A reliable radiographic measurement for evaluation of normal distal tibiofibular syndesmosis: a multi‐detector computed tomography study in adults
Abstract Background Syndesmotic injury may be difficult to diagnose, and radiological evaluation is very important. The purpose of this study was to offer a series of reliable and repeatable normal tibiofibular syndesmosis parameters in diagnosing injuries of the syndesmosis. Methods Multi‐detector...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2015-01-01
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| Series: | Journal of Foot and Ankle Research |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13047-015-0093-6 |
| _version_ | 1797321410124709888 |
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| author | Yanxi Chen Minfei Qiang Kun Zhang Haobo Li Hao Dai |
| author_facet | Yanxi Chen Minfei Qiang Kun Zhang Haobo Li Hao Dai |
| author_sort | Yanxi Chen |
| collection | DOAJ |
| description | Abstract Background Syndesmotic injury may be difficult to diagnose, and radiological evaluation is very important. The purpose of this study was to offer a series of reliable and repeatable normal tibiofibular syndesmosis parameters in diagnosing injuries of the syndesmosis. Methods Multi‐detector computed tomography (MDCT) and radiographs of the distal tibiofibular syndesmosis in 484 cases were retrospectively reviewed. Relevant parameters included the tibiofibular clear space (TCS), the tibiofibular overlap (TFO), the depth of the incisura fibularis (IFD), and the height of the incisura fibularis (IFH), which were measured by novel three‐dimensional (3‐D) and two‐dimensional (2‐D) techniques. The distance between the measuring plane of the distal tibiofibular syndesmosis and the tibial plafond was measured. Intra‐ and inter‐rater reliability was assessed by intraclass correlation coefficient (ICC) and the root mean square standard deviation (RMS‐SD), to determine measurement precision. Sex differences of parameters were analyzed using analysis of covariance (ANCOVA) with body height as the covariate. Paired sample t‐testing was used to compare parameters in different image modalities, including radiography, and 2‐D and 3‐D CT. Results The reliability of the 3‐D images measurement (ICC range, 0.907 to 0.972) was greater than that for the 2‐D axial images (ICC range, 0.895 to 0.927), and the AP view radiographs (ICC range, 0.742 to 0.838). The intra‐rater RMS‐SD of the 3‐D CT, 2‐D CT and radiographic measurements were less than 0.94 mm, 0.26 mm, and 2.87 mm, respectively. The measuring plane of the distal tibiofibular syndesmosis showed the sex difference, which was 12.1 mm proximal to the tibial plafond in the male group and 7.8 mm in the female group. In this plane, the parameters for tibiofibular syndesmosis were measured in different image modalities. All variables were significantly different between females and males (p < 0.05). Conclusions 3‐D measurement technique could be helpful to identify the precise measurement planes for syndesmosis, which were not at the fixed level above the tibial plafond because of the sex difference. In this plane, reliable measurement results could be provided, in either 2‐D or 3‐D MDCT images. |
| first_indexed | 2024-03-08T04:58:14Z |
| format | Article |
| id | doaj.art-291bad3d84f248028e1406d43a9ecfa7 |
| institution | Directory Open Access Journal |
| issn | 1757-1146 |
| language | English |
| last_indexed | 2024-03-08T04:58:14Z |
| publishDate | 2015-01-01 |
| publisher | Wiley |
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| series | Journal of Foot and Ankle Research |
