Johansson A, Aurell Y, Romanus B
Department of Orthopaedics, Institute of Clinical Sciences, -Sahlgrenska Academy, University of Gothenburg, Gothenburg, -Sweden and Department of Orthopaedics, Skaraborg Hospital, Skövde, Sweden.
Department of Diagnostic Radiology, Sahlgrenska University -Hospital/Mölndal, Gothenburg, Sweden.
J Child Orthop. 2018 Jun 1;12(3):262-272. doi: 10.1302/1863-2548.12.170217.
To establish reproducible posterior ultrasonographic projections for evaluation of the movement in the talocrural joint in clubfeet and normal feet from the perinatal period up to the age of four years.
The feet in 105 healthy children and 46 patients (71 clubfeet and 21 normal feet) were examined. In all, 14 feet in seven patients were examined twice by two examiners independently to evaluate the repeatability of the ultrasonography scans. A posterior sagittal projection was used. The distance from the posterior aspect of the tibial physis to the posterior border of the talocalcaneal joint (Tib. phys - TCJ) was measured with the foot in neutral position and dorsiflexion. In plantar flexion the shortest distance between the tibial physis and the calcaneus was measured. The distance from the skin to the tibial epiphyses and the talus was measured in neutral position. The intraclass correlation coefficient (ICC) was calculated to evaluate the repeatability of the measurements.
The interexaminer reliability was 0.71 to 0.89 ICC. The intra- and interobserver reliability measured as ICC was 0.68 to 0.99 for all measurements. The correlation between Tib. phys. - TCJ and clinical dorsiflexion varied much between the age groups.
Ultrasonography of the posterior aspect of the ankle joint can be done with high interexaminer reliability. The repeatability of image evaluation was high. Correlation to clinical measurements varied, therefore dynamic ultrasound in real time is clinically more useful than single measurements on frozen ultrasound images.
建立可重复的超声后位投影法，用于评估从围产期至4岁的畸形足和正常足的距小腿关节运动情况。
对105名健康儿童和46例患者（71只畸形足和21只正常足）的足部进行检查。共有7例患者的14只脚由两名检查者独立进行了两次检查，以评估超声扫描的可重复性。采用后矢状面投影。在足部处于中立位和背屈位时，测量胫骨骨骺后缘至距跟关节后缘的距离（胫骨骨骺-距跟关节）。在跖屈位时，测量胫骨骨骺与跟骨之间的最短距离。在中立位时，测量皮肤至胫骨骨骺和距骨的距离。计算组内相关系数（ICC）以评估测量的可重复性。
检查者间可靠性的ICC为0.71至0.89。所有测量的观察者内和观察者间可靠性以ICC衡量为0.68至0.99。胫骨骨骺-距跟关节与临床背屈之间的相关性在各年龄组之间差异很大。
踝关节后方超声检查具有较高的检查者间可靠性。图像评估的可重复性很高。与临床测量的相关性各不相同，因此实时动态超声在临床上比静态超声图像的单次测量更有用。
