Interobserver Reliability in the Radiological Evaluation of Flatfoot (Pes Planus) Deformity: A Cross-Sectional Study

Abstract

This study was planned for analyzing the interobserver reliability on the diagnosis of flatfoot. This study aims to evaluate the interobserver reliability of the digital radiography of flatfoot patients. Eight parameters were used in digital x-rays within the as statistically in 2 groups. Study group includes 34 patients. Two groups were formed four medical specialists as 2 orthopedists and 2 radiologists. Two orthopedists made measurements on x-ray viewing as calcaneal pitch (CP) as CP floor, calcaneus-1 metatarsal angle, calcaneus-5 metatarsal angle; longitudinal arch angles (LAAs) as medial and lateral LAAs, Tomeno-Meary angle (TMA), anteroposterior and lateral CYMA line. The intraclass correlation coefficient (ICC) analysis was performed. Fleiss Kappa and Kappa was used to investigate the reliability of qualitative data between 2 observers. ICCs were in high levels for CP floor, calcaneus-1 metatarsal angle, calcaneus-5 metatarsal angle. ICCs of TMA was in high levels, also. ICCs of LAA-medial and LAA-lateral were not in high levels as other measurements. In the CYMA line (anteroposterior and lateral) Kappa was 0.140 for right feet in the quadruple group (p = .045; .458; and .314). Kappa was 0.197 for left feet in the quadruple group (p = .005; .146; .377). The ICCs was excellent for CP angles and TMA in all groups. LAAs as medial and lateral longitudinal arch angle had not high ICC's. CYMA line had significant p values in the quadruple group. But not in orthopedists and radiologists.

Keywords: CYMA line; ankle; biomechanics; calcaneal pitch; longitudinal arch.