scholarly journals WEIGHT-BEARING COMPUTED TOMOGRAPHY OF THE FOOT AND ANKLE: AN UPDATE AND FUTURE DIRECTIONS

2018 ◽  
Vol 26 (2) ◽  
pp. 135-139 ◽  
Author(s):  
ALEXANDRE LEME GODOY-SANTOS ◽  
CESAR DE CESAR NETTO
Keyword(s):  
Computed Tomography ◽  
Decision Making ◽  
Weight Bearing ◽  
Correct Diagnosis ◽  
Standing Position ◽  
Acquisition Time ◽  
Foot And Ankle ◽  
Level Of Evidence ◽  
Spatial Understanding ◽  
Therapeutic Decision Making

ABSTRACT Spatial understanding of osteoarticular deformities of the foot and ankle is vital to correct diagnosis and therapeutic decision making. Poor reproducibility in conventional standing radiography in three orthogonal views has driven the development of weight-bearing computed tomography (WBCT) technology over the last decade. We analyzed the available literature on WBCT imaging in patients with foot and ankle disorders by performing a literature review of relevant clinical studies in multiple databases including PubMed, MedLine, and Scopus from January 1999 to October 2017. WBCT imaging allows correct evaluation of foot and ankle anatomy with the patient in a standing position, providing images with high spatial resolution, short image acquisition time, low dose of radiation, and costs which are similar to other available imaging technologies. This diagnostic tool can be used for decision making in the treatment of deformities of the ankle, hindfoot, midfoot, and forefoot. Level of Evidence III; Systematic review of level III studies.

scholarly journals Hindfoot alignment using weight-bearing computed tomography

2020 ◽  
Vol 14 (3) ◽  
pp. 239-242
Author(s):  
Eduardo Pires ◽  
Carlos Lôbo ◽  
Cesar De Cesar Netto ◽  
Alexandre Godoy-Santos
Keyword(s):  
Computed Tomography ◽  
Weight Bearing ◽  
Treatment Decision ◽  
Metatarsal Head ◽  
Foot And Ankle ◽  
Level Of Evidence ◽  
Hindfoot Alignment ◽  
Treatment Decision Making ◽  
First Metatarsal ◽  
Block Test

Measurement of hindfoot malalignment and flexibility is essential for treatment decision-making in cavovarus foot deformity. Weight-bearing computed tomography (WBCT) shows greater diagnostic accuracy and allows the study of osteoarticular alignment in the physiological upright position. The most commonly used method for measurements on WBCT scans is the foot and ankle offset (FAO), which is based on the structural tripod of the foot: the calcaneus and the first and fifth metatarsal heads. During the Coleman block test, the first metatarsal head is not resting on the ground and, therefore, does not represent the physiological support of the tripod. We describe a new measurement, the forefoot/hindfoot offset (FHO), for assessing hindfoot alignment on WBCT scans. Level of Evidence V; Diagnostic Studies; Expert Opinion.

Weightbearing Computed Tomography of the Foot and Ankle: Emerging Technology Topical Review

2017 ◽  
Vol 39 (3) ◽  
pp. 376-386 ◽  
Author(s):  
Alexej Barg ◽  
Travis Bailey ◽  
Martinus Richter ◽  
Cesar de Cesar Netto ◽  
François Lintz ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Literature Review ◽  
Imaging Modality ◽  
Weight Bearing ◽  
Emerging Technology ◽  
Review Article ◽  
Cone Beam ◽  
Future Research ◽  
Foot And Ankle ◽  
Level Of Evidence

In the last decade, cone-beam computed tomography technology with improved designs allowing flexible gantry movements has allowed both supine and standing weight-bearing imaging of the lower extremity. There is an increasing amount of literature describing the use of weightbearing computed tomography in patients with foot and ankle disorders. To date, there is no review article summarizing this imaging modality in the foot and ankle. Therefore, we performed a systematic literature review of relevant clinical studies targeting the use of weightbearing computed tomography in diagnosis of patients with foot and ankle disorders. Furthermore, this review aims to offer insight to those with interest in considering possible future research opportunities with use of this technology. Level of Evidence: Level V, expert opinion.

Weight Bearing Cone Beam Computed Tomography (WBCT) in the Foot and Ankle

2020 ◽  
Author(s):  
Martinus Richter ◽  
Francois Lintz ◽  
Cesar de Cesar Netto ◽  
Alexej Barg ◽  
Arne Burssens ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Cone Beam Computed Tomography ◽  
Weight Bearing ◽  
Cone Beam ◽  
Foot And Ankle

scholarly journals Correction to: Weight Bearing Cone Beam Computed Tomography (WBCT) in the Foot and Ankle

2020 ◽  
pp. C1-C1
Author(s):  
Martinus Richter ◽  
Francois Lintz ◽  
Cesar de Cesar Netto ◽  
Alexej Barg ◽  
Arne Burssens ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Cone Beam Computed Tomography ◽  
Weight Bearing ◽  
Cone Beam ◽  
Foot And Ankle

scholarly journals Computed tomography texture analysis to facilitate therapeutic decision making in hepatocellular carcinoma

Oncotarget ◽  
2016 ◽  
Vol 7 (11) ◽  
pp. 13248-13259 ◽  
Author(s):  
Meng Li ◽  
Sirui Fu ◽  
Yanjie Zhu ◽  
Zaiyi Liu ◽  
Shuting Chen ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Hepatocellular Carcinoma ◽  
Decision Making ◽  
Texture Analysis ◽  
Therapeutic Decision ◽  
Therapeutic Decision Making

scholarly journals Hallux valgus measurements using weight-bearing computed tomography: what changes?

