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Assessment of lateral hindfoot pain in acquired flatfoot deformity using weightbearing multiplanar imaging.
Foot Ankle Int. 2010 May; 31(5):361-71.FA

Abstract

BACKGROUND

The etiology of lateral hindfoot pain in flatfoot deformity can be difficult to assess on plain radiographs. We hypothesized that multiplanar measurements obtained in a fully upright, weightbearing position would reliably demonstrate an increase in lateral hindfoot arthrosis and/or impingement in a cohort of flatfoot patients with lateral hindfoot pain compared to a cohort without pain.

MATERIALS AND METHODS

Ten consecutive patients with flexible flatfoot deformity and lateral hindfoot pain (mean age, 55.5 +/- 13.9) were compared to 10 consecutive patients with flexible deformity but no pain (mean age, 61.0 +/- 8.6). Conventional radiographs and weightbearing multiplanar images were performed on all patients before surgical reconstruction. Flatfoot, hindfoot impingement, and arthrosis parameters were interpreted in a blinded fashion by two musculoskeletal radiologists. Interrater reliability was determined with intraclass correlation coefficients (ICC). All parameters were compared between groups with a Wilcoxon rank sum test (p < 0.05).

RESULTS

A significant increase in posterior facet subtalar arthrosis (p = 0.006) and combined anterior and posterior facet subtalar arthrosis (p = 0.022) was evident in the pain group. Calcaneofibular impingement and calcaneocuboid arthritis were increased in the pain group, but did not reach significance (p = 0.057 and p = 0.067 respectively). The multiplanar imaging parameters demonstrated good (ICC = 0.60 to 0.73) to excellent (ICC >or= 0.74) reliability for most impingement and arthrosis parameters and for many of the standard flatfoot parameters.

CONCLUSION

The results indicate that weightbearing, multiplanar imaging provides a reliable means of assessing lateral pain in patients with flexible flatfoot deformity.

Authors+Show Affiliations

Department of Foot and Ankle Surgery, The Hospital for Special Surgery, New York, NY 10021, USA. elliss@hss.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Controlled Clinical Trial
Journal Article

Language

eng

PubMed ID

20460061

Citation

Ellis, Scott J., et al. "Assessment of Lateral Hindfoot Pain in Acquired Flatfoot Deformity Using Weightbearing Multiplanar Imaging." Foot & Ankle International, vol. 31, no. 5, 2010, pp. 361-71.
Ellis SJ, Deyer T, Williams BR, et al. Assessment of lateral hindfoot pain in acquired flatfoot deformity using weightbearing multiplanar imaging. Foot Ankle Int. 2010;31(5):361-71.
Ellis, S. J., Deyer, T., Williams, B. R., Yu, J. C., Lehto, S., Maderazo, A., Pavlov, H., & Deland, J. T. (2010). Assessment of lateral hindfoot pain in acquired flatfoot deformity using weightbearing multiplanar imaging. Foot & Ankle International, 31(5), 361-71. https://doi.org/10.3113/FAI.2010.0361
Ellis SJ, et al. Assessment of Lateral Hindfoot Pain in Acquired Flatfoot Deformity Using Weightbearing Multiplanar Imaging. Foot Ankle Int. 2010;31(5):361-71. PubMed PMID: 20460061.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Assessment of lateral hindfoot pain in acquired flatfoot deformity using weightbearing multiplanar imaging. AU - Ellis,Scott J, AU - Deyer,Timothy, AU - Williams,Benjamin R, AU - Yu,Joseph C, AU - Lehto,Scott, AU - Maderazo,Alex, AU - Pavlov,Helene, AU - Deland,Jonathan T, PY - 2010/5/13/entrez PY - 2010/5/13/pubmed PY - 2010/7/23/medline SP - 361 EP - 71 JF - Foot & ankle international JO - Foot Ankle Int VL - 31 IS - 5 N2 - BACKGROUND: The etiology of lateral hindfoot pain in flatfoot deformity can be difficult to assess on plain radiographs. We hypothesized that multiplanar measurements obtained in a fully upright, weightbearing position would reliably demonstrate an increase in lateral hindfoot arthrosis and/or impingement in a cohort of flatfoot patients with lateral hindfoot pain compared to a cohort without pain. MATERIALS AND METHODS: Ten consecutive patients with flexible flatfoot deformity and lateral hindfoot pain (mean age, 55.5 +/- 13.9) were compared to 10 consecutive patients with flexible deformity but no pain (mean age, 61.0 +/- 8.6). Conventional radiographs and weightbearing multiplanar images were performed on all patients before surgical reconstruction. Flatfoot, hindfoot impingement, and arthrosis parameters were interpreted in a blinded fashion by two musculoskeletal radiologists. Interrater reliability was determined with intraclass correlation coefficients (ICC). All parameters were compared between groups with a Wilcoxon rank sum test (p < 0.05). RESULTS: A significant increase in posterior facet subtalar arthrosis (p = 0.006) and combined anterior and posterior facet subtalar arthrosis (p = 0.022) was evident in the pain group. Calcaneofibular impingement and calcaneocuboid arthritis were increased in the pain group, but did not reach significance (p = 0.057 and p = 0.067 respectively). The multiplanar imaging parameters demonstrated good (ICC = 0.60 to 0.73) to excellent (ICC >or= 0.74) reliability for most impingement and arthrosis parameters and for many of the standard flatfoot parameters. CONCLUSION: The results indicate that weightbearing, multiplanar imaging provides a reliable means of assessing lateral pain in patients with flexible flatfoot deformity. SN - 1071-1007 UR - https://www.unboundmedicine.com/medline/citation/20460061/Assessment_of_lateral_hindfoot_pain_in_acquired_flatfoot_deformity_using_weightbearing_multiplanar_imaging_ L2 - http://journals.sagepub.com/doi/full/10.3113/FAI.2010.0361?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -