Advertisement

Skeletal Radiology

, Volume 45, Issue 2, pp 205–211 | Cite as

Navicular bone position determined by positional MRI: a reproducibility study

  • Philip Hansen
  • Finn E. Johannsen
  • Stine Hangaard
  • Sandra E. Stallknecht
  • Bjarke B. Hansen
  • Janus D. Nybing
  • Mikael Boesen
Scientific Article

Abstract

Objective

To examine intraobserver, interobserver and between-day reproducibility of positional MRI for evaluation of navicular bone height (NVH) and medial navicular position (MNP).

Materials and methods

Positional MRI (pMRI) of the foot was performed on ten healthy participants (0.25 T G-scanner). Scanning was performed in supine and standing position, respectively. Two radiologists evaluated the images in a blinded manner. Reliability and agreement were assessed by calculation of intraclass correlation coefficient (ICC) and 95 % limits of agreement as a percentage of the mean (LOA%).

Results

Intraobserver and interobserver reliability was “substantial” in both supine and standing position (ICC 0.86–0.98) and showed good agreement (LOA% 4.9–14.7 %). Between-day reliability of navicular height and medial navicular position in standing position remained substantial (ICC 0.85–0.92) with adequate agreement (LOA% 8.3–19.8 %). In supine position between-day reliability was “moderate” for NVH (ICC 0.72) and “slight” for MNP (ICC 0.39). Agreement remained adequate between-days for MNP in supine position (LOA% 17.7 %), but it was less than adequate for NVH in supine position (LOA% 24.2 %).

Conclusion

Navicular height and medial navicular position can be measured by pMRI in a very reproducible manner within and between observers. Increased measurement variation is observed between-days in supine position, which may be due to small positional differences or other unknown biomechanical factors.

Keywords

Navicular bone Positional MRI Weight-bearing MRI Plantar arch Foot posture Reproducibility Reliability Agreement 

Notes

Acknowledgements

The Danish Council for Independent Research (Det Frie Forskningsråd), the Danish Rheumatism Association (Gigtforeningen) and the OAK Foundation have kindly provided grants supporting the study. The authors declare no conflicts of interest. We wish to acknowledge professor Marius Henriksen for fruitful discussions during preparation of the manuscript and research technologist Rasmus Bouert for technical assistance. Esaote SpA, Genoa, Italy has kindly provided technical support to optimize the pMRI protocol design.

Compliance with ethical standards

Source of funding

No external funding source was used for this study.

Conflict of interest

No conflict of interest. The authors declare that they have no conflict of interest.

Supplementary material

256_2015_2272_MOESM1_ESM.docx (51 kb)
ESM 1 (DOCX 50 kb)

