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- Author or Editor: RA Christman x
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A methodic analysis of foot radiographs is valuable when evaluating for joint disease. The author presents a system that allows the interpreter to establish a list of expected differential diagnoses. This is especially useful when the arthritide does not present with its classic radiographic appearance.
Normal radiographic anatomy of the first metatarsal bone is established through cadaver dissection, examination of bone specimens, and radiography. Extra-articular and distal articular anatomical landmarks are identified with wire markers. Dorsoplantar, lateral, lateral oblique, and medial oblique radiographs of 15 osteologic sites are presented, including the articular margins of the first metatarsal head, the borders of the three diaphyseal surfaces, the origins of the metatarsophalangeal collateral and metatarsosesamoid suspensory ligaments, and the insertions of the first cuneiform-metatarsal joint ligaments and the tibialis anterior and peroneus longus tendons. The correlation of gross anatomy and radiographs is described.
Gout and rheumatoid arthritis are relatively common entities individually; however, the coexistence of these two conditions has been reported rarely in the literature. The authors present a case that was followed for 20 years. The patient was seen by the acknowledged internist and podiatrist. Criteria for the evaluation and diagnosis of each disease entity are discussed and correlated to the case reported. Various theories and research attempting to explain the negative coexistence of gout and rheumatoid arthritis are presented.
Gross discrepancy and error regarding the identification and location of the peroneal tubercle have been found in the literature. Furthermore, the authors found no evidence of a repeatable measurement technique in applicable descriptions of this osteologic landmark. In accordance with interrater reliability procedures, the authors established repeatability of peroneal tubercle measurements. In conjunction with the instrumentation's accuracy and resolution, the investigators infer reliability for these measurements. To the best of the authors' knowledge, this study is the only one in which interrater reliability was established for the morphometric assessment of the peroneal tubercle and the retrotrochlear eminence. The results also reestablish the correct anatomical presentation of the retrotrochlear eminence and the peroneal tubercle along the lateral surface of the calcaneus.
