How reliable are standard radiographic measures of the foot and ankle in children with achondroplasia?

Jia Xu, Kwang Won Park, Qing Lin Kang, Young Jin Jung, Hae Ryong Song

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Background: Radiographic measurements are typically used in achondroplasia (ACH) during correction of lower limb alignment. However, reliabilities for the measurements on weightbearing radiographs of the foot and ankle in patients with ACH have not been described, and the differences between the ACH population and subjects without ACH likewise have not been well characterized; these issues limit the use of studies on this subject. Questions/purposes: We proposed (1) to measure the inter- and intraobserver reliability of a number of radiographic measures of ankle and foot alignment in an achondroplastic cohort of patients; and (2) to compare our radiographic measurement values with age-matched literature-based normative values. Methods: Ten radiographic measurements were applied to foot and ankle radiographs of 20 children (40 feet) with ACH (mean age, 10 years; range, 8-16 years). Interobserver and intraobserver reliabilities of these radiographic measurement methods were obtained and expressed by intraclass correlation coefficients (ICCs). The mean values were calculated and compared with the literature-based values. Results: The interobserver reliability was excellent for eight measurements with ICCs ranging from 0.801 to 0.962, except for lateral talo-first metatarsal angle and mediolateral column ratio, which were much lower. The intraobserver reliability was excellent for all 10 radiographic measurements with ICCs ranging from 0.812 to 0.998. Compared with existing literature-based values, all 10 measurements had a significant difference (p < 0.01). Conclusions: We suggest tibiotalar angle, calcaneal pitch angle, tibiocalcaneal angle, talocalcaneal angle, naviculocuboid overlap, talonavicular coverage angle, metatarsal stacking angle, and AP talo-first metatarsal angle with excellent interobserver and intraobserver reliabilities should be considered preferentially in analysis of foot and ankle alignment in children with ACH. Level of Evidence: Level II, diagnostic study. See Guidelines for Authors for a complete description of levels of evidence.

Original languageEnglish
Pages (from-to)3021-3028
Number of pages8
JournalClinical Orthopaedics and Related Research
Volume471
Issue number9
DOIs
Publication statusPublished - 2013 Sep 1

Fingerprint

Achondroplasia
Ankle
Foot
Metatarsal Bones
Weight-Bearing
Lower Extremity
Guidelines
Population

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine

Cite this

How reliable are standard radiographic measures of the foot and ankle in children with achondroplasia? / Xu, Jia; Park, Kwang Won; Kang, Qing Lin; Jung, Young Jin; Song, Hae Ryong.

In: Clinical Orthopaedics and Related Research, Vol. 471, No. 9, 01.09.2013, p. 3021-3028.

Research output: Contribution to journalArticle

Xu, Jia ; Park, Kwang Won ; Kang, Qing Lin ; Jung, Young Jin ; Song, Hae Ryong. / How reliable are standard radiographic measures of the foot and ankle in children with achondroplasia?. In: Clinical Orthopaedics and Related Research. 2013 ; Vol. 471, No. 9. pp. 3021-3028.
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abstract = "Background: Radiographic measurements are typically used in achondroplasia (ACH) during correction of lower limb alignment. However, reliabilities for the measurements on weightbearing radiographs of the foot and ankle in patients with ACH have not been described, and the differences between the ACH population and subjects without ACH likewise have not been well characterized; these issues limit the use of studies on this subject. Questions/purposes: We proposed (1) to measure the inter- and intraobserver reliability of a number of radiographic measures of ankle and foot alignment in an achondroplastic cohort of patients; and (2) to compare our radiographic measurement values with age-matched literature-based normative values. Methods: Ten radiographic measurements were applied to foot and ankle radiographs of 20 children (40 feet) with ACH (mean age, 10 years; range, 8-16 years). Interobserver and intraobserver reliabilities of these radiographic measurement methods were obtained and expressed by intraclass correlation coefficients (ICCs). The mean values were calculated and compared with the literature-based values. Results: The interobserver reliability was excellent for eight measurements with ICCs ranging from 0.801 to 0.962, except for lateral talo-first metatarsal angle and mediolateral column ratio, which were much lower. The intraobserver reliability was excellent for all 10 radiographic measurements with ICCs ranging from 0.812 to 0.998. Compared with existing literature-based values, all 10 measurements had a significant difference (p < 0.01). Conclusions: We suggest tibiotalar angle, calcaneal pitch angle, tibiocalcaneal angle, talocalcaneal angle, naviculocuboid overlap, talonavicular coverage angle, metatarsal stacking angle, and AP talo-first metatarsal angle with excellent interobserver and intraobserver reliabilities should be considered preferentially in analysis of foot and ankle alignment in children with ACH. Level of Evidence: Level II, diagnostic study. See Guidelines for Authors for a complete description of levels of evidence.",
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