Computed tomography of the hindfoot

Area of Science:

• Radiology
• Orthopedics
• Anatomy

Background:

• The hindfoot's complex anatomy is crucial for weight-bearing and mobility.
• Understanding normal hindfoot alignment and morphology is essential for diagnosing various pathologies.

Purpose of the Study:

• To utilize computed tomography (CT) for detailed examination of normal hindfoot anatomy.
• To identify and characterize hindfoot abnormalities in patients with rheumatoid arthritis, pes planovalgus, trauma, and soft-tissue masses.

Main Methods:

• CT scans of 10 normal volunteers and 17 patients were performed in coronal and axial planes.
• Assessment included articular surfaces of the tibia, talus, and calcaneus, and inter-bone relationships.
• Key measurements included the heel valgus angle, sustentacular angle, and medial offset.

Main Results:

• Normal hindfeet exhibited significant symmetry with specific angular and offset measurements.
• Rheumatoid arthritis patients showed subtalar joint erosions and alignment issues.
• Pes planovalgus cases displayed increased heel valgus and decreased sustentacular elevation.
• CT detected talocalcaneal fusions, fractures, pigmented villonodular synovitis, and postoperative healing patterns.

Conclusions:

• CT is a valuable tool for assessing normal and abnormal hindfoot anatomy.
• It provides essential pre- and postoperative evaluation for various hindfoot conditions.
• CT aids in understanding the impact of diseases like rheumatoid arthritis and pes planovalgus on hindfoot structure.