2D or Not 2D, That Is the Question? Weight-Bearing Radiography vs Weight-Bearing Computed Tomography in the Preoperative Evaluation of Charcot-Marie-Tooth Deformity

Category: Midfoot/Forefoot; Hindfoot Introduction/Purpose: This is the first study to compare weight-bearing radiographs to weight-bearing computed tomography (WBCT) in the preoperative evaluation of Charcot-Marie-Tooth patients. This comparison is important as WBCT is not widely available, and its current role in preoperative planning remains unclear. Methods: We performed a retrospective review of CMT patients with cavovarus deformity with weight-bearing radiographs (WBR) and WBCT. Lateral talus-first metatarsal angle, calcaneal pitch, anteroposterior (AP) talus-first metatarsal angle, and talonavicular coverage angle were measured on WBR on WBCT. Intraclass correlation coefficients (ICC) between raters and imaging modalities were calculated. ICC values were interpreted as follows: ICC < 0.50 = poor agreement; 0.50 < ICC < 0.75 = moderate agreement; 0.75 < ICC < 0.90 = good agreement; and ICC > 0.90 = excellent agreement. Results: 38 feet from 34 patients, 21 female, 13 male, with an average age of 42 years old (range 19-72) were included. Interrater reliability was good or excellent for all measures except talonavicular coverage angle, which was moderate for both WBR and WBCT (Table 1A). Inter-method reliability was good for all measures except talonavicular coverage angle which was moderate (Table 1B). Conclusion: In the 38 CMT feet assessed in this study, we found good agreement between WBR and WBCT measurements, except for talonavicular coverage angle. For surgeons without access to WBCT, these results may ease concern regarding surgical planning using weight-bearing radiographs alone.