References

  1. 1.
    Younger AS, Sawatzky B, Dryden P. Radiographic assessment of adult flatfoot. Foot Ankle Int. 2005;26:820–5.PubMedGoogle Scholar
  2. 2.
    Neal BS, Griffiths IB, Dowling GJ, Murley GS, Munteanu SE, Franettovich Smith MM, et al. Foot posture as a risk factor for lower limb overuse injury: a systematic review and meta-analysis. J Foot Ankle Res. 2014;7:55.CrossRefPubMedCentralPubMedGoogle Scholar
  3. 3.
    Williams DS, Davis IM, Scholz JP, Hamill J, Buchanan TS. High-arched runners exhibit increased leg stiffness compared to low-arched runners. Gait Posture. 2004;19:263–9.CrossRefPubMedGoogle Scholar
  4. 4.
    Saltzman CL, Nawoczenski DA, Talbot KD. Measurement of the medial longitudinal arch. Arch Phys Med Rehabil. 1995;76:45–9.CrossRefPubMedGoogle Scholar
  5. 5.
    Menz HB. Alternative techniques for the clinical assessment of foot pronation. J Am Podiatr Med Assoc. 1998;88:119–29.CrossRefPubMedGoogle Scholar
  6. 6.
    Williams DS, McClay IS. Measurements used to characterize the foot and the medial longitudinal arch: reliability and validity. Phys Ther. 2000;80:864–71.PubMedGoogle Scholar
  7. 7.
    Metcalfe SA, Bowling FL, Baltzopoulos V, Maganaris C, Reeves ND. The reliability of measurements taken from radiographs in the assessment of paediatric flat foot deformity. Foot (Edinb). 2012;22:156–62.CrossRefGoogle Scholar
  8. 8.
    Cavanagh PR, Boulton AJM. The relationship of static foot structure to dynamic foot function. J Biomech. 1997;30:243–50.CrossRefPubMedGoogle Scholar
  9. 9.
    McCrory JL, Young MJ, Boulton AJM, Cavanagh PR. Arch index as a predictor of arch height. Foot. 1997;7:79–81.CrossRefGoogle Scholar
  10. 10.
    Cornwall MW, McPoil TG. Relative movement of the navicular bone during normal walking. Foot Ankle Int. 1999;20:507–12.CrossRefPubMedGoogle Scholar
  11. 11.
    Harris EJ, Vanore JV, Thomas JL, Kravitz SR, Mendelson SA, Mendicino RW, et al. Diagnosis and treatment of pediatric flatfoot. J Foot Ankle Surg. 2004;43:341–73.CrossRefPubMedGoogle Scholar
  12. 12.
    Hansen BB, Bouert R, Bliddal H, Christensen R, Bendix T, Christensen A, et al. External pneumatic compression device prevents fainting in standing weight-bearing MRI: a cohort study. Skelet Radiol. 2013; 1437–42.Google Scholar
  13. 13.
    De Vet HCW, Terwee CB, Knol DL, Bouter LM. When to use agreement versus reliability measures. J Clin Epidemiol. 2006;59:1033–9.CrossRefPubMedGoogle Scholar
  14. 14.
    Shrout PE. Measurement reliability and agreement in psychiatry. Stat Methods Med Res. 1998;7:301–17.CrossRefPubMedGoogle Scholar
  15. 15.
    Weir JP. Quantifying test-retest reliability using the intraclass correlation coefficient and the SEM. J Strength Train. 2005;19:231–40.Google Scholar
  16. 16.
    Henriksen M, Lund H, Moe-Nilssen R, Bliddal H, Danneskiod-Samsøe B. Test-retest reliability of trunk accelerometric gait analysis. Gait Posture. 2004;19:288–97.CrossRefPubMedGoogle Scholar
  17. 17.
    Kottner J, Audigé L, Brorson S, Donner A, Gajewski BJ, Hróbjartsson A, et al. Guidelines for reporting reliability and agreement studies (GRRAS) were proposed. J Clin Epidemiol. 2011;64:96–106.CrossRefPubMedGoogle Scholar
  18. 18.
    Rathleff MS, Moelgaard C, Lykkegaard OJ. Intra- and interobserver reliability of quantitative ultrasound measurement of the plantar fascia. J Clin Ultrasound. 2010;39:128–34.CrossRefGoogle Scholar
  19. 19.
    Scharfbillig R, Evans AM, Pod D, Dev GC, Copper AW, Pod B, et al. Criterion validation of four criteria of the foot posture index. J Am Podiatr Med Assoc. 2004;94:31–8.CrossRefPubMedGoogle Scholar
  20. 20.
    Wolf P, Luechinger R, Boesiger P, Stuessi E, Stacoff A. A MR imaging procedure to measure tarsal bone rotations. J Biomech Eng. 2007;129:931–6.CrossRefPubMedGoogle Scholar
  21. 21.
    Vinicombe A, Raspovic A, Menz HB. Reliability of navicular displacement measurement as a clinical indicator of foot posture. J Am Podiatr Med Assoc. 2001;91:262–8.CrossRefPubMedGoogle Scholar
  22. 22.
    Sutera R, Iovane A, Sorrentino F, Candela F, Mularo V, La TG, et al. Plantar fascia evaluation with a dedicated magnetic resonance scanner in weight-bearing position: our experience in patients with plantar fasciitis and in healthy volunteers. Radiol Med. 2010;115:246–60.CrossRefPubMedGoogle Scholar

Copyright information

© ISS 2015

Authors and Affiliations

  • Philip Hansen
    • 1
  • Finn E. Johannsen
    • 3
  • Stine Hangaard
    • 2
  • Sandra E. Stallknecht
    • 3
  • Bjarke B. Hansen
    • 2
  • Janus D. Nybing
    • 1
  • Mikael Boesen
    • 1
    • 2
  1. 1.Department of RadiologyCopenhagen University Hospital Frederiksberg & BispebjergFrederiksbergDenmark
  2. 2.Parker Institute, Department of RheumatologyCopenhagen University Hospital FrederiksbergFrederiksbergDenmark
  3. 3.Institute of Sports Medicine CopenhagenCopenhagen University Hospital BispebjergCopenhagenDenmark

Personalised recommendations