Woerman AL, Binder-Macleod SA: Leg length discrepancy assessment: accuracy and precision in five clinical methods of evaluation. J Orthop Sports Phys Ther5: 230, 1984.10.2519/jospt.1922.214.171.12418806409)| false
Knutson GA: Anatomic and functional leg-length inequality: a review and recommendation for clinical decision-making: part II. The functional or unloaded leg-length asymmetry. Chiropr Osteopat13: 12, 2005.
Knutson GA: Anatomic and functional leg-length inequality: a review and recommendation for clinical decision-making: part II. The functional or unloaded leg-length asymmetry. Chiropr Osteopat13: 12, 2005.10.1186/1746-1340-13-1216080787)| false
Petrone MR, Guinn J, Reddin A, et al: The accuracy of the palpation meter (PALM) for measuring pelvic crest height difference and leg length discrepancy. J Orthop Sports Phys Ther33: 319, 2003.1283920610.2519/jospt.2003.33.6.319)| false
Friberg O, Nurminen M, Korhonen K, et al: Accuracy and precision of clinical estimation of leg length inequality and lumbar scoliosis: comparison of clinical and radiological measurements. Int Disabil Stud10: 49, 1998.
Friberg O, Nurminen M, Korhonen K, et al: Accuracy and precision of clinical estimation of leg length inequality and lumbar scoliosis: comparison of clinical and radiological measurements. Int Disabil Stud10: 49, 1998.10.3109/09638288809164098)| false
The aim of this work is to introduce a useful method for the clinical diagnosis of leg-length inequality: distance between the malleoli and the ground (DMG).
A transversal observational study was performed on 17 patients with leg-length discrepancy. Leg-length inequality was determined with different clinical methods: with a tape measure in a supine position from the anterior superior iliac spine (ASIS) to the internal and external malleoli, as the difference between the iliac crests when standing (pelvimeter), and as asymmetry between ASISs (PALpation Meter [PALM]; A&D Medical Products Healthcare, San Jose, California). The Foot Posture Index (FPI) and the navicular drop test were also used. The DMG with Perthes rule (perpendicular to the foot when standing), the distance between the internal malleolus and the ground (DIMG), and the distance between the external malleolus and the ground were designed by the authors.
The DIMG is directly related to the traditional ASIS–external malleolus measurement (P = .003), the FPI (P = .010), and the navicular drop test (P < .001). There are statistically significant differences between measurement of leg-length inequality with a tape measure, in supine decubitus, from the ASIS to the internal malleolus, and from the ASIS to the external malleolus.
This new method (the DMG) is useful for diagnosing leg-length discrepancy and is related to the ASIS–external malleolus measurement. The DIMG is significantly inversely proportional to the degree of pronation according to the FPI. Conversely, determination of leg-length discrepancy with a tape measure from the ASIS to the malleoli cannot be performed interchangeably at the level of the internal or external malleolus.
Corresponding author: Estela Gomez Aguilar, Department of Podiatry, University of Seville, C/ Avicena s/n 41009, Sevilla, Sevilla 14540, Spain. (E-mail: email@example.com)