Comparison of Angle Measurements on Hallux Valgus with Two Different Methods Using Digital Images

디지털 영상을 이용한 무지 외반증 변형각 측정에서 서로 다른 두 계측 방법의 비교

  • Sung, Il-Hoon (Department of Orthopaedic Surgery, Hanyang University College of Medicine) ;
  • Kim, Ki Chun (Department of Orthopaedic Surgery, Hongik General Hospital) ;
  • Sung, Chang-Ho (Department of Orthopaedic Surgery, Hanyang University College of Medicine) ;
  • Seo, Woo-Young (Department of Orthopaedic Surgery, Himchan Hospital) ;
  • Lee, Doo-Yeon (Department of Orthopaedic Surgery, Mediheal Hospital) ;
  • Cho, Young A (Department of Orthopaedic Surgery, Good Shepherd Hospital)
  • 성일훈 (한양대학교 의과대학 정형외과학교실) ;
  • 김기천 (홍익병원 정형외과) ;
  • 성창호 (한양대학교 의과대학 정형외과학교실) ;
  • 서우영 (힘찬 병원 정형외과) ;
  • 이두연 (메디힐 병원 정형외과) ;
  • 조영아 (선한 목자 병원 정형외과)
  • Received : 2013.01.20
  • Accepted : 2013.02.14
  • Published : 2013.03.15

Abstract

Purpose: To study inter- and intra-observer reliabilities of computerized measurements of the angular parameters of hallux valgus deformity, using two different kinds of software tools for angle measurement on the digital radiography. Materials and Methods: On 35 digital radiographies of standing foot anteroposterior view of hallux valgus, two observers (A, B) independently measured hallux valgus angle (HVA) and 1-2 intermetatarsal angle ($IMA_{1-2}$) twice, using two methods. In method I, an angle was determined from duplicated lines to longitudinal axes made for bisecting line on the target bones with software tool. In method II, an angle was calculated automatically and directly from bisecting lines (longitudinal axes) made on the target bones. We compared two methods using paired t-test to determine significance of differences. Inter- and intraobserver reliabilities were evaluated using the intraclass correlation coefficients (ICC). Results: There were no significant differences between measurements of method I and II for each observer (p>0.05) and intraobserver reliability were good. (ICC>0.9) Inter-observer reliability for method I and II was good of the HVA (ICCs, 0.912 and 0.905) and moderate of the $IMA_{1-2}$ (ICCs, 0.505 and 0.537). There were interobserver differences in HVA of method I and II. Conclusion: No significant difference was found statistically between measurements of method I and II. Both methods I and II would be acceptable to measure angular parameters of hallux valgus deformity.

Keywords

References

  1. Pique-Vidal C, Maled-Garcia I, Arabi-Moreno J, Vila J. Radiographic angles in hallux valgus: differences between measurements made manually and with a computerized program. Foot Ankle Int. 2006;27:175-80. https://doi.org/10.1177/107110070602700304
  2. Farber DC, Deorio JK, Steel MW, 3rd. Goniometric versus computerized angle measurement in assessing hallux valgus. Foot Ankle Int. 2005;26:234-8. https://doi.org/10.1177/107110070502600309
  3. Srivastava S, Chockalingam N, El Fakhri T. Radiographic angles in hallux valgus: comparison between manual and computer-assisted measurements. J Foot Ankle Surg. 2010; 49:523-8. https://doi.org/10.1053/j.jfas.2010.07.012
  4. Sung I-H, Lee D-Y, Sung C-H, Seo W-Y. Computerized Measurement on Angular Parameters for Hallux Valgus:Comparison of 100% and 150% Magnified Digital Radiography. J Korean Foot Ankle Soc. 2012;16:53-57.
  5. Coughlin MJ, Saltzman CL, Nunley JA, 2nd. Angular measurements in the evaluation of hallux valgus deformities: a report of the ad hoc committee of the American Orthopaedic Foot & Ankle Society on angular measurements. Foot Ankle Int. 2002;23:68-74. https://doi.org/10.1177/107110070202300114
  6. Shrout PE, Fleiss JL. Intraclass correlations: uses in assessing rater reliability. Psychol Bull. 1979;86:420-8. https://doi.org/10.1037/0033-2909.86.2.420
  7. Pisano ED, Cole EB, Hemminger BM et al. Image processing algorithms for digital mammography: a pictorial essay. Radiographics. 2000;20:1479-91. https://doi.org/10.1148/radiographics.20.5.g00se311479
  8. De Carvalho A, Vialle R, Thomsen L et al. Reliability analysis for manual measurement of coronal plane deformity in adolescent scoliosis. Are $30{\times}90$cm plain films better than digitized small films? Eur Spine J. 2007;16:1615-20. https://doi.org/10.1007/s00586-007-0437-4
  9. Van Vo H, Safiedine AM, Short T, Merrill T. A comparison of 4 common methods of hand-measured techniques with a computerized technique to measure the first intermetatarsal angle. J Foot Ankle Surg. 2004;43:395-9. https://doi.org/10.1053/j.jfas.2004.09.005
  10. Coughlin MJ, Freund E. Roger A. Mann Award. The reliability of angular measurements in hallux valgus deformities. Foot Ankle Int. 2001;22:369-79. https://doi.org/10.1177/107110070102200503
  11. Saltzman CL, Brandser EA, Berbaum KS et al. Reliability of standard foot radiographic measurements. Foot Ankle Int. 1994;15:661-5. https://doi.org/10.1177/107110079401501206
  12. Resch S, Ryd L, Stenstrom A, Johnsson K, Reynisson K. Measuring hallux valgus: a comparison of conventional radiography and clinical parameters with regard to measurement accuracy. Foot Ankle Int. 1995;16:267-70. https://doi.org/10.1177/107110079501600504
  13. Shima H, Okuda R, Yasuda T, Jotoku T, Kitano N, Kinoshita M. Radiographic measurements in patients with hallux valgus before and after proximal crescentic osteotomy. J Bone Joint Surg Am. 2009;91:1369-76. https://doi.org/10.2106/JBJS.H.00483