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Volume 12
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10.3390/diagnostics12102288
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Article

Diagnostic Accuracy of Various Radiological Measurements in the Evaluation and Differentiation of Flatfoot: A Cross-Sectional Study

by
Fayaz Khan
1,*,
Mohamed Faisal Chevidikunnan
1,
Mashael Ghazi Alsobhi
1,
Israa Anees Ibrahim Ahmed
1,
Nada Saleh Al-Lehidan
1,
Mohd Rehan
2,3,
Hashim Abdullah Alalawi
4 and
Ahmed H. Abduljabbar
5
1
Department of Physical Therapy, Faculty of Medical Rehabilitation Sciences, King Abdulaziz University, Jeddah 22252, Saudi Arabia
2
King Fahd Medical Research Center, King Abdulaziz University, Jeddah 22252, Saudi Arabia
3
Department of Medical Laboratory Sciences, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah 22252, Saudi Arabia
4
Department of Radiology, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah 22252, Saudi Arabia
5
Department of Radiology, Faculty of Medicine, King Abdulaziz University Hospital, Jeddah 22252, Saudi Arabia
*
Author to whom correspondence should be addressed.
Diagnostics 2022, 12(10), 2288; https://doi.org/10.3390/diagnostics12102288
Submission received: 1 September 2022 / Revised: 12 September 2022 / Accepted: 16 September 2022 / Published: 22 September 2022
(This article belongs to the Special Issue Skeletal Radiology)
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Abstract

Arch angle is used to indicate flatfoot, but in some cases, it is not easily defined. The presence of flatfoot deformity remains difficult to diagnose due to a lack of reliable radiographic assessment tools. Although various assessment methods for flatfoot have been proposed, there is insufficient evidence to prove the diagnostic accuracy of the various tools. The main purpose of the study was to determine the best radiographic measures for flatfoot concerning the arch angle. Fifty-two feet radiographs from thirty-two healthy young females were obtained. Five angles and one index were measured using weight-bearing lateral radiographs; including arch angle, calcaneal pitch (CP), talar-first metatarsal angle (TFM), lateral talar angle (LTA), talar inclination angle (TIA) and navicular index (NI). Receiver-operating characteristics were generated to evaluate the flatfoot diagnostic accuracy for all radiographic indicators and Matthews correlation coefficient was calculated to determine the cutoff value for each measure. The strongest correlation was between arch angle and CP angle [r = −0.91, p ≤ 0.0001, 95% confidence interval (CI) (from −0.94 to −0.84)]. Also, significant correlations were found between arch angle and NI [r = 0.62, p ≤ 0.0001, 95% CI (0.42 to 0.76)], and TFM [r = 0.50, p ≤ 0.0001, 95% CI (from 0.266 to 0.68)]. Furthermore, CP (cutoff, 12.40) had the highest accuracy level with value of 100% sensitivity and specificity followed by NI, having 82% sensitivity and 89% specificity for the cutoff value of 9.90. In conclusion, CP angle is inversely correlated with arch angle and considered a significant indicator of flatfoot. Also, the NI is easy to define radiographically and could be used to differentiate flat from normal arched foot among young adults.
Keywords: flatfoot; X-rays; pes planus; diagnosis; evaluation flatfoot; X-rays; pes planus; diagnosis; evaluation

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MDPI and ACS Style

Khan, F.; Chevidikunnan, M.F.; Alsobhi, M.G.; Ahmed, I.A.I.; Al-Lehidan, N.S.; Rehan, M.; Alalawi, H.A.; Abduljabbar, A.H. Diagnostic Accuracy of Various Radiological Measurements in the Evaluation and Differentiation of Flatfoot: A Cross-Sectional Study. Diagnostics 2022, 12, 2288. https://doi.org/10.3390/diagnostics12102288

AMA Style

Khan F, Chevidikunnan MF, Alsobhi MG, Ahmed IAI, Al-Lehidan NS, Rehan M, Alalawi HA, Abduljabbar AH. Diagnostic Accuracy of Various Radiological Measurements in the Evaluation and Differentiation of Flatfoot: A Cross-Sectional Study. Diagnostics. 2022; 12(10):2288. https://doi.org/10.3390/diagnostics12102288

Chicago/Turabian Style

Khan, Fayaz, Mohamed Faisal Chevidikunnan, Mashael Ghazi Alsobhi, Israa Anees Ibrahim Ahmed, Nada Saleh Al-Lehidan, Mohd Rehan, Hashim Abdullah Alalawi, and Ahmed H. Abduljabbar. 2022. "Diagnostic Accuracy of Various Radiological Measurements in the Evaluation and Differentiation of Flatfoot: A Cross-Sectional Study" Diagnostics 12, no. 10: 2288. https://doi.org/10.3390/diagnostics12102288

APA Style

Khan, F., Chevidikunnan, M. F., Alsobhi, M. G., Ahmed, I. A. I., Al-Lehidan, N. S., Rehan, M., Alalawi, H. A., & Abduljabbar, A. H. (2022). Diagnostic Accuracy of Various Radiological Measurements in the Evaluation and Differentiation of Flatfoot: A Cross-Sectional Study. Diagnostics, 12(10), 2288. https://doi.org/10.3390/diagnostics12102288

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