Comparison of Angle Measurements on Hallux Valgus with Two Different Methods Using Digital Images / 대한족부족관절학회지

PURPOSE: To study inter- and intra-observer reliabilities of computerized measurements of the angular parameters of hallux valgus deformity, using two different kinds of software tools for angle measurement on the digital radiography. MATERIALS AND METHODS: On 35 digital radiographies of standing foot anteroposterior view of hallux valgus, two observers (A, B) independently measured hallux valgus angle (HVA) and 1-2 intermetatarsal angle (IMA1-2) twice, using two methods. In method I, an angle was determined from duplicated lines to longitudinal axes made for bisecting line on the target bones with software tool. In method II, an angle was calculated automatically and directly from bisecting lines (longitudinal axes) made on the target bones. We compared two methods using paired t-test to determine significance of differences. Inter- and intra-observer reliabilities were evaluated using the intraclass correlation coefficients (ICC). RESULTS: There were no significant differences between measurements of method I and II for each observer (p>0.05) and intraobserver reliability were good. (ICC>0.9) Inter-observer reliability for method I and II was good of the HVA (ICCs, 0.912 and 0.905) and moderate of the IMA1-2 (ICCs, 0.505 and 0.537). There were interobserver differences in HVA of method I and II. CONCLUSION: No significant difference was found statistically between measurements of method I and II. Both methods I and II would be acceptable to measure angular parameters of hallux valgus deformity.

Computerized Measurement on Angular Parameters for Hallux Valgus: Comparison of 100% and 150% Magnified Digital Radiography / 대한족부족관절학회지

PURPOSE: To study computerized measurements of angular parameters on 100% and 150% resized digital radiography of hallux valgus deformity. MATERIALS AND METHODS: 30 digital radiography of standing foot anteroposterior view of hallux valgus patients were included. Two observers(A, B) independently measured hallux valgus angle (HVA), 1-2 intermetatarsal angle (IMA), and distal metatarsal articular angle (DMAA) in two times on both 100%-size and 150% magnified images respectively, using computerized measurement software tools. The results were interpreted with the statistical software program, Statistical Analysis System, version 9.2. RESULTS: In repeated measurements of each observer, measurements on 150% magnified image showed no differences of all three parameters and with 100%-size image, there were differences of HVA (observer A) and 1-2 IMA (observer B) (p>0.05). When testing interobserver reliability, both observers showed differences in measurement of HVA and DMAA (p<0.05), but no differences in measurement of 1-2 IMA in both images. Within the 95% confidence interval, limits of error of measurements between two observers on HVA, IMA and DMAA were 2.7degrees 1.4degrees and 5.0degrees respectively in 100%-size images, and 2.6degrees, 1.6degrees and 4.7degrees respectively in 150% magnified images. CONCLUSION: In computerized measurements for angular parameters of hallux valgus with digital radiography, 150% magnified images showed intraobserver reliability. Both 100% and 150% magnified images failed to show interobserver reliability. Measurement of 1-2 IMA in both 100% and 150% images showed less interobserver error.

The Computerized Measurement for the Radiological Severity of Hallux Valgus / 대한족부족관절학회지

PURPOSE: To study the reliability of intra- and interobserver reliability in angular measurement of hallux valgus deformity by assessing hallux valgus angle (HVA) and the 1st to 2nd intermetatarsal angle (1-2 IMA) through using computerized system. MATERIALS AND METHODS:20 cases of moderate to severe hallux valgus patients were included in this study. With the standing anteroposterior view of foot, the HVA and 1-2 IMA were calculated by computerized measurement system of Infinity cooperation, called phi-view, with its software tools. Using the statistical software program, SPSS (version 12th), we interpreted the results which were measured by two independent observers. RESULTS:In the intraobserver measurement, the HVA of observer A showed reliability (32.5 degrees +/-6.9 and 33.1 degrees +/-6.8)(p005). In the results of observer B, HVAs were measured as 35.7 degrees +/-7.6 and 36.2 degrees +/-7.7, and were not reliable (p>005). 1-2 IMA in observer B was not reliable as well (17.0 degrees +/-0.8 and 20.8 degrees +/-1.5)(p>005). In the interobservers' measurements, the first and the second results of HVA were 3.2 degrees +/-3.6 and 3.1 degrees +/-3.1, reliable within the 95% confidence interval (p005). CONCLUSION: In the angular measurement of the hallux valgus by computerized system, the HVA and 1-2 IMA showed less error range in the interobserver's results, compared with the previous studies about the manual measurement. However, our results failed to show the statistical reliability of intra- and interobserver's measuring. Therefore, even the computerized angular measurements in the severity of hallux valgus require development of the measuring methods and software tools.