TY - JOUR
T1 - Precision of foot alignment measures in charcot arthropathy
AU - Hastings, Mary K.
AU - Sinacore, David R.
AU - Mercer-Bolton, Nicole
AU - McCormick, Jeremy J.
AU - Hildebolt, Charles F.
AU - Prior, Fred W.
AU - Johnson, Jeffrey E.
PY - 2011/9
Y1 - 2011/9
N2 - Background: Foot deformity associated with diabetes mellitus (DM) and peripheral neuropathy (PN) contributes to joint instability, ulceration and amputation. This study reports the intrarater and inter-rater measurement precision and least significant change (LSC) of radiological measures of foot deformity in subjects with DM, PN, and foot related complications. Methods: Cuboid height, Meary's angle, calcaneal pitch and hindfoot-forefoot angle were measured from plain-film radiographs on 15 subjects with DM, PN, and foot-related complications. A foot and ankle fellowship-trained orthopedic surgeon with 23 years of experience (Rater 1) measured radiographs twice. A foot and ankle fellowship-trained orthopedic surgeon with 2 years of experience (Rater 2) and a radiologist in residency training (Rater 3) measured radiographs once. Root mean square standard deviation and LSC were calculated to determine measurement precision and the smallest change considered biologically real, not the result of chance. Results: Intrarater measurement precision was: 0.9 mm for cuboid height, 3 degrees for Meary's angle, and 2 degrees for calcaneal pitch and hindfoot-forefoot angle. Inter-rater measurement precision for rater 1 versus 2 and 1 versus 3 were: 1.7 and 1.6 mm for cuboid height, 4 degrees for Meary's angle, 2 degrees for calcaneal pitch, and 3 degrees for the hindfootforefoot angle. The LSC was less than or equal to: 4.7 mm for cuboid, 12 degrees for Meary's angle, 6 degrees for calcaneal pitch, and 8 degrees for hindfoot-forefoot angle. Conclusion: Cuboid height, calcaneal pitch, and hindfoot-forefoot angle measures can be completed with relatively good measurement precision.
AB - Background: Foot deformity associated with diabetes mellitus (DM) and peripheral neuropathy (PN) contributes to joint instability, ulceration and amputation. This study reports the intrarater and inter-rater measurement precision and least significant change (LSC) of radiological measures of foot deformity in subjects with DM, PN, and foot related complications. Methods: Cuboid height, Meary's angle, calcaneal pitch and hindfoot-forefoot angle were measured from plain-film radiographs on 15 subjects with DM, PN, and foot-related complications. A foot and ankle fellowship-trained orthopedic surgeon with 23 years of experience (Rater 1) measured radiographs twice. A foot and ankle fellowship-trained orthopedic surgeon with 2 years of experience (Rater 2) and a radiologist in residency training (Rater 3) measured radiographs once. Root mean square standard deviation and LSC were calculated to determine measurement precision and the smallest change considered biologically real, not the result of chance. Results: Intrarater measurement precision was: 0.9 mm for cuboid height, 3 degrees for Meary's angle, and 2 degrees for calcaneal pitch and hindfoot-forefoot angle. Inter-rater measurement precision for rater 1 versus 2 and 1 versus 3 were: 1.7 and 1.6 mm for cuboid height, 4 degrees for Meary's angle, 2 degrees for calcaneal pitch, and 3 degrees for the hindfootforefoot angle. The LSC was less than or equal to: 4.7 mm for cuboid, 12 degrees for Meary's angle, 6 degrees for calcaneal pitch, and 8 degrees for hindfoot-forefoot angle. Conclusion: Cuboid height, calcaneal pitch, and hindfoot-forefoot angle measures can be completed with relatively good measurement precision.
KW - 2nd metatarsal angle
KW - Calcaneal pitch
KW - Cuboid height
KW - Dorsoplantar talocalcaneal bisector
KW - Meary's line
UR - http://www.scopus.com/inward/record.url?scp=80052358563&partnerID=8YFLogxK
U2 - 10.3113/FAI.2011.0867
DO - 10.3113/FAI.2011.0867
M3 - Article
C2 - 22097162
AN - SCOPUS:80052358563
SN - 1071-1007
VL - 32
SP - 867
EP - 872
JO - Foot and Ankle International
JF - Foot and Ankle International
IS - 9
ER -