Radiographic angles in hallux valgus: differences between measurements made manually and with a computerized program.

Area of Science:

• Orthopedics
• Radiology
• Medical Imaging Analysis

Background:

• Hallux valgus (HV) deformities require accurate angular measurements for effective evaluation.
• Traditional manual goniometer measurements may lack reliability compared to newer digital methods.

Purpose of the Study:

• To compare angular measurements for hallux valgus (HV) using a goniometer versus a computerized program.
• To assess the concordance and reliability of manual versus digital measurement techniques.

Main Methods:

• Preoperative weightbearing radiographs of 176 symptomatic hallux valgus patients were analyzed.
• Manual angular measurements (HVA, IMA, DMAA, PPAA) were taken with a goniometer.
• Digital measurements of the same angles were performed using Autocad software on digitized images.

Main Results:

• Autocad measurements yielded significantly higher mean values for IMA and PPAA compared to the goniometer.
• Manual measurements tended to show higher DMAA values, while Autocad showed higher IMA and PPAA values.
• Intraclass correlation coefficients indicated excellent concordance for HVA (0.89) and DMAA (0.80), but poor concordance for PPAA (0.11) and IMA (0.42).

Conclusions:

• Computerized angular measurements using Autocad on weightbearing radiographs are more reliable for hallux valgus evaluation.
• While HVA and DMAA measurements showed similarity between methods, manual techniques may underestimate IMA and PPAA.
• Digital analysis offers improved reliability for assessing key angular parameters in hallux valgus.