title: Reliability of radiological and cosmetic measurements in hallux valgus.
abstract: OBJECTIVE
  To evaluate the reliability of angular, linear, and sesamoid position measurements on preoperative and postoperative radiographs in hallux valgus (HV), as well as cosmetic foot appearance.
  
  
  METHODS
  Radiographs and photographs from 100 patients undergoing HV surgery were evaluated by two independent observers.
  
  
  RESULTS
  Interobserver and intraobserver agreements for HV angle using coefficient of repeatability measures were 4.4 degrees and 3.7 degrees, respectively. Intraclass correlation coefficient measures within and between agreements were 0.97 for HV angle. For intermetatarsal distance, interobserver and intraobserver values were 0.90 and 0.94 when measuring from the midline of each metatarsal and 0.75 and 0.92 when measuring between cortices. Using the visual analog scale to evaluate esthetic appearance, interobserver and intraobserver agreements were 0.59 and 0.79, respectively. Sesamoid position values were also measured. Interobserver and intraobserver kappa values for preoperative and postoperative evaluations with two established methods (Mann or Smith) were 0.47 and 0.70 or 0.65 and 0.75, respectively.
  
  
  CONCLUSIONS
  Intraobserver reliability was higher than interobserver for intermetatarsal distance, cosmetics, and sesamoid position. Angular measurements were more accurate than linear. Esthetic evaluation was less reliable than radiographic, except in the case of sesamoid position measurements.
authors.affiliation: Department of Clinical science, intervention and technology (CLINTEC), division of orthopaedics, Karolinska Institutet at Karolinska University Hospital, Huddinge, Stockholm, Sweden. carlos.saro@cfss.ki.se
authors.forename: C
authors.initials: C
authors.lastname: Saro
authors.forename: D N
authors.initials: DN
authors.lastname: Johnson
authors.forename: J
authors.initials: J
authors.lastname: Martinez De Aragón
authors.forename: U
authors.initials: U
authors.lastname: Lindgren
authors.forename: L
authors.initials: L
authors.lastname: Felländer-Tsai
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004954:Esthetics; D006215:Hallux Valgus / Q000000981:diagnostic imaging* / Q000473:pathology* / Q000601:surgery; D006801:Humans; D008683:Metatarsophalangeal Joint / Q000000981:diagnostic imaging* / Q000473:pathology* / Q000601:surgery; D008875:Middle Aged; D015588:Observer Variation; D010027:Osteotomy; D011859:Radiography; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012716:Sesamoid Bones / Q000000981:diagnostic imaging / Q000473:pathology; D016896:Treatment Outcome