Chun Dong-Il, Cho Jaeho, Won Sung Hun, Nomkhondorj Otgonsaikhan, Kim Jahyung, An Chi Young, Yi Young
Department of Orthopaedic Surgery, Soonchunhyang University Seoul Hospital, 59, Daesagwan-ro, Yongsan-gu, Seoul 04401, Republic of Korea.
Department of Orthopaedic Surgery, Chuncheon Sacred Heart Hospital, Hallym University, 77, Sakju-ro, Chuncheon-si 24253, Republic of Korea.
Diagnostics (Basel). 2025 Jan 31;15(3):343. doi: 10.3390/diagnostics15030343.
Since its introduction, weight-bearing computed tomography (WBCT) has gained prominence due to its ability to produce accurate three-dimensional images under natural loading conditions, making it particularly useful for assessing complex foot deformities. This review aimed to focus on the diseases of the foot and categorized the pathological conditions into forefoot disease (hallux valgus), midfoot disease (Lisfranc injuries and midfoot osteoarthritis), and progressive collapsing foot deformity. For each category, the authors detail how WBCT enhances diagnostic accuracy and informs treatment strategies. In hallux valgus, WBCT allows for more precise measurement of established parameters and reveals crucial information about metatarsal pronation and ray instability. For midfoot pathologies, WBCT's superiority in detecting subtle Lisfranc injuries and characterizing midfoot osteoarthritis is emphasized, highlighting the development of novel measurement techniques. The review extensively covers the application of WBCT in assessing the complex three-dimensional features of PCFD, including hindfoot valgus, midfoot/forefoot abduction, medial column instability, peritalar subluxation, and valgus tilting, presenting several WBCT-specific measurements and the use of distance mapping to quantify joint surface interaction. The authors conclude that WBCT, potentially enhanced through integration with artificial intelligence (AI), represents a significant advancement in foot and ankle care, promising improved diagnostic accuracy, streamlined treatment planning, and, ultimately, better patient outcomes.
自从引入以来，负重计算机断层扫描（WBCT）因其能够在自然负荷条件下生成精确的三维图像而受到关注，这使其在评估复杂的足部畸形方面特别有用。本综述旨在聚焦足部疾病，并将病理状况分为前足疾病（拇外翻）、中足疾病（Lisfranc损伤和中足骨关节炎）以及进行性塌陷性足部畸形。对于每个类别，作者详细阐述了WBCT如何提高诊断准确性并为治疗策略提供依据。在拇外翻中，WBCT能够更精确地测量既定参数，并揭示有关跖骨内旋和跖骨列不稳定的关键信息。对于中足病变，强调了WBCT在检测细微的Lisfranc损伤和描述中足骨关节炎特征方面的优势，突出了新型测量技术的发展。该综述广泛涵盖了WBCT在评估进行性塌陷性足部畸形（PCFD）复杂三维特征方面的应用，包括后足外翻、中足/前足外展、内侧柱不稳定、距骨周围半脱位和外翻倾斜，介绍了几种WBCT特有的测量方法以及使用距离映射来量化关节面相互作用。作者得出结论，WBCT可能通过与人工智能（AI）集成而得到增强，代表了足踝护理领域的一项重大进展，有望提高诊断准确性、简化治疗计划，并最终改善患者预后。
