CME OnDemand: 2022 AOFAS Annual Meeting-Interobserver Reliability of Radiographic Angles and Measurements in Flat Foot Deformity

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This study aimed to determine the inter-observer reliability of various radiographic angles and measurements in flat foot deformity. The study analyzed radiographs of 18 patients with flatfoot deformity using departmental PACS and involved eight clinicians of different experience levels. Eleven radiological parameters were studied, including Meary's angle, Talar-1st MT angle (AP), medial cuneiform height (C1H), medial cuneiform-1st MT angle (C1MTA), talo-navicular angle (TNA), medial cuneiform articular angle (CAA), medial arch sag angle (MASA), calcaneal pitch angle (CPA), talonavicular coverage angle (TNCA), talo-navicular uncoverage percentage (TNUP), and lateral incongruency angle (LIA).<br /><br />The results showed that the inter-observer reliability was good to excellent for most parameters. The parameters with excellent reliability were calcaneal pitch angle (CPA), medial cuneiform height (C1H), and lateral incongruency angle (LIA). The parameters with good reliability were talo-navicular angle (TNA), medial cuneiform articular angle (CAA), medial arch sag angle (MASA), medial cuneiform-1st MT angle (C1MTA), talonavicular coverage angle (TNCA), and Talar-1st MT angle on AP radiograph (T1MTA). The parameters with moderate reliability were Meary's angle and talo-navicular uncoverage percentage (TNUP).<br /><br />The study concluded that most of the parameters analyzed have good to excellent reliability and can be reliably used in clinical practice. However, measurements that cross more than one joint, such as Meary's angle, showed lower reliability. This study is the first to analyze eleven radiographic measurements in flatfoot deformity, providing valuable insights into the inter-observer reliability of these measurements.

Asset Subtitle

Lizzy Weigelt, Darren Myatt, MBChB, MRCS, James Chapman, Matthew Philpott, Shirley Lyle, Gerry Kelly, Sarang P. Kasture, Gavin Heyes, Lyndon W. Mason, MB BCh, MRCS(Eng), FRCS(TR&Orth), FRCS(Glasg), Andrew P. Molloy, MB ChB, FRCS(Tr&Orth)

Keywords

inter-observer reliability

radiographic angles

measurements

flat foot deformity

radiological parameters

calcaneal pitch angle

medial cuneiform height

lateral incongruency angle

talo-navicular angle

Meary's angle