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Radiographic Assessment of Lower-Limb Discrepancy

Maria Reina-Bueno Department of Podiatry, University of Seville, Seville, Spain.

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Guillermo Lafuente-Sotillos Department of Podiatry, University of Seville, Seville, Spain.

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Jose M. Castillo-Lopez Department of Podiatry, University of Seville, Seville, Spain.

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Estela Gomez-Aguilar Department of Podiatry, University of Seville, Seville, Spain.

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Pedro V. Munuera-Martinez Department of Podiatry, University of Seville, Seville, Spain.

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Background:

This study compares different lower-limb length measurements using tests of lower-limb upright full-length radiography and anteroposterior radiography of load-bearing hips.

Methods:

Forty-seven consecutive individuals aged 17 to 61 years (mean ± SD, 31.47 ± 11.42 years) voluntarily took part in the study; 23 (48.9%) were women and 24 (51.1%) were men. All individuals presenting a difference of 5 mm or greater between both lower limbs quantified with a tape measure were included. All of the participants signed an informed consent form to take part in the study. Two anteroposterior load-bearing radiographs were taken: one of the hip and an upright full-length radiograph of the lower limbs. Lower-limb–length discrepancy was quantified by taking different reference points. Interobserver and intraobserver reliability was assessed for each radiographic measurement. Any correlation between the different measurements were also verified.

Results:

Interobserver and intraobserver reliability was high for all of the measurements because the intraclass correlation was greater than 0.75 in all of the cases. There was a strong and positive correlation between the different measurements because when performing bivariate correlations with the Pearson correlation coefficient, positive values close to 1 were found.

Conclusions:

In this study, the different reference points reported in the upright full-length radiograph in addition to the hip radiographs are useful for assessing lower-limb–length discrepancy. The results showed that there is a correct correlation between the different measurements.

Corresponding author: Maria Reina-Bueno, PhD, Departamento de Podologia, University of Seville, Calle Avicena s/n, Seville, 41009, Spain. (E-mail: mreina1@us.es)
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