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How reliable are standard radiographic measures of the foot and ankle in children with achondroplasia?
[achondroplasia]
Radiographic
measurements
are
typically
used
in
achondroplasia
(
ACH
)
during
correction
of
lower
limb
alignment
.
However
,
reliabilities
for
the
measurements
on
weightbearing
radiographs
of
the
foot
and
ankle
in
patients
with
ACH
have
not
been
described
,
and
the
differences
between
the
ACH
population
and
subjects
without
ACH
likewise
have
not
been
well
characterized
;
these
issues
limit
the
use
of
studies
on
this
subject
.
We
proposed
(
1
)
to
measure
the
inter-
and
intraobserver
reliability
of
a
number
of
radiographic
measures
of
ankle
and
foot
alignment
in
an
achondroplastic
cohort
of
patients
;
and
(
2
)
to
compare
our
radiographic
measurement
values
with
age-matched
literature-based
normative
values
.
Ten
radiographic
measurements
were
applied
to
foot
and
ankle
radiographs
of
20
children
(
40
feet
)
with
ACH
(
mean
age
,
10
years
;
range
,
8
-
16
years
)
.
Interobserver
and
intraobserver
reliabilities
of
these
radiographic
measurement
methods
were
obtained
and
expressed
by
intraclass
correlation
coefficients
(
ICCs
)
.
The
mean
values
were
calculated
and
compared
with
the
literature-based
values
.
The
interobserver
reliability
was
excellent
for
eight
measurements
with
ICCs
ranging
from
0
.
801
to
0
.
962
,
except
for
lateral
talo-
first
metatarsal
angle
and
mediolateral
column
ratio
,
which
were
much
lower
.
The
intraobserver
reliability
was
excellent
for
all
10
radiographic
measurements
with
ICCs
ranging
from
0
.
812
to
0
.
998
.
Compared
with
existing
literature-based
values
,
all
10
measurements
had
a
significant
difference
(
p
<
0
.
01
)
.
We
suggest
tibiotalar
angle
,
calcaneal
pitch
angle
,
tibiocalcaneal
angle
,
talocalcaneal
angle
,
naviculocuboid
overlap
,
talonavicular
coverage
angle
,
metatarsal
stacking
angle
,
and
AP
talo-
first
metatarsal
angle
with
excellent
interobserver
and
intraobserver
reliabilities
should
be
considered
preferentially
in
analysis
of
foot
and
ankle
alignment
in
children
with
ACH
.
Diseases
Validation
Diseases presenting
"mediolateral column ratio"
symptom
achondroplasia
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