A new method for radiography of weight-bearing metatarsal heads

A radiographic system has been developed that provides a standardized quantitative analysis of the forefoot. The patient stands fully weight-bearing on a horizontal plexiglass platform that is constructed to ensure reproducible placement between the cassette, patient, and beam. Measurements are made from the images of radiopaque rulers placed in line with the first metatarsophalangeal joint of each foot. The height of each metatarsal head can then be calculated based on measurements obtained on the radiograph. Graphs plotted from the data demonstrate the height of the metatarsal heads in a normal individual, changes in the height of the metatarsal heads with and without weight-bearing, before and after insole placement, and before and after metatarsal osteotomy. This information may be useful in obtaining a better understanding of abnormalities of the forefoot as related to bony anatomy and load distribution.