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Radiographic validation of a self-report instrument for hallux valgus.

Authors
  • Gupta, Vatsal1
  • Lingham, Aranghan2
  • Marshall, Michelle3
  • Rathod-Mistry, Trishna3
  • Menz, Hylton B3, 4
  • Roddy, Edward3, 5
  • 1 Trauma & Orthopaedics, University Hospital of Coventry and Warwickshire, Coventry, UK.
  • 2 Trauma & Orthopaedics, East Sussex Hospitals NHS Trust, Hastings, UK.
  • 3 Primary Care Centre Versus Arthritis, School of Medicine, Keele University, Keele, UK.
  • 4 Discipline of Podiatry, School of Allied Health, Human Services and Sport, La Trobe University, Victoria, Melbourne, Australia. , (Australia)
  • 5 Haywood Academic Rheumatology Centre, Midlands Partnership NHS Foundation Trust, Haywood Hospital, Burslem, UK.
Type
Published Article
Journal
Musculoskeletal care
Publication Date
Jun 01, 2022
Volume
20
Issue
2
Pages
383–389
Identifiers
DOI: 10.1002/msc.1604
PMID: 34861078
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Hallux valgus (HV) is a common condition causing substantial morbidity. Radiographic assessment is the gold standard for grading severity but is not always feasible in clinical/research settings. HV line-drawings, consisting of five drawings for each foot depicting a sequential increase in HV angle of 15°, have been clinically validated for self-reporting severity. We aimed to undertake radiographic validation of this self-report instrument. Adults aged ≥50 from four GP practices were sent a health survey. Responders self-reported HV severity for each foot using the line-drawing instrument. Those reporting foot pain in the last year had radiographs taken at a research clinic from which intermetatarsal, hallux abductus and hallux interphalangeal abductus angles were calculated. Ten feet were randomly selected for each HV line-drawing grade for both feet. Associations between self-reported HV line drawings and radiographic measurements were assessed using Spearman's ρ correlation coefficients, mean radiographic angle measurement (95% confidence interval) and one-way analysis of variance. Increasing HV line-drawing grade was positively correlated with radiographic measurements for intermetatarsal and hallux abductus angles (Spearman's ρ = 0.602, p < 0.001; 0.821, p < 0.001, respectively). Hallux interphalangeal abductus angle showed an inverse correlation with increasing line-drawing grade (-0.204, p = 0.053). Differences in radiographic measures between HV line drawing grades were significant for intermetatarsal (F = 13.98, p < 0.001) hallux abductus (F = 38.90, p < 0.001) but not hallux interphalangeal abductus angle (F = 2.21, p = 0.075). Grading HV severity by self-reported HV line-drawings provides a valid representation of deformity determined from radiographic measurements and is a useful screening/self-reporting tool. © 2021 John Wiley & Sons Ltd.

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