| spelling | doaj.art-291bad3d84f248028e1406d43a9ecfa72024-02-07T14:57:49ZengWileyJournal of Foot and Ankle Research1757-11462015-01-0181n/an/a10.1186/s13047-015-0093-6A reliable radiographic measurement for evaluation of normal distal tibiofibular syndesmosis: a multi‐detector computed tomography study in adultsYanxi Chen0Minfei Qiang1Kun Zhang2Haobo Li3Hao Dai4Department of Orthopedic TraumaShanghai East HospitalTongji University School of Medicine150 Jimo Road200120ShanghaiChinaDepartment of Orthopedic TraumaShanghai East HospitalTongji University School of Medicine150 Jimo Road200120ShanghaiChinaDepartment of Orthopedic TraumaShanghai East HospitalTongji University School of Medicine150 Jimo Road200120ShanghaiChinaDepartment of Orthopedic TraumaShanghai East HospitalTongji University School of Medicine150 Jimo Road200120ShanghaiChinaDepartment of Orthopedic TraumaShanghai East HospitalTongji University School of Medicine150 Jimo Road200120ShanghaiChinaAbstract Background Syndesmotic injury may be difficult to diagnose, and radiological evaluation is very important. The purpose of this study was to offer a series of reliable and repeatable normal tibiofibular syndesmosis parameters in diagnosing injuries of the syndesmosis. Methods Multi‐detector computed tomography (MDCT) and radiographs of the distal tibiofibular syndesmosis in 484 cases were retrospectively reviewed. Relevant parameters included the tibiofibular clear space (TCS), the tibiofibular overlap (TFO), the depth of the incisura fibularis (IFD), and the height of the incisura fibularis (IFH), which were measured by novel three‐dimensional (3‐D) and two‐dimensional (2‐D) techniques. The distance between the measuring plane of the distal tibiofibular syndesmosis and the tibial plafond was measured. Intra‐ and inter‐rater reliability was assessed by intraclass correlation coefficient (ICC) and the root mean square standard deviation (RMS‐SD), to determine measurement precision. Sex differences of parameters were analyzed using analysis of covariance (ANCOVA) with body height as the covariate. Paired sample t‐testing was used to compare parameters in different image modalities, including radiography, and 2‐D and 3‐D CT. Results The reliability of the 3‐D images measurement (ICC range, 0.907 to 0.972) was greater than that for the 2‐D axial images (ICC range, 0.895 to 0.927), and the AP view radiographs (ICC range, 0.742 to 0.838). The intra‐rater RMS‐SD of the 3‐D CT, 2‐D CT and radiographic measurements were less than 0.94 mm, 0.26 mm, and 2.87 mm, respectively. The measuring plane of the distal tibiofibular syndesmosis showed the sex difference, which was 12.1 mm proximal to the tibial plafond in the male group and 7.8 mm in the female group. In this plane, the parameters for tibiofibular syndesmosis were measured in different image modalities. All variables were significantly different between females and males (p < 0.05). Conclusions 3‐D measurement technique could be helpful to identify the precise measurement planes for syndesmosis, which were not at the fixed level above the tibial plafond because of the sex difference. In this plane, reliable measurement results could be provided, in either 2‐D or 3‐D MDCT images.https://doi.org/10.1186/s13047-015-0093-6Ankle jointTomographySpiral computedImagingThree‐dimensionalImage processing |
| spellingShingle | Yanxi Chen Minfei Qiang Kun Zhang Haobo Li Hao Dai A reliable radiographic measurement for evaluation of normal distal tibiofibular syndesmosis: a multi‐detector computed tomography study in adults Journal of Foot and Ankle Research Ankle joint Tomography Spiral computed Imaging Three‐dimensional Image processing |
| title | A reliable radiographic measurement for evaluation of normal distal tibiofibular syndesmosis: a multi‐detector computed tomography study in adults |
| title_full | A reliable radiographic measurement for evaluation of normal distal tibiofibular syndesmosis: a multi‐detector computed tomography study in adults |
| title_fullStr | A reliable radiographic measurement for evaluation of normal distal tibiofibular syndesmosis: a multi‐detector computed tomography study in adults |
| title_full_unstemmed | A reliable radiographic measurement for evaluation of normal distal tibiofibular syndesmosis: a multi‐detector computed tomography study in adults |
| title_short | A reliable radiographic measurement for evaluation of normal distal tibiofibular syndesmosis: a multi‐detector computed tomography study in adults |
| title_sort | reliable radiographic measurement for evaluation of normal distal tibiofibular syndesmosis a multi detector computed tomography study in adults |
| topic | Ankle joint Tomography Spiral computed Imaging Three‐dimensional Image processing |
| url | https://doi.org/10.1186/s13047-015-0093-6 |
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