Lôbo Carlos Felipe Teixeira, Pires Eduardo Araújo, Bordalo-Rodrigues Marcelo, de Cesar Netto Cesar, Godoy-Santos Alexandre Leme
Lab. Prof. Manlio Mario Marco Napoli, Faculdade de Medicina, Universidade de São Paulo, R. Ovidio Pires de Campos, 333, São Paulo, SP, 05403-010, Brazil.
Hospital Sírio Libanês, São Paulo, Brazil.
Skeletal Radiol. 2022 Jun;51(6):1127-1141. doi: 10.1007/s00256-021-03942-1. Epub 2021 Oct 25.
The term progressive collapsing foot deformity (PCFD) is currently recommended as the replacement to adult-acquired flatfoot deformity and posterior tibial tendon dysfunction to better reflect its pathology, which consists of a complex three-dimensional deformity involving the foot and ankle. The new consensus has also provided a new classification that requires clinical and radiographic findings for patient stratification into each class. However, conventional radiographs are susceptible to errors resulting from the inadequate positioning of patients, incorrect angulation of the X-ray tube, and overlapping of bone structures. Weightbearing cone beam computed tomography (WBCBCT), which has greater diagnostic accuracy than conventional radiograph, is useful for evaluating progressive collapsing foot deformity to determine medial arch collapse, hindfoot alignment, peritalar subluxation, posterior subtalar joint valgus, intrinsic talus valgus, and lateral extra-articular bone impingement. The present review aimed to discuss the new recommendations for nomenclature, classification, and imaging evaluation of PCFD, with an illustrative and quantitative focus on the measurements used in conventional radiography and WBCBCT. The measurements presented here are important criteria for decision-making.
目前推荐使用“进行性塌陷性足畸形（PCFD）”这一术语来取代成人获得性平足畸形和胫后肌腱功能障碍，以便更好地反映其病理情况，该病理情况包括涉及足和踝的复杂三维畸形。新的共识还提供了一种新的分类方法，该方法需要根据临床和影像学检查结果将患者分层到各个类别中。然而，传统X线片容易因患者体位摆放不当、X线球管角度不正确以及骨结构重叠而产生误差。负重锥形束计算机断层扫描（WBCBCT）比传统X线片具有更高的诊断准确性，有助于评估进行性塌陷性足畸形，以确定内侧足弓塌陷、后足对线、距周半脱位、距下后关节外翻、距骨内翻以及外侧关节外骨撞击。本综述旨在讨论PCFD命名、分类和影像学评估的新建议，并对传统X线摄影和WBCBCT中使用的测量方法进行说明和定量分析。这里介绍的测量方法是决策的重要标准。
