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Diagnostic performance of MRI measurements to assess hindfoot malalignment. An assessment of four measurement techniques

Buck, Florian ; Hoffmann, Adrienne ; Mamisch-Saupe, Nadja ; Farshad, Mazda ; Resnick, Donald ; Espinosa, Norman ; Hodler, Juerg

In: European Radiology, 2013, vol. 23, no. 9, p. 2594-2601

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    Titre
    • Diagnostic performance of MRI measurements to assess hindfoot malalignment. An assessment of four measurement techniques
    Auteur
    • Buck, Florian. Radiology, University Hospital Balgrist & University of Zurich, Forchstrasse 340, 8008, Zürich, Switzerland
    • Hoffmann, Adrienne. Radiology, University Hospital Balgrist & University of Zurich, Forchstrasse 340, 8008, Zürich, Switzerland
    • Mamisch-Saupe, Nadja. Radiology, University Hospital Balgrist & University of Zurich, Forchstrasse 340, 8008, Zürich, Switzerland
    • Farshad, Mazda. Department of Orthopaedic Surgery, University Hospital Balgrist & University of Zurich, Forchstrasse 340, 8008, Zürich, Switzerland
    • Resnick, Donald. Department of Radiology, University of California San Diego, 3350 La Jolla Village Drive, 92161, San Diego, CA, USA
    • Espinosa, Norman. Department of Orthopaedic Surgery, University Hospital Balgrist & University of Zurich, Forchstrasse 340, 8008, Zürich, Switzerland
    • Hodler, Juerg. Radiology, University Hospital Balgrist & University of Zurich, Forchstrasse 340, 8008, Zürich, Switzerland
    Type de document
    • Postprint
    Langue
    • Anglais
    Publié dans
    • European Radiology, 2013, vol. 23, no. 9, p. 2594-2601. Springer Berlin Heidelberg
    Autre version électronique
    Identifiant OAI-PMH
    • oai:doc.rero.ch:311485
    Summary
    Objective: To investigate the ability of coronal non-weight-bearing MR images to discriminate between normal and abnormal hindfoot alignment. Methods: Three different measurement techniques (calcaneal axis, medial/lateral calcaneal contour) based on weight-bearing hindfoot alignment radiographs were applied in 49 patients (mean, 48years; range 21-76years). Three groups of subjects were enrolled: (1) normal hindfoot alignment (0°-10° valgus); (2) abnormal valgus (>10°); (3) any degree of varus hindfoot alignment. Hindfoot alignment was then measured on coronal MR images using four different measurement techniques (calcaneal axis, medial/lateral calcaneal contour, sustentaculum tangent). ROC analysis was performed to find the MR measurement with the greatest sensitivity and specificity for discrimination between normal and abnormal hindfoot alignment. Results: The most accurate measurement on MR images to detect abnormal hindfoot valgus was the one using the medial calcaneal contour, reaching a sensitivity/specificity of 86%/75% using a cutoff value of >11° valgus. The most accurate measurement on MR images to detect abnormal hindfoot varus was the sustentaculum tangent, reaching a sensitivity/specificity of 91%/71% using a cutoff value of <12° valgus. Conclusion: It is possible to suspect abnormal hindfoot alignment on coronal non-weight-bearing MR images. Key Points : • Abnormal hindfoot alignment can be identified on coronal non-weight-bearing MR images. • The sustentaculum tangent was the best predictor of an abnormally varus hindfoot. • The medial calcaneal contour was the best predictor of a valgus hindfoot