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Quantitative Magnetic Resonance Imaging of Skeletal Muscle Disease
Published on: December 18, 2016
Evaluation of pathologic abnormalities of clubfoot by magnetic resonance imaging
M Kamegaya1, Y Shinohara, Y Kokuji
1Chiba Children's Hospital, Division of Orthopaedic Surgery, Chiba City, Japan.
Insights
Magnetic resonance imaging (MRI) effectively identified 3D abnormalities in infant clubfoot. MRI measurements showed significant differences in clubfoot compared to normal feet, aiding severity evaluation.
Area of Science:
- Orthopedics
- Radiology
- Pediatric Medicine
Background:
- Congenital clubfoot is a common birth defect affecting foot and ankle alignment.
- Accurate three-dimensional assessment is crucial for understanding clubfoot's complex deformities.
- Magnetic resonance imaging (MRI) offers advanced visualization capabilities for in vivo studies.
Purpose of the Study:
- To utilize three-dimensional MRI to analyze tarsal bone abnormalities in infants with congenital clubfoot.
- To quantitatively evaluate the severity of clubfoot using specific MRI measurements.
- To compare MRI findings between surgically and conservatively treated clubfoot cases.
Main Methods:
- In vivo three-dimensional MRI analysis of 31 infant clubfeet (21 patients) aged 4-12 months.
- Four key measurements performed: calcaneus adduction angle, navicular angle, talus neck angle, and calcaneus shift index.
- Comparison of measurements between clubfeet and normal feet, and between surgical and conservative treatment groups.
Main Results:
- All four MRI measurements were statistically different in clubfeet compared to normal feet.
- Significant differences were observed between surgical and conservative groups for calcaneus adduction angle, navicular angle, and calcaneus shift index.
- No statistical difference in the talus neck angle between the surgical and conservative groups.
Conclusions:
- Three-dimensional MRI can effectively delineate complex tarsal bone abnormalities in infant clubfoot.
- MRI provides quantitative data to assess clubfoot severity and differentiate treatment outcomes.
- MRI is a valuable tool for evaluating congenital clubfoot deformities in young children.
Abstract:
Three-dimensional analyses of clubfoot in infants younger than 1 year of age were done using magnetic resonance imaging in an in vivo study. Twenty-one patients (31 feet) with congenital clubfoot were examined. The average age at examination was 8.6 months (range, 4-12 months). All patients originally were treated using corrective casts. Seventeen feet required complete subtalar release operations and the remaining 14 feet were treated conservatively with various orthoses. Four measurements using magnetic resonance imaging were performed in the transverse and coronal planes as follows: the calcaneus adduction angle, to define the degree of medial rotation of the calcaneus in the transverse plane; the navicular angle, to define the degree of medial displacement of the navicular; the talus neck angle, to define the degree of medial angulation of the talus; and the calcaneus shift index, to define the degree of medial shift of the calcaneus beneath the talar head in the coronal plane. In the results, all four measurements of clubfoot on magnetic resonance imaging were statistically different from those of normal feet. In the surgical group there were statistical differences in the calcaneus adduction angle, the navicular angle, and the calcaneus shift index (including two feet of patients whose parents had rejected proposed treatment), compared with the conservative group, but there was no statistical difference in the talus neck angle. Magnetic resonance imaging could delineate the three-dimensional abnormalities of the tarsal bones in clubfoot and quantitatively evaluate the severity of clubfoot.
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