The Grading of Hallux Valgus

Abstract

This article describes a new, noninvasive method of assessing the severity of hallux valgus deformity by means of a set of standardized photographs. Six podiatrists were independently asked to grade the level of deformity of 13 subjects (26 feet) on a scale of 1 (no deformity) to 4 (severe deformity). The reliability of the four-point scale for the severity of hallux valgus was investigated by means of kappa-type statistics for more than two raters. The results showed that the grading method had excellent interobserver repeatability with a combined kappa-type statistic of 0.86, making it a suitable instrument for clinical and research purposes.

Functional Impairments Characterizing Mild, Moderate, and Severe Hallux Valgus

“…The foot with the greater HV angle was chosen for HV participants (n ϭ 60; 28 right feet, 32 left feet), while for control participants (n ϭ 30) the right or left foot was chosen at random using a random number generator (15 right feet, 15 left feet). HV participants were classified as mild, moderate, or severe in accordance with clinical convention (40). K-means cluster analysis was performed to partition observations of radiographic HV angle into 3 groups, which were defined as mild, moderate, and severe.…”

Validity and Reliability of Hallux Valgus Angle Measured on Digital Photographs

“…The Manchester scale, which is based on visual comparison with 4 standardized photographs of increasing HV severity, has been validated against radiographs and shown to be reliable. 9, 17 Roddy et al 23 validated a similar 5-grade scale based on line drawings for self-reporting of HV. Although these scales are useful for classifying the severity of deformity, they have limited clinical utility when an incremental measure of the progression of HV deformity is required.…”

Myofascial Trigger Point: Symptoms, Diagnosis, Intervention

“…I n t h i s s c e n a r i o , i t i s v e r y t e m p t i n g t o a s s u m e a n d w i t h o u t f u r t h e r investigations of a muscular nature, dismiss it as early onset of neuropathy or peripheral vascular disease. In another situation, a patient presented with mild hallux abducto valgus (bunion) according to the (Garrow et al, 2001), no pressure-related lesions noted but hypersensitive to footwear and light touch at the joint medially and pain radiating into the proximal phalanx dorsally. The overlap in each of these scenarios may confuse the clinical picture and can undermine the confidence of an accurate diagnosis.…”