Quantitative Analysis of Subtalar Joint Motion With 4D CT: Proof of Concept With Cadaveric and Healthy Subject Evaluation.
OBJECTIVE
The purpose of this study was to show the application of quantitative 4D CT for subtalar joint evaluation in healthy volunteers and cadavers.


METHODS
Fifteen healthy volunteers with no history of subtalar joint trauma and three cadavers were prospectively evaluated with dynamic CT. The subtalar joint was evaluated during a pronosupination cycle. All acquisitions (cadavers and healthy volunteers) were performed using intermittent sequential mode with a 320-MDCT scanner. Angles and distances between the talus and the calcaneus were measured semiautomatically. Measurement variation was described in healthy volunteers and in cadavers, the latter before and after resection of the cervical and interosseous ligaments. The mean effective dose was below 0.1 mSv.


RESULTS
In cadavers, mean increases in joint amplitude over 19% and of 22% were seen after partial ligament sectioning and after full ligament sectioning, respectively. The interobserver variability of the measurement ratios was considered to be excellent for three of the measurements made (ICC > 0.87) and moderate for the fourth (ICC = 0.57). The normal range of joint motion in healthy volunteers is described, with joint amplitudes varying from 6.4% to 22.8%.


CONCLUSIONS
Quantitative dynamic CT of the subtalar joint can provide a detailed analysis of joint motion, supporting its potential role in the evaluation of subtalar instability.
1 Service d'Imagerie Guilloz, Hôpital Central, Centre Hospitalier Universitaire de Nancy, 29 Ave du Maréchal de Lattre de Tassigny, Nancy 54035, France.
Pedro Augusto
PA
Gondim Teixeira
1 Service d'Imagerie Guilloz, Hôpital Central, Centre Hospitalier Universitaire de Nancy, 29 Ave du Maréchal de Lattre de Tassigny, Nancy 54035, France.
Anne-Sophie
AS
Formery
2 Service de Chirurgie Orthopedique et Traumatologique, Centre Chirurgical Emile Gallé, Nancy, France.
Adrien
A
Jacquot
3 Radiolor, Clinique Louis Pasteur, Essey-lès-Nancy, France.
Guillaume
G
Lux
4 Institut Régional de Médicine Physique et Réadaptation Louis Pierquin, Nancy, France.
Isabelle
I
Loiret
5 Department of Anatomy, Faculty of Medicine of Nancy, Vandoeuvre-les-Nancy, France.|6 General and Emergency Surgery Department, University Hospital of Nancy, Nancy, France.
Manuela
M
Perez
1 Service d'Imagerie Guilloz, Hôpital Central, Centre Hospitalier Universitaire de Nancy, 29 Ave du Maréchal de Lattre de Tassigny, Nancy 54035, France.
Alain
A
Blum
D000328:Adult; D000368:Aged; D000465:Algorithms; D002102:Cadaver; D005240:Feasibility Studies; D056973:Four-Dimensional Computed Tomography / Q000379:methods*; D006801:Humans; D008875:Middle Aged; D009038:Motion; D010865:Pilot Projects; D011857:Radiographic Image Interpretation, Computer-Assisted / Q000379:methods*; D016059:Range of Motion, Articular / Q000502:physiology*; D012016:Reference Values; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013380:Subtalar Joint / Q000000981:diagnostic imaging* / Q000502:physiology*
CT; dynamic; healthy volunteers; quantitative analysis; subtalar joint