Robinson AH, Cullen NP, Chhaya NC, et al: Variation of the distal metatarsal articular angle with axial rotation and inclination of the first metatarsal. .Foot Ankle Int27::1036. ,2006. .17207429)| false
Klaue K, Hansen S, Masquelet A: Clinical, quantitative assessment of first tarsometatarsal mobility in the sagittal plane and its relation to hallux valgus deformity. .Foot Ankle Int15::9. ,1994. .7981800)| false
Calvo A, Viladot R, Gine J, et al: The importance of the length of the first metatarsal and the proximal phalanx of hallux in the etiopathogeny of the hallux rigidus. .Foot Ankle Surg15::69. ,2009. .19410172)| false
Drapeau MS, Harmon EH: “Metatarsal Head Torsion in Apes, Humans, and A. Afarensis E,” in Abstract Program of the 74th Annual Meeting of the American Association of Physical Anthropologist, Columbus, OH, April. 2008. .
Largey A, Bonnel F, Canovas F, et al: Three-dimensional analysis of the intrinsic anatomy of the metatarsal bones. .J Foot Ankle Surg46::434. ,2007. .
Background: After failing to statistically confirm a perceived pattern noted on radiographs that the sesamoids were proximally positioned in patients with hallux limitus compared with a control population without evidence of the deformity, the probable causes of this failure were examined. Measurement error was briefly considered but rejected owing to the careful manner in which the measurements were taken. The most plausible explanations were that the observations were incorrect and that the radiographs, which were retrospectively analyzed, were taken in a manner that distorted the spatial relationships between the metatarsal and the tibial sesamoid to a point that the results did not reflect reality.
Methods: This study examines potential difficulties in obtaining consistently reliable radiographic data regarding the spatial relationships of the metatarsal and the tibial sesamoid and establishes guidelines to minimize experimental error. Criteria for measuring metatarsal sesamoidal distances to the radiographic plate are established, along with application of the criteria to a control population. The principle of radiographic image distortion as it relates to these objects is presented, and, based on a predetermined range of radiographic angles, radiographic image distortion is calculated for the metatarsal head and the tibial sesamoid separately.
Results: By using accepted trigonometric principles, a mathematical model is developed that makes it possible to collectively quantify image shift between the two objects.
Conclusions: Criteria are established that, if followed, should minimize image distortion when it is important to measure metatarsal sesamoidal distances. (J Am Podiatr Med Assoc 100(1): 1–9, 2010)
Corresponding author: Michael Durrant, DPM, MPH, 16 E Fern Ave, Ste B, Redlands, CA 92373. (E-mail: Durrant.email@example.com)