BACKGROUND: The etiology of lateral hindfoot pain in flatfoot deformity can be difficult to assess on plain radiographs. We hypothesized that multiplanar measurements obtained in a fully upright, weightbearing position would reliably demonstrate an increase in lateral hindfoot arthrosis and/or impingement in a cohort of flatfoot patients with lateral hindfoot pain compared to a cohort without pain. MATERIALS AND METHODS: Ten consecutive patients with flexible flatfoot deformity and lateral hindfoot pain (mean age, 55.5 +/- 13.9) were compared to 10 consecutive patients with flexible deformity but no pain (mean age, 61.0 +/- 8.6). Conventional radiographs and weightbearing multiplanar images were performed on all patients before surgical reconstruction. Flatfoot, hindfoot impingement, and arthrosis parameters were interpreted in a blinded fashion by two musculoskeletal radiologists. Interrater reliability was determined with intraclass correlation coefficients (ICC). All parameters were compared between groups with a Wilcoxon rank sum test (p < 0.05). RESULTS: A significant increase in posterior facet subtalar arthrosis (p = 0.006) and combined anterior and posterior facet subtalar arthrosis (p = 0.022) was evident in the pain group. Calcaneofibular impingement and calcaneocuboid arthritis were increased in the pain group, but did not reach significance (p = 0.057 and p = 0.067 respectively). The multiplanar imaging parameters demonstrated good (ICC = 0.60 to 0.73) to excellent (ICC >or= 0.74) reliability for most impingement and arthrosis parameters and for many of the standard flatfoot parameters. CONCLUSION: The results indicate that weightbearing, multiplanar imaging provides a reliable means of assessing lateral pain in patients with flexible flatfoot deformity.
BACKGROUND: The etiology of lateral hindfoot pain in flatfoot deformity can be difficult to assess on plain radiographs. We hypothesized that multiplanar measurements obtained in a fully upright, weightbearing position would reliably demonstrate an increase in lateral hindfoot arthrosis and/or impingement in a cohort of flatfootpatients with lateral hindfoot pain compared to a cohort without pain. MATERIALS AND METHODS: Ten consecutive patients with flexible flatfoot deformity and lateral hindfoot pain (mean age, 55.5 +/- 13.9) were compared to 10 consecutive patients with flexible deformity but no pain (mean age, 61.0 +/- 8.6). Conventional radiographs and weightbearing multiplanar images were performed on all patients before surgical reconstruction. Flatfoot, hindfoot impingement, and arthrosis parameters were interpreted in a blinded fashion by two musculoskeletal radiologists. Interrater reliability was determined with intraclass correlation coefficients (ICC). All parameters were compared between groups with a Wilcoxon rank sum test (p < 0.05). RESULTS: A significant increase in posterior facet subtalar arthrosis (p = 0.006) and combined anterior and posterior facet subtalar arthrosis (p = 0.022) was evident in the pain group. Calcaneofibular impingement and calcaneocuboid arthritis were increased in the pain group, but did not reach significance (p = 0.057 and p = 0.067 respectively). The multiplanar imaging parameters demonstrated good (ICC = 0.60 to 0.73) to excellent (ICC >or= 0.74) reliability for most impingement and arthrosis parameters and for many of the standard flatfoot parameters. CONCLUSION: The results indicate that weightbearing, multiplanar imaging provides a reliable means of assessing lateral pain in patients with flexible flatfoot deformity.
Authors: Anna Hirschmann; Christian W A Pfirrmann; Georg Klammer; Norman Espinosa; Florian M Buck Journal: Eur Radiol Date: 2013-09-26 Impact factor: 5.315
Authors: Matthieu Lalevée; Nacime Salomao Barbachan Mansur; Edward O Rojas; Hee Young Lee; Samuel J Ahrenholz; Kevin N Dibbern; François Lintz; Cesar de Cesar Netto Journal: Arch Orthop Trauma Surg Date: 2021-07-02 Impact factor: 3.067
Authors: W Zbijewski; P De Jean; P Prakash; Y Ding; J W Stayman; N Packard; R Senn; D Yang; J Yorkston; A Machado; J A Carrino; J H Siewerdsen Journal: Med Phys Date: 2011-08 Impact factor: 4.071