How Reliable is Clinical Evaluation in Hindfoot Coronal Alignment?
Category: Hindfoot Introduction/Purpose: Hindfoot alignment in the coronal plane is an extremely important aspect to consider in order to make a comprehensive evaluation of different foot and ankle disorders. To the authors knowledge the evidence concerning the precision of clinical hindfoot alignme...
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
SAGE Publishing
2016-08-01
|
| Series: | Foot & Ankle Orthopaedics |
| Online Access: | https://doi.org/10.1177/2473011416S00198 |
| _version_ | 1819066879472304128 |
|---|---|
| author | Gaston Slullitel MD Victoria Alvarez MD Juan P. Calvi MD Ana B. Calvo MD |
| author_facet | Gaston Slullitel MD Victoria Alvarez MD Juan P. Calvi MD Ana B. Calvo MD |
| author_sort | Gaston Slullitel MD |
| collection | DOAJ |
| description | Category: Hindfoot Introduction/Purpose: Hindfoot alignment in the coronal plane is an extremely important aspect to consider in order to make a comprehensive evaluation of different foot and ankle disorders. To the authors knowledge the evidence concerning the precision of clinical hindfoot alignment assessment is scarce. The aim of this study is to evaluate correlation and reproducibility between clinical and radiographical hindfoot alignment. Methods: Intra and interobserver reliability of clinical and radiographical hindfoot assessment was performed in 85 patients. Clinical alignment was evaluated on photographs taken at the time of presentation and hindfoot alignment was quantified on long axial view radiographs in neutral rotation position. Photographs were classified into three categories (valgus, neutral and varus) and radiographs were measured taking standardized parameters. Each observer made measurements independently and was blinded to both patient identification and the others’ measurements. All measurements were made on two separate occasions with the order of images randomized. Results: We did not observe a significant correlation between clinical and radiographical assessment (k1a 0,072 - p=0,24; k1b 0,167 - p=0,029; k2a 0,23 - p< 0,001; k2b 0,137 - p=0,021). We did find a good clinical and radiographical intraobserver agreement (K1= 0,789; K2=0,783; Pearson1= 0,956; Pearson2= 0,990). Clinical interobserver agreement was moderate (K1= 0,584; K2=0,566) while radiographical interobserver agreement was statical significant (Pearson1= 0,926; Pearson2= 0,953). Conclusion: Due to a poor clinical-radiographical correlation we should not rely on clinical evaluation to guide the decision making in different foot and ankle conditions. We strongly recommend the use of the long axial view in order to assess the magnitude of the hindfoot deformity. |
| first_indexed | 2024-12-21T16:09:22Z |
| format | Article |
| id | doaj.art-d6c491fd18f94ae1bc9a5b74bccb215c |
| institution | Directory Open Access Journal |
| issn | 2473-0114 |
| language | English |
| last_indexed | 2024-12-21T16:09:22Z |
| publishDate | 2016-08-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Foot & Ankle Orthopaedics |
| spelling | doaj.art-d6c491fd18f94ae1bc9a5b74bccb215c2022-12-21T18:57:49ZengSAGE PublishingFoot & Ankle Orthopaedics2473-01142016-08-01110.1177/2473011416S00198How Reliable is Clinical Evaluation in Hindfoot Coronal Alignment?Gaston Slullitel MDVictoria Alvarez MDJuan P. Calvi MDAna B. Calvo MDCategory: Hindfoot Introduction/Purpose: Hindfoot alignment in the coronal plane is an extremely important aspect to consider in order to make a comprehensive evaluation of different foot and ankle disorders. To the authors knowledge the evidence concerning the precision of clinical hindfoot alignment assessment is scarce. The aim of this study is to evaluate correlation and reproducibility between clinical and radiographical hindfoot alignment. Methods: Intra and interobserver reliability of clinical and radiographical hindfoot assessment was performed in 85 patients. Clinical alignment was evaluated on photographs taken at the time of presentation and hindfoot alignment was quantified on long axial view radiographs in neutral rotation position. Photographs were classified into three categories (valgus, neutral and varus) and radiographs were measured taking standardized parameters. Each observer made measurements independently and was blinded to both patient identification and the others’ measurements. All measurements were made on two separate occasions with the order of images randomized. Results: We did not observe a significant correlation between clinical and radiographical assessment (k1a 0,072 - p=0,24; k1b 0,167 - p=0,029; k2a 0,23 - p< 0,001; k2b 0,137 - p=0,021). We did find a good clinical and radiographical intraobserver agreement (K1= 0,789; K2=0,783; Pearson1= 0,956; Pearson2= 0,990). Clinical interobserver agreement was moderate (K1= 0,584; K2=0,566) while radiographical interobserver agreement was statical significant (Pearson1= 0,926; Pearson2= 0,953). Conclusion: Due to a poor clinical-radiographical correlation we should not rely on clinical evaluation to guide the decision making in different foot and ankle conditions. We strongly recommend the use of the long axial view in order to assess the magnitude of the hindfoot deformity.https://doi.org/10.1177/2473011416S00198 |
| spellingShingle | Gaston Slullitel MD Victoria Alvarez MD Juan P. Calvi MD Ana B. Calvo MD How Reliable is Clinical Evaluation in Hindfoot Coronal Alignment? Foot & Ankle Orthopaedics |
| title | How Reliable is Clinical Evaluation in Hindfoot Coronal Alignment? |
| title_full | How Reliable is Clinical Evaluation in Hindfoot Coronal Alignment? |
| title_fullStr | How Reliable is Clinical Evaluation in Hindfoot Coronal Alignment? |
| title_full_unstemmed | How Reliable is Clinical Evaluation in Hindfoot Coronal Alignment? |
| title_short | How Reliable is Clinical Evaluation in Hindfoot Coronal Alignment? |
| title_sort | how reliable is clinical evaluation in hindfoot coronal alignment |
| url | https://doi.org/10.1177/2473011416S00198 |
| work_keys_str_mv | AT gastonslullitelmd howreliableisclinicalevaluationinhindfootcoronalalignment AT victoriaalvarezmd howreliableisclinicalevaluationinhindfootcoronalalignment AT juanpcalvimd howreliableisclinicalevaluationinhindfootcoronalalignment AT anabcalvomd howreliableisclinicalevaluationinhindfootcoronalalignment |