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Reproducibility of foot structure measurements in neuropathic diabetic patients using magnetic resonance imaging
Sicco A Bus1, Mario Maas, Robert Lindeboom
1Department of Internal Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands. s.a.bus@amc.uva.nl
Purpose:
To assess the intra- and interobserver agreement of commonly reported foot structure measurements in diabetic patients with neuropathy using magnetic resonance imaging (MRI).
Materials And Methods:
In 23 neuropathic diabetic patients and five age-matched healthy controls, sagittal-plane MR images of the forefoot were obtained to assess joint configuration and plantar fat-pad thickness on two different occasions by the same observer and once by a different observer. The degree of intrinsic muscle atrophy was scored from coronal plane images on two different occasions by two observers.
Results:
The intraclass correlation coefficients (ICCs) between occasions and between observers were >0.94. The mean differences (bias) and the limits of agreement (LoA = mean +/- 2 SDs) were small for the metatarsal-phalangeal (MTP) joint angle, toe angle, and plantar fat-pad thickness (bias
Conclusion:
Static foot structure data can be assessed reliably using MRI. Because changes in foot structure contribute to the development of foot ulcers in neuropathic patients, MRI may be a useful technique to assess risk of ulceration in these patients.
