Proposals for talonavicular joint assessment using ultrasound imaging and its reliability and validity.
Keisuke Hirakawa, Masahiro Tsutsumi, Isao Yamaguchi and 1 others
PMID 38562531WHAT IT FOUND
Ultrasound imaging reliably detects talonavicular joint changes under load in healthy adults, correlating moderately with X-ray.
Unlike common clinical measures, it specifically tracks joint mobility, offering a non-radiation alternative for assessing foot deformity mechanics.
Key findings
01The talonavicular angle measured by ultrasound was significantly larger when standing compared to sitting, indicating detectable joint movement under load.
02Ultrasound measurements showed good to excellent reliability among raters, with all intraclass correlation coefficients being 0.69 or higher.
03The change in ultrasound angle correlated moderately with the standard X-ray measure, whereas common clinical foot assessments did not correlate with the X-ray measure.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The study was conducted only on healthy individuals, so it is unknown if this method can distinguish between normal and pathological flatfoot conditions. The ultrasound method measures movement in a two-dimensional plane and may not fully account for three-dimensional foot movements like eversion. The correlation with the X-ray gold standard was moderate, not perfect, suggesting it may not replace X-ray for all diagnostic purposes.
Declared interests
The study was supported by the Descente and Ishimoto Memorial Foundation for the Promotion of Sports Science, though the authors state the funders had no role in the study design, analysis, or publication.
The easy way to misread this
Do not assume this ultrasound method is validated for diagnosing or monitoring flatfoot deformity in patients. It was tested only in healthy volunteers, so its ability to detect pathological changes or track treatment effects in patients with flatfoot has not been established.