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KMID : 0361420110350050673
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Journal of Korean Academy of Rehabilitation Medicine
2011 Volume.35 No. 5 p.673 ~ p.679
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The Availability of Radiological Measurement of Tibial Torsion: Three-Dimensional Computed Tomography Reconstruction
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Shin Sang-Yeop
Yoon Chul-Ho
Lee Eun-Shin
Oh Min-Kyun
Kim A-Ram
Park Jong-Moon
Shin Jun-Hwa
Shin Hee-Suk
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Abstract
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Objective: To assess the intra-rater and inter-rater reliability for measuring tibial torsion measurements by a radiographic method using three-dimensional computed tomography reconstruction (3D-CT) and to compare the physical measures to those of 3D-CT.
Method: Th e study included 33 children who presented with intoeing gait. Tibial torsion was measured by 3D-CT. Distal reference point was the bimalleolar axis. Proximal reference points were the transtibial axis and posterior condylar axis. Physical measurements included thigh-foot angle (TFA) and bimalleolar angle (BMA). 3D-CT measurement and physical measurement were performed twice at both lower extremities by each rater. The intra-rater and inter-rater reliability were calculated by intraclass correlation coeffi ciency (ICC). Th e relationship between radiological and physical examination was calculated by Spearman correlation coeffi cient.
Results: Th e 3D-CT measures for tibial torsion were reliable within individual raters and between diff erent raters. However, physical measures for tibial torsion were reliable within an individual rater but not reliable between raters. The 3D-CT measures by any proximal reference axis were more reliable within a rater and between raters than physical measurements. Th ere was no signifi cant impact introduced by the selection of the proximal reference axis. Th e correlation coeffi ciency between 3D-CT and physical measurement methods was low.
Conclusion: Because the 3D-CT measurements for tibial torsion are more reliable than physical measurements, we recommend that accurate diagnosis of internal tibial torsion should be detected by using 3D-CT measurements. Also, considering the disadvantages of radiological measurements, physical measurement may be used for short term follow-up by same raters, as intra-rater reliability is relatively good.
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KEYWORD
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Torsion abnormalities, Radiography, Tomography, Reproducibility of findings
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