Foot & ankle orthopaedics · 2026
Does Conventional Radiography Overrepresent Joint Space Narrowing in Hallux Rigidus? A Comparative Study With Weightbearing CT Imaging.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Saleh Ahmed, Mallavarapu Vineel, Mansur Nacime Salomao Barbachan, Fayed Aly M, de Cesar Netto Cesar
Аннотация
BACKGROUND: Conventional weightbearing radiographs are the gold standard for grading hallux rigidus (HR), yet clinical symptoms often do not correlate with radiographic severity. This study compared 2-dimensional (2D) weightbearing radiographs with weightbearing computed tomography (WBCT) to evaluate if traditional imaging overrepresents joint degeneration.
METHODS: A retrospective study of 21 patients (13 males; average age 55.9 years) with HR was conducted. All patients had both weightbearing radiographs and WBCT. Two fellowship-trained orthopaedic surgeons measured the first metatarsophalangeal joint (first MTPJ) space, dorsal osteophyte height, and dorsal narrowing percentage. Inter-rater reliability was assessed using intraclass correlation coefficients (ICCs).
RESULTS: Joint space width was significantly larger on WBCT (1.9 ± 0.44 mm) compared to radiographs (0.92 ± 0.53 mm; P < .001). WBCT also showed significantly less narrowing of the dorsal articular surface (22.78% ± 8.71% vs 46.57% ± 18.8%, P < .001). Inter-rater reliability for joint space narrowing was excellent for WBCT (ICC = 0.91) but moderate for radiographs (ICC = 0.67; P < .001). WBCT was more sensitive in detecting loose bodies and sesamoid changes.
CONCLUSION: WBCT demonstrated consistently larger joint-space measurements and less dorsal joint-space narrowing compared with conventional radiographs, along with substantially higher inter-rater reliability for joint space narrowing. These findings indicate a systematic measurement difference between modalities, with radiographs tending to overrepresent joint-space loss. This discrepancy may help explain why joint-preserving procedures such as cheilectomy can succeed even when radiographs appear advanced.
LEVEL OF EVIDENCE: Level III, retrospective comparative study.
METHODS: A retrospective study of 21 patients (13 males; average age 55.9 years) with HR was conducted. All patients had both weightbearing radiographs and WBCT. Two fellowship-trained orthopaedic surgeons measured the first metatarsophalangeal joint (first MTPJ) space, dorsal osteophyte height, and dorsal narrowing percentage. Inter-rater reliability was assessed using intraclass correlation coefficients (ICCs).
RESULTS: Joint space width was significantly larger on WBCT (1.9 ± 0.44 mm) compared to radiographs (0.92 ± 0.53 mm; P < .001). WBCT also showed significantly less narrowing of the dorsal articular surface (22.78% ± 8.71% vs 46.57% ± 18.8%, P < .001). Inter-rater reliability for joint space narrowing was excellent for WBCT (ICC = 0.91) but moderate for radiographs (ICC = 0.67; P < .001). WBCT was more sensitive in detecting loose bodies and sesamoid changes.
CONCLUSION: WBCT demonstrated consistently larger joint-space measurements and less dorsal joint-space narrowing compared with conventional radiographs, along with substantially higher inter-rater reliability for joint space narrowing. These findings indicate a systematic measurement difference between modalities, with radiographs tending to overrepresent joint-space loss. This discrepancy may help explain why joint-preserving procedures such as cheilectomy can succeed even when radiographs appear advanced.
LEVEL OF EVIDENCE: Level III, retrospective comparative study.