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Indian J Radiol Imaging. 2019 Oct-Dec;29(4):364-371. doi: 10.4103/ijri.IJRI_288_19. Epub 2019 Dec 31.

Role of the weight-bearing cone-beam CT in evaluation of flatfoot deformity.

Author information

1
Department of Radiodiagnosis, Jankharia Imaging Centre, 383 S V P Road, Bhaveshwar Vihar, Mumbai, Maharashtra, India.
2
Department of Orthopaedics, Breach Candy Hospital Trust, 60 A Bhulabhai Desai Road, Girgaon, Mumbai, Maharashtra, India.
3
Department of Orthopaedics, Sir H N Reliance Foundation Hospital, Raja Rammohan Roy Rd, Prarthana Samaj, Khetwadi, Girgaon, Mumbai, Maharashtra, India.

Abstract

Introduction:

Till date, weight-bearing radiographs have been the cornerstone for planning surgeries on flatfoot. The technique, however, has limitations due to the superimposition of the bones and the lack of reproducibility. Weight-bearing CT with its unique design overcomes these limitations and enables cross-sectional imaging of the foot to be done in the natural weight-bearing position. In this paper, we report our initial experience in weight-bearing cross-sectional imaging of the foot for assessment of flatfoot deformity.

Materials and Methods:

Around 19 known cases of flatfoot were scanned on the weight-bearing CT. Each foot was then assessed for the various angles and also for the presence/absence of extra-articular talocalcaneal impingement and subfibular impingement. Other associated abnormalities like secondary osteoarthritic changes, were also noted.

Results:

The Meary, as well as the calcaneal angles, were abnormal, in all but one separate foot. Forefoot abduction was seen in 7 of the 19 feet. The hind foot valgus angle was greater than 10° in all patients. Extra-articular talocalcaneal impingement was seen in 13 of 19 feet. Secondary osteoarthritic changes were seen in 14 feet.

Conclusion:

Weight-bearing CT scan is a very useful technique for evaluation of flatfoot and associated complications. It overcomes the limitations of the radiographs by providing multiplanar three-dimensional assessment of the foot in the natural weight-bearing position and at the same time being easily reproducible and consistent for the measurements around the foot. The definite advantage over the conventional cross-sectional scanners is the weight-bearing capability.

KEYWORDS:

Extremity CT; flatfoot; pes planus; weight-bearing CT

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