Washington University School of Medicine, Campus Box 8502, 4444 Forest Park Blvd., Room 1101, St. Louis, MO 63108-2212, USA.
Foot Ankle Int. 2011 Sep;32(9):867-72. doi: 10.3113/FAI.2011.0867.
Foot deformity associated with diabetes mellitus (DM) and peripheral neuropathy (PN) contributes to joint instability, ulceration and amputation. This study reports the intrarater and inter-rater measurement precision and least significant change (LSC) of radiological measures of foot deformity in subjects with DM, PN, and foot related complications.
Cuboid height, Meary's angle, calcaneal pitch and hindfoot-forefoot angle were measured from plain-film radiographs on 15 subjects with DM, PN, and foot-related complications. A foot and ankle fellowship-trained orthopedic surgeon with 23 years of experience (Rater 1) measured radiographs twice. A foot and ankle fellowship-trained orthopedic surgeon with 2 years of experience (Rater 2) and a radiologist in residency training (Rater 3) measured radiographs once. Root mean square standard deviation and LSC were calculated to determine measurement precision and the smallest change considered biologically real, not the result of chance.
Intrarater measurement precision was: 0.9 mm for cuboid height, 3 degrees for Meary's angle, and 2 degrees for calcaneal pitch and hindfoot-forefoot angle. Inter-rater measurement precision for rater 1 versus 2 and 1 versus 3 were: 1.7 and 1.6 mm for cuboid height, 4 degrees for Meary's angle, 2 degrees for calcaneal pitch, and 3 degrees for the hindfoot-forefoot angle. The LSC was less than or equal to: 4.7 mm for cuboid, 12 degrees for Meary's angle, 6 degrees for calcaneal pitch, and 8 degrees for hindfoot-forefoot angle.
Cuboid height, calcaneal pitch, and hindfoot-forefoot angle measures can be completed with relatively good measurement precision.
与糖尿病（DM）和周围神经病变（PN）相关的足部畸形会导致关节不稳定、溃疡和截肢。本研究报告了糖尿病、周围神经病变和足部相关并发症患者足部畸形的放射学测量的内部和外部测量精度和最小有意义变化（LSC）。
在 15 名患有糖尿病、周围神经病变和足部相关并发症的患者的普通 X 光片上测量了骰骨高度、Meary 角、跟骨倾斜角和后足-前足角。一位具有 23 年经验的足踝部专科培训骨科医生（评估者 1）对 X 光片进行了两次测量。一位具有 2 年经验的足踝部专科培训骨科医生（评估者 2）和一位住院医师培训放射科医生（评估者 3）对 X 光片进行了一次测量。计算均方根标准偏差和 LSC，以确定测量精度和最小变化，这些变化被认为是生物学上真实的，而不是偶然的结果。
内部评估者的测量精度为：骰骨高度为 0.9 毫米，Meary 角为 3 度，跟骨倾斜角和后足-前足角为 2 度。评估者 1 与 2 以及 1 与 3 之间的外部评估者的测量精度为：骰骨高度为 1.7 和 1.6 毫米，Meary 角为 4 度，跟骨倾斜角为 2 度，后足-前足角为 3 度。LSC 小于或等于：骰骨为 4.7 毫米，Meary 角为 12 度，跟骨倾斜角为 6 度，后足-前足角为 8 度。
骰骨高度、跟骨倾斜角和后足-前足角的测量可以具有相对较好的测量精度。
