Weightbearing CT assessment of foot and ankle joints in Pes Planovalgus using distance mapping
Weightbearing CT assessment of foot and ankle joints in Pes Planovalgus using distance mapping
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DOI：
10.1016/j.fas.2021.10.004
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发表时间：
2022-08-05
影响因子：
2.5
通讯作者：
Lintz, Francois
中科院分区：
文献类型：
--
作者：
Bernasconi, Alessio;Netto, Cesar De Cesar;Lintz, Francois
简介：本研究的目的是通过比较一系列平足畸形与一系列正常足部排列，利用负重计算机断层扫描（WBCT）图像上的三维（3D）距离映射，描述平足畸形（PPV）患者踝关节、后足和足中关节的异常关节面相互作用。我们假设在ppv中，关节相互作用会显示踝关节内侧、后足和足中部关节的间隙显著增加。方法：在本病例对照研究中，将10例无症状PPV患者与10例配对（按年龄、性别和体重指数）正常对齐的患者进行比较。根据图像生成三维模型，并生成踝关节、后足关节和足中关节的关节面构型距离图。然后比较两组之间以及同一组中不同区域之间每个关节的距离图。结果：PPV患者踝关节前内侧的体表距离显著增加（+46.3%,p < 0.001），内侧和外踝前半部分的体表距离均显著增加（+21.3%,p = 0.098）和外踝（+22.7%,p = 0.038）。在距下关节后突的后外侧角，我们发现表面到表面的距离增加了（57.1%,p < 0.001），而在距骨棘关节，上内侧角的距离减少了（-20%,p = 0.097），上中央区（+20%,p = 0.039）和外侧区（+30.7%,p = 0.015）明显增加。在跟骨立方关节的四个区域中的三个区域也观察到表面距离的减少。最后，在舟状骨和跗跖关节处观察到的平均距离在38%到93.4%之间有统计学意义的增加（在所有病例中p < 0.001）。结论：我们发现足跖外翻与正常对照在足部和踝关节的表面相互作用有显著差异。WBCT图像的距离定位可作为诊断平翻足关节间隙形态变化的依据。证据等级：III级，病例对照研究。(c) 2021年欧洲足部和脚踝协会。Elsevier Ltd.出版。版权所有。
Introduction: The goal of this study was to describe the abnormal joint surface interaction at the ankle, hindfoot and midfoot joints in patients presenting with Pes Planovalgus (PPV) using three-dimensional (3D) distance mapping on weightbearing computed tomography (WBCT) images by comparing a series of PPVs to a series of normally-aligned feet. We hypothesized that in PPVs joint interactions would reveal significantly increased spaces in the medial side of the ankle, hindfoot and midfoot joints.Methods: In this case-control study, ten feet (10 patients) with asymptomatic PPV were compared to 10 matched-paired (by age, gender and body mass index) normally-aligned feet (10 patients). Three-dimensional models were produced from the images and distance maps representing joint surface configuration were generated for the ankle, hindfoot and midfoot joints. The distance maps for each joint were then compared between the two groups and between regions in the same group.Results: In PPV patients there was a significantly increased surface-to-surface distance anteromedially at the ankle joint (+46.3%, p < 0.001) along with an increased distance on the anterior halves of both the medial (+21.3%, p = 0.098) and lateral malleoli (+22.7%, p = 0.038). At the posterolateral corner of the posterior facet of the subtalar joint we found an increased surface-to-surface distance (by 57.1%, p < 0.001), while at the talonavicular joint there was a reduction of the distance at the superomedial corner (-20%, p = 0.097) along with a significant increase in the upper central (+20%, p = 0.039) and lateral (+30.7%, p = 0.015) zones. A reduction of the surface-to-surface distance was also observed in three of the four zones of the calcaneocuboid joint. Finally, a statistically significant increase in the mean distance was observed at the naviculocuneiform and tarsometatarsal joints in a range between 38% and 93.4% (p < 0.001 in all cases).Conclusion: We found significant differences in surface-to-surface interaction at the foot and ankle joints between Pes Planovalgus and normally-aligned controls. Distance mapping on WBCT images could be used in clinical practice as a diagnostic support to gauge the morphological changes of articular spaces occurring in Pes Planovalgus.Level of evidence: Level III, case-control study.(c) 2021 European Foot and Ankle Society. Published by Elsevier Ltd. All rights reserved.