Abstract
Portable fluoroscopy devices provide point-of-care imaging in emergency and out-patient
clinics. In this prospective study, we compared weightbearing images of syndesmosis
obtained using a novel lightweight portable battery-powered fluoroscopy device with
those obtained with a conventional radiography device. Eleven healthy participants
underwent bilateral 3-view weightbearing imaging of both ankles using a radiography
(X-ray group) device and a portable fluoroscopy system (LPF group). Anteroposterior,
mortise, and lateral views were compared between the 2 techniques. Radiographic measurements
were done by 2 observers. These measurements included talar tilt, tibiofibular clear
space, tibiofibular overlap, plafond malleolar angle, medial distal tibial angle,
medial clear space, lateral distal tibial angle, anterior and posterior tibiofibular
distance were measured using the appropriate view. Data were compared between the
2 techniques; the interobserver agreement was calculated within each group. P < .05 was considered statistically significant. Comparing the 2 imaging modalities,
there was no significant difference between the measurements in LPF and X-ray groups
except plafond malleolar angle. The overall interobserver agreement was excellent
between the 2 observers. There was no significant difference between the measures
by the 2 observers and between the bilateral ankles. Fluoroscopy was associated with
about 50% extra radiation exposure, although the absolute amount of radiation was
not clinically significant. These results support the use of weightbearing images
using portable fluoroscopy device as an alternative for the conventional radiography
systems.
Level of Clinical Evidence
Keywords
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References
- Radiographic angular measurements of the foot and ankle in weight-bearing: a literature review.Foot Ankle Surg. 2020; 26: 509-517
- Bedside fluoroscopy to screen for simple extremity trauma in the ED.Am J Emerg Med. 1995; 13: 545-547
- Can portable bedside fluoroscopy replace standard, postreduction radiographs in the management of pediatric fractures?.Pediatr Emerg Care. 1999; 15: 249-251
- Utility of Postreduction Radiographs After Fluoroscopy-Guided Reduction and Casting of Uncomplicated Pediatric Forearm Fractures.Pediatr Emerg Care. 2020; 36: 92-94
- Medicine's Dilemmas: Infinite Needs Versus Finite Resources.Yale University Press, 1994
- Portable mini-fluoroscopy improves operative efficiency in hand surgery.J Hand Surg [Am]. 1999; 24: 182-184
- Point-of-care ultrasound compared with conventional radiographic evaluation in children with suspected distal forearm fractures in the Netherlands: a diagnostic accuracy study.Emerg Med J. 2019; 36: 613-616
- Imaging in syndesmotic injury: a systematic literature review.Skelet Radiol. 2018; 47: 631-648
- Diagnostic Imaging of the Foot and Ankle.Thieme, 2015
- NIH Image to ImageJ: 25 years of image analysis.Nat Methods. 2012; 9: 671-675
- Sample size estimation in clinical research: from randomized controlled trials to observational studies.Chest. 2020; 158: S12-S20
- Cracking the code: providing insight into the fundamentals of research and evidence-based practice a guideline of selecting and reporting intraclass correlation coefficients for reliability research.J Chiropract Med. 2016; 15: 155-163
- The effects of rotation on radiographic evaluation of the tibiofibular syndesmosis.Foot Ankle Int. 2002; 23: 107-111
- Weight-bearing MR imaging of knee, ankle and foot.Semin Musculoskelet Radiol. 2019; 23: 594-602
- The additional value of weight-bearing and gravity stress ankle radiographs in determining stability of isolated type B ankle fractures.Eur J Trauma Emerg Surg. 2021; ([Epub ahead of print])https://doi.org/10.1007/s00068-021-01757-2
- Volume measurements on weightbearing computed tomography can detect subtle syndesmotic instability.J Orthopaed Res. 2022; 40: 460-467
- Image quality is resilient against tube voltage variations in post-mortem skeletal radiography with a digital flat-panel detector.Sci Rep. 2021; 11: 7701
Article info
Publication history
Published online: May 18, 2022
Footnotes
Financial Disclosure: The study was supported by Turner Imaging Systems.
Conflict of Interest: The study was supported by Turner Imaging Systems.
Identification
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© 2022 by the American College of Foot and Ankle Surgeons. All rights reserved.
