J Am Podiatr Med Assoc. 2020 Jul 1;110(4). doi: 10.7547/18-119.
The aim of this study was to investigate the relationship between foot deformities by comparing foot radiographs of patients with complaints of foot pain with those of healthy individuals.
The study included 30 patients with pes cavus, 30 patients with pes planus, 30 patients with calcaneal spur, and 30 controls aged 30 to 60 years. All participants underwent measurement of right and left foot length; metatarsophalangeal width; and calcaneal pitch (CA), talohorizontal (TA), talometatarsal (TM), and lateral talocalcaneal (LTC) angles from lateral radiographs.
There were no statistically significant differences between all participants regarding sex, age, weight, and body mass index (P > .05). Among patients with clinically diagnosed pes cavus, the diagnostic rate of CA was 100% in both feet, and 83.3% in the right foot and 96.7% in the left foot according to the TM angle. The diagnostic rates of angular measurements in patients with pes planus were as follows: 20% in the right foot and 30% in the left foot depending on the CA angle, 100% in both feet depending on the TM angle, and 66.7% in the right foot and 46.7% in the left foot depending on the LTC angle. A very strong positive correlation was found between the CA and LTC angles in patients with calcaneal spur and pes planus (P < .001); also, statistically significant positive correlation was found between the CA and TA angles (P < .05). The angular measurements in patients with calcaneal spur were found to be consistent with pes planus with a high rate.
Angular changes caused by deterioration of foot biomechanics lead to various deformities. Pes planus ranks first among these. Therefore, we believe that radiographic angular measurements in patients presenting with foot pain in addition to clinical evaluation would be useful in considering associated deformities and planning treatments.
本研究旨在通过比较足部疼痛患者和健康个体的足部 X 光片,探讨足部畸形之间的关系。
本研究纳入 30 例高弓足患者、30 例扁平足患者、30 例跟骨骨刺患者和 30 例年龄在 30 至 60 岁之间的健康对照者。所有参与者均接受了右侧和左侧足长、跖趾关节宽度以及跟骨倾斜角(CA)、距下关节(TA)、距跟关节(TM)和外侧跟距角(LTC)的测量。
所有参与者在性别、年龄、体重和体重指数方面均无统计学差异(P>.05)。在临床诊断为高弓足的患者中,根据 TM 角,双侧 CA 角的诊断率为 100%,右侧为 83.3%,左侧为 96.7%。根据 CA 角,扁平足患者的角度测量诊断率为:右侧为 20%,左侧为 30%;根据 TM 角,双侧为 100%;根据 LTC 角,右侧为 66.7%,左侧为 46.7%。跟骨骨刺和扁平足患者的 CA 角和 LTC 角之间存在很强的正相关(P<.001);CA 角和 TA 角之间也存在显著的正相关(P<.05)。跟骨骨刺患者的角度测量结果与扁平足相似,且具有较高的发生率。
由于足部生物力学恶化引起的角度变化导致各种畸形,其中以扁平足最为常见。因此,我们认为,对于出现足部疼痛的患者,在临床评估的基础上,结合影像学的角度测量有助于考虑相关畸形并制定治疗方案。