Current lines and angles used in paediatric foot radiograph: A scoping review of literature

Abstract

Objective: This article aimed to review the main currently described lines and angles and gather them in a single article and arrange  them in a systematic way to facilitate the process of assessment of the pediatric foot for deformities.

Methods: The review was a scoping  literature review. Electronic database websites such as PubMed, Europe PMC, Cochrane Library, and Google Scholar in addition to some  books on anatomy and human movements biomechanics, diagnostic radiology, and orthopedics were searched for relevant articles for  the topic of the present review. No statistical analysis was applied in this review.

Results: Data from thirty articles included in this review  were arranged into different subheadings. In the anteroposterior view (AP), assessment of the hindfoot deviation was by the AP talo- calcaneal angle (Kite’s angle); the forefoot and midfoot for abduction and adduction alignment was by the AP talo-first metatarsal angle,  the talo-second metatarsal angle, the calcaneo-second metatarsal angle, the calcaneofifth metatarsal angle; the forefoot and midfoot  rotation was by observing the normal proximal convergence of the metatarsal bones axes. In the lateral view, assessment of the hindfoot  sagittal plane alignment was by the lateral tibio-calcaneal angle; hindfoot varus or valgus deviation by the lateral talo-calcaneal  angle; talus bone alignment by talar declination angle and the tibio-talar angle; calcaneal bone alignment by the calcaneal inclination  angle and the tibio-calcaneal angle, the midfoot and forefoot sagittal plane alignment for the plantar arch by the lateral talo-first metatarsal -Meary’s- angle, the calcaneal inclination angle, and the lateral calcaneofirst metatarsal -Hibbs- angle; forefoot and midfoot  rotational alignment by observing the overlap shadows of the metatarsals’ shafts and drawing their axes.

Conclusion: Drawing certain  lines and angles with a systematic approach to assess different regions of the foot in the radiographic films of children can facilitate the   process of assessment of the foot (as a whole) for deformities.