title: Radiographic assessment of adult flatfoot.
abstract: BACKGROUND
  The accurate measurement of flatfoot on standing radiographs allows correct diagnosis of the condition and evaluation of reconstructive procedures.
  
  
  METHODS
  The standing radiographic measurements of patients with symptomatic, adult flatfoot were compared to controls using blinded observers.
  
  
  RESULTS
  On the lateral radiograph, the talar-to-first metatarsal angle, the calcaneal pitch angle, and the medial cuneiform-fifth metatarsal height differed significantly between the patient group and the controls. The difference in the talar-to-first metatarsal angles on lateral radiographs was the most statistically significant (patient group 21.1 +/- 10.8 degrees and control 7.1 +/- 10.7 degrees, p < 0.0001) with good correlation between readings (intraobserver 0.75, interobserver 0.83). On the anteroposterior (AP) radiograph, the talar head uncoverage distance was the most significantly different measurement between these groups.
  
  
  CONCLUSIONS
  These findings support the hypothesis that the talar-first metatarsal angle is an accurate radiographic identifier of patients with symptomatic, adult flatfoot.
authors.affiliation: Providence Health Care, Vancouver, BC V6N 2N4, Canada. asyounger@shaw.ca
authors.forename: Alastair S
authors.initials: AS
authors.lastname: Younger
authors.forename: Bonita
authors.initials: B
authors.lastname: Sawatzky
authors.forename: Peter
authors.initials: P
authors.lastname: Dryden
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005413:Flatfoot / Q000000981:diagnostic imaging*; D005529:Foot Bones / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011859:Radiography; D015203:Reproducibility of Results