Foot Postures: Relation With Family History And Foot Wears

Introduction: Development of different foot types (normal, high and low arch) is influenced by factors like weight,height, family history. Studies have shown that the age at which a person starts wearing foot wear affects footposture. Not many studies have focused on the effect of type of foot wear worn by the individuals (high, low heelor flat) on the foot posture. Accurate classification of the type of foot in a specific age group is important as thetype of foot wear worn also change with age of a person.Aim: The aim of the present study is to relate the different types of foot with the type of footwear worn by theindividual and family history in young adult individuals.Methods: foot prints of 250 volunteers were taken on a paper and visually assessed for the type of foot arch. Thetype of foot wear worn and the duration was noted and family history of abnormal foot type was also noted.Statistical analysis: relation of the study group with various parameters was done using Chi square test andANOVA.Results: relation of different types of foot wear worn by the individuals with different types of foot was notstatistically significant. There was a significant relation of family history of foot abnormalities with differenttypes of foot arch noted.Conclusion: Foot postures strongly correlate with the family history of an individual but the type of foot wearworn does not significantly influence the foot posture in adult age group.

Fibular Hemimelia: A Case Report

Fibular hemimelia is the most common congenital absence or hypoplasia of long bone. In addition to fibular absence or hypoplasia, this entity also includes various combined abnormalities of the lower limbs. We present here three cases of fibular hemimelia who underwent diagnosis and treatment in our hospital. Wee especially focus on the imaging findings of the plain radiographs, and we compare them with the findings found at another presentation.

Naviculo-Medial Cuneiform Coalition: Radiological Features

PURPOSE: To define the radiological features of the naviculo-medial cuneiform coalition. MATERIALS AND METHODS: This study examined 35 feet from 25 patients (mean age 26 years) with a naviculo-medial cuneiform coalition. The images were analyzed retrospectively with regard to irregular articular surface, subchondral sclerosis, subchondral cyst, beak-like spur, the change in joint space, bony fusion seen on plain radiographs (n=35) and CT (n=14), and the histological type of coalition on MRI (n=3). The extent of joint involvement was also evaluated. RESULTS: Of the 35 feet, plain radiographs and/or CT showed an irregular articular surface in 34 (97.1%), subchondral sclerosis in 30 (85.7%), a subchondral cyst in 29 (82.9%), a beak-like spur in 23 (65.7%), a narrowing of the joint space in 24 (68.6%) and no bony fusions (0%). The T1-weighted images revealed low signal intensity, and the T2-weighted fast spin-echo and gradient images revealed high signal intensity in the three feet with a cartilaginous coalition. The coalition involved the plantar part of the joint in all 35 feet. CONCLUSION: The characteristic radiological features of a naviculo-medial cuneiform coalition include an irregular articular surface with possible secondary degenerative changes in the plantar margin of the joint, non-osseous type.

MR Imaging Findings of Painful Type II Accessory Navicular Bone: Correlation with Surgical and Pathologic Studies

OBJECTIVE: To evaluate the MR imaging findings of painful type II accessory navicular bone and to correlate these with the surgical and pathologic findings. MATERIALS AND METHODS: The MR images of 17 patients with medial foot pain and surgically proven type II accessory navicular abnormalities were reviewed. The changes of signal intensity in the accessory navicular, synchondrosis and adjacent soft tissue, the presence of synchondrosis widening, and posterior tibial tendon (PTT) pathology on the T1-weighted and fat-suppressed T2-weighted images were analyzed. The MR imaging findings were compared with the surgical and pathologic findings. RESULTS: The fat-suppressed T2-weighted images showed high signal intensity in the accessory navicular bones and synchondroses in all patients, and in the soft tissue in 11 (64.7%) of the 17 patients, as well as synchondrosis widening in 3 (17.6%) of the 17 patients. The MR images showed tendon pathology in 12 (75%) of the 16 patients with PTT dysfunction at surgery. The pathologic findings of 16 surgical specimens included areas of osteonecrosis with granulomatous inflammation, fibrosis and destruction of the cartilage cap. CONCLUSION: The MR imaging findings of painful type II accessory navicular bone are a persistent edema pattern in the accessory navicular bone and within the synchondrosis, indicating osteonecrosis, inflammation and destruction of the cartilage cap. Posterior tibial tendon dysfunction was clinically evident in most patients.

Sonographic Evaluation of Plantar Fasciitis

PURPOSE: To evaluate the sonographic findings of plantar fasciitis. MATERIALS AND METHODS: Both feet of 30patients(mean age, 44years) in whom plantar fasciitis had been clinically diagnosed, and those of healthyvolunteers(mean age, 34years) were evaluated with ultrasound(US) using a 7.0MHz linear array transducer. Heel painwas unilateral in 26 patients and bilateral in four. Sagittal sonograms were obtained in the prone position, andthe thickness of the plantar fascia was measured at its proximal end near its insertion into the calcaneus. Wealso evaluated hypoechoic fascia, perifascial fluid collection, fiber rupture, calcaneal spur and calcifications. RESULTS: Plantar fascia thickness was significantly greater in the heels of patients with plantarfasciitis(3.2-8mm; mean, 5.1 +/-1.12) than in their asymptomatic heels(1.3-5mm; mean, 3.5 +/-0.78)(p<0.0001), inwhich it was similar to that of heels of patients in the control group(1.8-5mm; mean, 3.0 +/-0.71)(p<0.0001). Theproximal plantar fascia was hypoechoic in 31 symptomatic heels(91.2%), in four asymptomatic heels(15.4%), and innone of the patients in the control group. Calcaneal spurs were identified in sixteen symptomatic heels(47.1%),and in two which were asymptomatic(7.7%). Perifascial fluid collection was identified in only two symptomaticheels(5.9%). CONCLUSION: In plantar fasciitis, sonography demonstrates that the fascia is thicker as well ashypoechic. For the clinical diagnosis of planter fasciitis, US can therefore be used as an adjunct to clinicaldiagnosis.