Eduardo Pérez-Boal, Carlos Martin-Villa, Ricardo Becerro-de-Bengoa-Vallejo, Marta Elena Losa-Iglesias, Bibiana Trevissón-Redondo, Daniel López-López, César Calvo-Lobo, David Rodríguez-Sanz, Eva María Martínez-Jiménez, Israel Casado-Hernández
{"title":"儿童跖内收角的内部和内部观察者的可靠性和可重复性：一项一致性研究。","authors":"Eduardo Pérez-Boal, Carlos Martin-Villa, Ricardo Becerro-de-Bengoa-Vallejo, Marta Elena Losa-Iglesias, Bibiana Trevissón-Redondo, Daniel López-López, César Calvo-Lobo, David Rodríguez-Sanz, Eva María Martínez-Jiménez, Israel Casado-Hernández","doi":"10.1007/s00247-025-06375-3","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Metatarsus adductus is a relatively common congenital foot deformity often unrecognized at birth. There is adduction of the metatarsals, supination of the subtalar joint, and plantar flexion of the first ray.</p><p><strong>Objective: </strong>The objective of this study was to utilize the most commonly used methods for assessing metatarsus adductus deformity in children and to identify the measurements with the least intra- and inter-observer variability.</p><p><strong>Materials and methods: </strong>All consecutive patients between 2 and 9 years of age with metatarsus adductus by roentgenographic evaluation on weight-bearing dorsoplantar images were included in this cross-sectional study. Measurements included 32 radiographs, 18 feet from 14 girls with a mean age of 3.73 ± 2.53 years, and 14 feet corresponding to 11 boys with a mean age of 5.21 ± 2.15 years. We identified and assessed all radiographic measurements to evaluate the metatarsus adductus with the different measurements commonly used today, including the Berg, Kilmartin, Laaveg & Ponseti, rearfoot, Root, and Simons' angles.</p><p><strong>Results: </strong>The reliability of the variables measured in 32 weight-bearing dorsoplantar foot radiographs showed excellent reliability ranging in Laaveg-Ponseti and rearfoot angles with low standard error of measurement (SEM), coefficient of variation (CV), and minimum detectable change (MDC) with intraclass correlation coefficient (ICC) higher than 0.990. Kilmartin, Root, and Simons' angles showed good intra- and inter-observer reliability, with ICC values greater than 0.900; however, they also exhibited systematic differences between sessions or between observers (P < 0.05), or a high MDC value, which may limit their reproducibility.</p><p><strong>Conclusion: </strong>Based on the results obtained in this study from the different measurements performed, the rearfoot measurement and the method proposed by Laaveg and Ponseti can be considered the most reliable, as they showed the highest intra- and inter-observer reliability.</p>","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":""},"PeriodicalIF":2.3000,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Intra- and inter-observer reliability and repeatability of the metatarsus adductus angle in childhood: A concordance study.\",\"authors\":\"Eduardo Pérez-Boal, Carlos Martin-Villa, Ricardo Becerro-de-Bengoa-Vallejo, Marta Elena Losa-Iglesias, Bibiana Trevissón-Redondo, Daniel López-López, César Calvo-Lobo, David Rodríguez-Sanz, Eva María Martínez-Jiménez, Israel Casado-Hernández\",\"doi\":\"10.1007/s00247-025-06375-3\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Metatarsus adductus is a relatively common congenital foot deformity often unrecognized at birth. There is adduction of the metatarsals, supination of the subtalar joint, and plantar flexion of the first ray.</p><p><strong>Objective: </strong>The objective of this study was to utilize the most commonly used methods for assessing metatarsus adductus deformity in children and to identify the measurements with the least intra- and inter-observer variability.</p><p><strong>Materials and methods: </strong>All consecutive patients between 2 and 9 years of age with metatarsus adductus by roentgenographic evaluation on weight-bearing dorsoplantar images were included in this cross-sectional study. Measurements included 32 radiographs, 18 feet from 14 girls with a mean age of 3.73 ± 2.53 years, and 14 feet corresponding to 11 boys with a mean age of 5.21 ± 2.15 years. We identified and assessed all radiographic measurements to evaluate the metatarsus adductus with the different measurements commonly used today, including the Berg, Kilmartin, Laaveg & Ponseti, rearfoot, Root, and Simons' angles.