The missed chapter on midfoot: Chopart injuries.

IF 9.7 1区 医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Radiologia Medica Pub Date : 2024-11-04 DOI:10.1007/s11547-024-01905-9
Bilal Abs, David Ferreira Branco, Axel Gamulin, Paul Botti, Marcello Buzzi, Pierre-Alexandre Poletti, Hicham Bouredoucen, Sana Boudabbous
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Abstract

Purpose: Midtarsal injuries are often missed at initial presentation which may lead to long-term complications. Nonetheless, radiographs (XR) are used as a primary imaging method. The place of cone beam computer tomography (CBCT) remains unclear in the management of midfoot injuries. The aim of this study was to update imaging findings on traumatic ankle and foot injuries (TAAFI) with CBCT and to assess the sensitivity, specificity and accuracy of XR compared to CBCT for midfoot injuries detections.

Material and methods: All CBCT studies performed due to (TAAFI) that had previous XR were collected for a period of 5 years. They were retrospectively anonymized and analyzed by a radiologist. A second blinded study of XR was made by a second radiologist as a control.

Results: A total of 754 cases were included. Lisfranc and Chopart injuries were detected in 153 (20.2%) and 154 (20.4%) patients, respectively. Lisfranc and Chopart's lesions combined together were seen in 33 cases (10.7%). A blinded retrospective analysis of XR compared to CBCT shows a sensitivity of 64.9% (56.8-72.4%; 95% CI), a specificity of 95.0% (92.9-96.6%; 95% CI) and an accuracy of 88.9% (86.4-91.0%; 95% CI) for Chopart's injuries. Regarding Lisfranc, the sensitivity was 62.1% (53.9-69.8%; 95% CI), specificity 99.0% (97.8-99.6%; 95% CI) and accuracy 91.5% (89.3-93.4%; 95% CI).

Conclusion: This cohort study highlights the missed injuries of Chopart on XR and the low association with Lisfranc avulsions. The use of CBCT helps in detecting and assessing midfoot injury.

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关于中足的遗漏章节Chopart 损伤。
目的:跗骨中段损伤往往在初诊时被漏诊,这可能会导致长期并发症。尽管如此,X 光片(XR)仍被用作主要的成像方法。锥形束计算机断层扫描(CBCT)在足中部损伤治疗中的地位仍不明确。本研究的目的是通过 CBCT 更新创伤性踝关节和足部损伤(TAAFI)的成像结果,并评估 XR 与 CBCT 相比在检测中足损伤方面的敏感性、特异性和准确性:收集5年来因踝关节损伤(TAAFI)而进行的所有CBCT研究,这些研究之前都进行过XR检查。一名放射科医生对这些数据进行了匿名回顾性分析。作为对照,第二位放射科医生对 XR 进行了第二次盲法研究:结果:共纳入 754 个病例。分别有 153 例(20.2%)和 154 例(20.4%)患者发现了 Lisfranc 损伤和 Chopart 损伤。33例(10.7%)患者合并有Lisfranc和Chopart损伤。与 CBCT 相比,XR 的盲法回顾性分析显示,Chopart 损伤的灵敏度为 64.9% (56.8-72.4%; 95% CI),特异度为 95.0% (92.9-96.6%; 95% CI),准确度为 88.9% (86.4-91.0%; 95% CI)。关于Lisfranc,灵敏度为62.1%(53.9-69.8%;95% CI),特异度为99.0%(97.8-99.6%;95% CI),准确度为91.5%(89.3-93.4%;95% CI):这项队列研究强调了XR检查对Chopart损伤的遗漏以及与Lisfranc撕脱的低关联性。使用 CBCT 有助于检测和评估中足损伤。
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来源期刊
Radiologia Medica
Radiologia Medica 医学-核医学
CiteScore
14.10
自引率
7.90%
发文量
133
审稿时长
4-8 weeks
期刊介绍: Felice Perussia founded La radiologia medica in 1914. It is a peer-reviewed journal and serves as the official journal of the Italian Society of Medical and Interventional Radiology (SIRM). The primary purpose of the journal is to disseminate information related to Radiology, especially advancements in diagnostic imaging and related disciplines. La radiologia medica welcomes original research on both fundamental and clinical aspects of modern radiology, with a particular focus on diagnostic and interventional imaging techniques. It also covers topics such as radiotherapy, nuclear medicine, radiobiology, health physics, and artificial intelligence in the context of clinical implications. The journal includes various types of contributions such as original articles, review articles, editorials, short reports, and letters to the editor. With an esteemed Editorial Board and a selection of insightful reports, the journal is an indispensable resource for radiologists and professionals in related fields. Ultimately, La radiologia medica aims to serve as a platform for international collaboration and knowledge sharing within the radiological community.
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