Abstract

Scientific and technical progress of modern surgical treatment of foot pathology poses new diagnostic tasks for radiologists. Opening of the functional MSCT (fMSCT) of the foot with weight-bearing significantly changed the treatment protocol of patients with acquired foot deformities.

Purpose: to conduct a comparative analysis of the angular parameters on x-ray images anc weight-bearing fMSCT images of the foot in patients with acquired adult flat feet.

Materials and methods: 45 patients (88 feet) were examined, who underwent x-ray examination of the foot with weight-bearing and weight-bearing fMSCT of the foot. On the received images were examined angular indicators of a foot and was carried out statistical comparison of the received results.

Results: after processing the measurement data of fMSCT and x-ray examination it was found that statistically significant differences in the standard definition of the angular parameters of the foot is not determined. To compare the values obtained by radiographic method and fMSCT was used paired Student's t-test. To determine the presence or absence of dependence of the difference of measurements obtained by the two methods from the average values of these measurements were constructed graphs of Bland-Altman. Evaluation of the longitudinal arch angle of the foot showed that all measurements are within the 95% predictive interval. The index of the calcaneal inclination angle, the individual values of the difference were outside the borders of the 95% predictive interval, but do not depend on the measurements.

Conclusion: comparative analysis showed the statistical insignificance of differences in the average values of individual angular indicators measured in the two groups (radiography and fMSCT) The data obtained in the course of the study allow us to assert the possibility of using the fMSCT of the foot with the load as a modern reliable method for assessing the angular parameters of the foot in order to determine the degree of flat deformation.

References

1.     Orthopaedia: national guide. (Under S.P. Mironov, G. P. Kotelnikov). М.: GEOTAR-Media, 2008; 642-646 [In Russ].

2.     Bock P. et al. The inter- and intraobserver reliability for the radiological parameters of flatfoot, before and after surgery. Bone Joint J. 2018; 100: 596-602.

3.     Neri T, Barthelemy R, Tourne Y Radiologic analysis of hindfoot alignment: comparison of Meary, long axial and hindfoot alignment views. Orthop Traumatol Surg Res. 2016.     http://dx.doi.org/10.1016Zj.otsr.2017.08.014.

4.     Saltzman CL, El-Khoury GY The hindfoot alignment view. Foot Ankle Int. 1995; 16 (9): 572-576. DOI: 10.1177/107110079501600911.

5.     Serova NS., Belyaev AS, Bobrov DS, Ternovoy KS. Modern X-ray diagnosis of adult acquired flatfoot deformity. Vestnik Rentgenologii i Radiologii (Russian Journal of Radiology). 2017; 98 (5): 275-80. DOI: 10.20862/00424676-2017-98-5-275-280 [In Russ].

6.     Cheung ZB. et al. Weightbearing CT scan assessment of foot alignment in patients with hallux rigidus. Foot Ankle Int. 2018; 39 (1): 67-74. doi: 10.1177/ 1071100717732549.

7.     Ternovoy SK, Serova NS, Belyaev AS, Bobrov D S, Ternovoy KS. Methodology of functional multispiral computed tomography in the diagnosis of adult flatfoot. REJR. 2017; 7 (1):94-100. DOI:10.21569/2222-7415-2017-7-1- 94-100 [In Russ].

8.     Godoy-Santos AL, Cesar Netto C. Weight-bearing Computed Tomography International Study Group. Weight-bearing computed tomography of the foot and ankle: an update and future directions. Acta Ortop Bras. 2018; 26 (2): 135-9.

9.     Haleem AM. et al. Comparison of deformity with respect to the talus in patients with posterior tibial tendon dysfunction and controls using multiplanar weight-bearing imaging or conventional radiography. J Bone Joint Surg Am. 2014; 96 (8): 63. doi: 10.2106/JBJS.L.01205.

10.   Burssens A. et al. Reliability and correlation analysis of computed methods to convert conventional 2D radiological hindfoot measurements to a 3D setting using weight-bearing CT. Int J Comput Assist Radiol Surg. 2018; 13 (12): 1999-2008. doi: 10.1007/s11548-018-1727-5.

11.   Ternovoy SK, Serova NS, Abramov AS, Ternovoy KS. Functional multislise computed tomography in the diagnosis of cervical spine vertebral-motor segment instability. REJR. 2016; 6 (4):38-43. DOI:10.21569/2222-7415- 2016-6-4-38-43. [In Russ]

12.   Lychagin AV, Rukin YA, Zakharov GG, Serova N.S., Bahvalova V.D, Dhillon H.S. Functional computed tomography for diagnostics of the knee endoprothesis loosening. REJR 2018; 8(4):134-142. DOI: 10.21569/2222-74152018-8-4-134-142 [In Russ].

13.   Tuominen EK. et al. Weight-bearing CT imaging of the lower extremity. AJR Am J Roentgenol. 2013; 200 (1): 146-8. doi: 10.2214/AJR.12.8481.

14.   De Cesar Netto C. et al. Flexible adult acquired flat-foot deformity: comparison between weight-bearing and non-weight-bearing measurements using cone-beam computed tomography. J Bone Joint Surg Am. 2017; 99 (18): 98. doi: 10.2106/JBJS.16.01366.

15.   Ferri M. et al. Weight-bearing CT scan of severe flexible pes planus deformities. Foot Ankle Int. 2008; 29 (2) : 199-204. doi: 10.3113/FAI.2008.0199.

16.   Bobrov DS. et al. Pain syndrome reasons in patients with acquired flatfoot. Kafedra travmatologii I ortopedii. 2015; 2 (14): 8-11 [In Russ].