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MRI for paediatric flatfoot: is it necessary?

Caroline Bagley1, Sean McIlhone2, Nehal Singla3

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Magnetic Resonance Imaging (MRI) offers significant benefits for diagnosing pediatric flatfoot when initial weight-bearing radiographs are inconclusive. MRI provides crucial additional diagnostic information in over 23% of cases, improving the assessment of flatfoot deformity.

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Area of Science:

  • Pediatric Orthopedics
  • Musculoskeletal Radiology
  • Medical Imaging

Background:

  • Flatfoot deformity is a common pediatric orthopedic condition.
  • Weight-bearing radiographs are standard for initial assessment.
  • Identifying underlying causes of flatfoot is crucial for effective treatment.

Purpose of the Study:

  • To evaluate the added diagnostic value of Magnetic Resonance Imaging (MRI) in pediatric flatfoot cases.
  • To compare MRI findings with weight-bearing radiography results.
  • To determine MRI's utility when radiographs are inconclusive.

Main Methods:

  • Retrospective review of pediatric patients with flatfoot deformity.
  • Analysis of weight-bearing radiographs and subsequent MRI studies.
  • Classification of findings by blinded musculoskeletal radiologists.

Main Results:

  • MRI provided additional diagnostic information in 23.5% of cases.
  • In cases with no radiographic diagnosis (60.8%), MRI identified no underlying abnormality.
  • MRI detected talocalcaneal coalition, calcaneonavicular coalition, and accessory navicular more comprehensively.

Conclusions:

  • MRI is a valuable adjunct to weight-bearing radiography for pediatric flatfoot.
  • MRI enhances diagnostic accuracy, especially when initial radiographs are non-specific.
  • This imaging modality aids in better management of pediatric flatfoot deformities.