2021 ◽  
Vol 15 (3) ◽  
pp. 259-264
Author(s):  
Samuel Braza ◽  
Nacime Salomão Barbachan Mansur ◽  
Vineel Mallavarapu ◽  
Kepler Alencar Mendes de Carvalho ◽  
Kevin Dibbern ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Hallux Valgus ◽  
Case Control Study ◽  
Weight Bearing ◽  
Metatarsal Head ◽  
Case Control ◽  
Retrospective Case ◽  
Level Of Evidence ◽  
Mean Values ◽  
Control Study

Objective: To assess whether traditional hallux valgus (HV) measurements obtained with conventional radiography (CR) correspond to those obtained with weight-bearing computed tomography (WBCT). Methods: In this retrospective case-control study, 26 HV feet and 20 control feet were analyzed with CR and WBCT. Hallux valgus angle (HVA), intermetatarsal angle (IMA), interphalangeal angle (IPA), distal metatarsal articular angle (DMAA), sesamoid station (SS), and first metatarsal head shape were measured. Chi-square tests were used to compare hallux valgus and control patients. T-tests were used to compare CR and WBCT. P-values less than 0.05 were considered significant. Results: WBCT was capable of discriminating patients with HV from controls, showing higher mean values for HV patients than controls in HVA (35.29 and 9.02, p < 0.001), IMA (16.01 and 10.01, p < 0.001), and DMAA (18.90 and 4.10, p < 0.001). When comparing the two methods, differences were not significant between CR and WBCT measurements in HVA (-0.84, p = 0.79), IMA (-0.93, p = 0.39), IPA (1.53, p = 0.09), or SS (p = 0.40), but were significant for DMAA (13.43, p < .0001). CR analysis yielded varied metatarsal head shapes, while all WBCT shape classifications were round.  Conclusion: Unidimensional HV measurements were similar between WBCT and CR, while more three-dimensional findings were not. CR may be used to assess the axial aspects of HV, but multidimensional aspects of the deformity may not be accurately assessed with plain radiographs. Level of Evidence III; Therapeutic Studies; Retrospective Case-Control Study.

Importance of Computed Tomography (CT) in Talar Neck Fractures. Case Studies

2018 ◽  
Vol 20 (1) ◽  
pp. 31-42 ◽  
Author(s):  
Tomasz Stołtny ◽  
Jarosław Pasek ◽  
Maria Leksowska-Pawliczek ◽  
Alina Ostałowska ◽  
Małgorzata Piechota ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Ct Scan ◽  
Ankle Joint ◽  
Weight Bearing ◽  
Correct Diagnosis ◽  
Ct Scans ◽  
Type I ◽  
Joint Rotation ◽  
Talar Neck Fractures

Computed tomography is a modern technique producing high quality image of scanned organs. It plays a significant role in diagnostic work-up on orthopedics wards. This paper presents an analysis of management of two cases of Hawkins type I talar neck fracture with ankle joint rotation. In both patients, the diagnosis was based on conventional radiographs of the ankle joint in two projections and was subsequently verified with CT scans. The findings of a CT scan of the talus had a significant impact on further treatment and physiotherapy. Non-surgical treatment consisting in immobilization with a short leg cast combined with medication and magnetic field therapy produced a positive therapeutic outcome. A follow-up CT scan of the talus revealed bone union with remodelling in both patients. The functional outcome according to the AOFAS scale should be regarded good. Computed tomography is the radiological modality for detecting talar neck fractures and determining the presence of displacement. Follow-up CT scans evaluate the natural process of bone healing, which is crucial for treatment decisions regarding weight-bearing status. A correct diagnosis based on CT helps to prevent the development of necrosis and posttraumatic (secondary) degenerative changes as well as advanced physical disability, especially among youn­ger patients, in whom the injury is most common, consequently helping to avoid a long and costly treatment.

Bone Marrow Edema Syndrome in the Foot and Ankle

2016 ◽  
Vol 37 (12) ◽  
pp. 1364-1373 ◽  
Author(s):  
Seyed Alireza Mirghasemi ◽  
Elly Trepman ◽  
Mohammad Saleh Sadeghi ◽  
Narges Rahimi ◽  
Shervin Rashidinia
Keyword(s):  
Bone Marrow ◽  
Bone Marrow Edema ◽  
Treatment Options ◽  
Correct Diagnosis ◽  
Symptomatic Treatment ◽  
Unknown Etiology ◽  
Foot And Ankle ◽  
Level Of Evidence ◽  
Bone Marrow Edema Syndrome ◽  
Marrow Edema

Bone marrow edema syndrome (BMES) is an uncommon and self-limited syndrome characterized by extremity pain of unknown etiology. Symptoms may include sudden or gradual onset of swelling and pain at rest or during activity, usually at night. This syndrome mostly affects middle-aged men and younger women who have pain in the lower extremities. The most common sites involved with BMES, in decreasing order of frequency, are the bones about the hip, knee, ankle, and foot. The diagnosis of BMES is confirmed with magnetic resonance imaging to exclude other causes of bone marrow edema. The correct diagnosis in the foot and ankle often is delayed because of the low prevalence and nonspecific signs. This delay may intensify bone pain and impair patient function and quality of life. The goal of BMES treatment is to relieve pain and shorten disease duration. Treatment options are limited and may include symptomatic treatment, pharmacologic treatment, and surgery. Level of Evidence: Level V, expert opinion.

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