</p><p><strong>Results: </strong>The reliability of the variables measured in 32 weight-bearing dorsoplantar foot radiographs showed excellent reliability ranging in Laaveg-Ponseti and rearfoot angles with low standard error of measurement (SEM), coefficient of variation (CV), and minimum detectable change (MDC) with intraclass correlation coefficient (ICC) higher than 0.990. Kilmartin, Root, and Simons' angles showed good intra- and inter-observer reliability, with ICC values greater than 0.900; however, they also exhibited systematic differences between sessions or between observers (P < 0.05), or a high MDC value, which may limit their reproducibility.</p><p><strong>Conclusion: </strong>Based on the results obtained in this study from the different measurements performed, the rearfoot measurement and the method proposed by Laaveg and Ponseti can be considered the most reliable, as they showed the highest intra- and inter-observer reliability.</p>\",\"PeriodicalId\":19755,\"journal\":{\"name\":\"Pediatric Radiology\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":2.3000,\"publicationDate\":\"2025-08-25\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Pediatric Radiology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s00247-025-06375-3\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"PEDIATRICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Pediatric Radiology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00247-025-06375-3","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"PEDIATRICS","Score":null,"Total":0}
Intra- and inter-observer reliability and repeatability of the metatarsus adductus angle in childhood: A concordance study.
Background: Metatarsus adductus is a relatively common congenital foot deformity often unrecognized at birth. There is adduction of the metatarsals, supination of the subtalar joint, and plantar flexion of the first ray.
Objective: The objective of this study was to utilize the most commonly used methods for assessing metatarsus adductus deformity in children and to identify the measurements with the least intra- and inter-observer variability.
Materials and methods: All consecutive patients between 2 and 9 years of age with metatarsus adductus by roentgenographic evaluation on weight-bearing dorsoplantar images were included in this cross-sectional study. Measurements included 32 radiographs, 18 feet from 14 girls with a mean age of 3.73 ± 2.53 years, and 14 feet corresponding to 11 boys with a mean age of 5.21 ± 2.15 years. We identified and assessed all radiographic measurements to evaluate the metatarsus adductus with the different measurements commonly used today, including the Berg, Kilmartin, Laaveg & Ponseti, rearfoot, Root, and Simons' angles.
Results: The reliability of the variables measured in 32 weight-bearing dorsoplantar foot radiographs showed excellent reliability ranging in Laaveg-Ponseti and rearfoot angles with low standard error of measurement (SEM), coefficient of variation (CV), and minimum detectable change (MDC) with intraclass correlation coefficient (ICC) higher than 0.990. Kilmartin, Root, and Simons' angles showed good intra- and inter-observer reliability, with ICC values greater than 0.900; however, they also exhibited systematic differences between sessions or between observers (P < 0.05), or a high MDC value, which may limit their reproducibility.
Conclusion: Based on the results obtained in this study from the different measurements performed, the rearfoot measurement and the method proposed by Laaveg and Ponseti can be considered the most reliable, as they showed the highest intra- and inter-observer reliability.
期刊介绍：
Official Journal of the European Society of Pediatric Radiology, the Society for Pediatric Radiology and the Asian and Oceanic Society for Pediatric Radiology
Pediatric Radiology informs its readers of new findings and progress in all areas of pediatric imaging and in related fields. This is achieved by a blend of original papers, complemented by reviews that set out the present state of knowledge in a particular area of the specialty or summarize specific topics in which discussion has led to clear conclusions. Advances in technology, methodology, apparatus and auxiliary equipment are presented, and modifications of standard techniques are described.
Manuscripts submitted for publication must contain a statement to the effect that all human studies have been reviewed by the appropriate ethics committee and have therefore been performed in accordance with the ethical standards laid down in an appropriate version of the 1964 Declaration of Helsinki. It should also be stated clearly in the text that all persons gave their informed consent prior to their inclusion in the study. Details that might disclose the identity of the subjects under study should be omitted.
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