaneal axial view is a radiographic technique that provides a view of the subtalar space and alignment of the calcaneus with the tibia [144, 149, 150]. Yet since these measures require extensive equipment and set-up, it can be challenging to incorporate these assessments into clinical settings.…”

Section: Ankle Painmentioning

confidence: 99%

Musculoskeletal conditions of the foot and ankle: Assessments and treatment options

Rao

Riskowski

Hannan

2012

Best Practice & Research Clinical Rheumatology

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Musculoskeletal conditions of the foot and ankle are an important public health challenge due to their increasing incidence combined with their substantial negative impact on patients’ quality of life. Non-pharmacological treatments serve as the first line of treatment and are frequently used for patients with musculoskeletal conditions of the foot and ankle. This review provides a summary of the assessments and non-invasive treatment options based upon available evidence. Recent studies show that individuals with foot and ankle pain have multiple co-existing impairments in alignment, motion, load distribution and muscle performance that may be evident in static and/or dynamic tasks. Additionally, both clinical and epidemiological studies support the inter-dependence between the foot and proximal joints. For instance, aberrant foot structure has been linked to foot osteoarthritis (OA), as well as OA and pain at the knee and hip. Most recently, advances in motion capture technology and plantar load distribution measurement offer opportunities for precise dynamic assessments of the foot and ankle. In individuals with musculoskeletal conditions of the foot and ankle, the chief objectives of treatment are to afford pain relief, restore mechanics (alignment, motion and/or load distribution) and return the patient to their desired level of activity participation. Given that most patients present with multiple impairments, combinational therapies that target foot-specific as well as global impairments have shown promising results. In particular, in individuals with rheumatoid arthritis and other rheumatic diseases, comprehensive rehabilitation strategies including early detection, foot-based interventions (such as orthoses) and wellness-based approaches for physical activity and self-management have been successful. While significant improvements have been made in the last decade to the assessment and treatment of foot and ankle conditions, few randomized clinical trials specifically have investigated patients with foot or ankle conditions to provide global insights into this area. Consequently, current recommendations vary based upon the scope of studies presented in this review as well as the strength of studies. This review indicates a need for more in-depth investigations into the components of assessment and treatment options for foot and ankle musculoskeletal conditions.

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First Ray Kinematics in Women With Rheumatoid Arthritis and Bunion Deformity: A Gait Simulation Imaging Study

Glasoe

Jensen

Kampa

et al. 2014

Arthritis Care & Research

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Objective. The first ray plays a role in the development of bunion foot deformity, but for unknown reasons. This prospective, cross-sectional study investigated first ray kinematics in women with rheumatoid arthritis (RA) and bunion. Methods. Nine participants having RA-bunion were analyzed in comparison to a control group (n ‫؍‬ 10). Data were acquired using a magnetic resonance scanner. Conditions were standardized to simulate gait midstance, heel off, and terminal stance. Foot posture (hallux angle, intermetatarsal angle, arch angle, and calcaneus angle) and relative first ray position angles/helical axis parameters registered across gait conditions were measured. An analysis of variance model compared data between groups and across conditions, and correlation assessed the relationship between selected variables. Results. Eversion of the calcaneus averaged 9°, and adduction of the first ray was increased (F ‫؍‬ 6.29, P ‫؍‬ 0.02) by >4.6°a cross conditions in the RA-bunion group. There was an interaction (F ‫؍‬ 7.73, P ‫؍‬ 0.01) for the first ray axis. Followup comparisons identified increased inclination of the first ray axis over middle stance compared to late stance in the group with RA and bunion. There was moderate correlation (r ‫؍‬ ؊0.42) between the calcaneus angle of eversion and inclination of the first ray axis. Conclusion. Optimal treatment for bunion has not been defined. This research identified calcaneus eversion and first ray adduction, as well as inclination of the first ray axis as risk factors of bunion. This result may inform the evaluation and treatment of bunion in women with RA.

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Static Rearfoot Alignment

Cited by 73 publications

References 10 publications

Measuring hindfoot alignment radiographically: the long axial view is more reliable than the hindfoot alignment view

Measuring hindfoot alignment radiographically: the long axial view is more reliable than the hindfoot alignment view

Musculoskeletal conditions of the foot and ankle: Assessments and treatment options

First Ray Kinematics in Women With Rheumatoid Arthritis and Bunion Deformity: A Gait Simulation Imaging Study

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