Issue: July 2012
June 25, 2012
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Study indicates potential of novel imaging modality for detecting flatfoot deformity

Issue: July 2012
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SAN DIEGO — Researchers found more significant differences between patients with adult-acquired flatfoot deformity and controls using 3-D multi-planar weightbearing imaging than X-rays, according to a study presented at the American Orthopaedic Foot and Ankle Society 2012 Annual Meeting.

“Deformity around the talus in flatfoot deformity is multi-factorial, but is notably seen in the talonavicular joint in the saggital plane with both 3-D multi-planar and conventional X-rays,” Amgad M. Haleem, MBBCh, MS, said during his presentation. “Good to excellent agreement was found between both modalities. However, more significant differences were expected by the 3-D multi-planar, which may reflect its accuracy or the small number of controls. There is a potential role for assessing with this modality preoperatively and postoperatively.”

Amgad M. Haleem, MBBCh, MS
Amgad M. Haleem

The researchers collected X-ray and 3-D multi-planar (MP) imaging of 23 patients with flexible, stage II adult-acquired flatfoot deformity between 2009 and 2011. The patients had a mean age of 63 years. The researchers selected 10 patients with different forefoot diagnoses to be used as controls. They then compared 13 3-D MP parameters on axial, saggital and coronal views between the control and flatfoot groups. They also compared AP and lateral views on X-ray between the groups.

Six parameters showed statistical significance between the groups on 3-D MP: axial talar-first metatarsal angle, talonavicular uncoverage percent, saggital talar-first metatarsal angle, talonavicular angle, talocalcaneal angle and “angle of the talus with respect to the floor,” according to the study abstract.

One parameter, lateral talar-first metatarsal angle, was significant between the groups on X-rays. The researchers found three correlations between the imaging modalities: talonavicular coverage angle, naviculocuneiform angle and talocalcaneal angle.

Reference:

  • Haleem AM, Young E, Pavlov H, et al. Comparison of deformity with respect to talus in adult-acquired flatfoot deformity patients and controls using multi-planar weight-bearing imaging vs. conventional radiography. Presented at the American Orthopaedic Foot & Ankle Society 2012 Annual Meeting. June 21-23. San Diego.
  • Disclosure: Haleem has no relevant financial disclosures.