Reliability of clinically relevant 3D foot bone angles from quantitative computed tomography

David J Gutekunst, Lu Liu, Tao Ju, Fred W Prior, David R Sinacore

Surgical treatment and clinical management of foot pathology requires accurate, reliable assessment of foot deformities. Foot and ankle deformities are multi-planar and therefore difficult to quantify by standard radiographs. Three-dimensional (3D) imaging modalities have been used to define bone orientations using inertial axes based on bone shape, but these inertial axes can fail to mimic established bone angles used in orthopaedics and clinical biomechanics. To provide improved clinical relevance of 3D bone angles, we developed techniques to define bone axes using landmarks on quantitative computed tomography (QCT) bone surface meshes. We aimed to assess measurement precision of landmark-based, 3D bone-to-bone orientations of hind foot and lesser tarsal bones for expert raters and a template-based automated method.