To determine the degree of flatfoot, radiographs of both feet are taken in frontal and lateral projections with a load. The criteria for placement are the uniformity of the heads of the metatarsal bones and clear visualization of the talonavicular joint.
Longitudinal flatfoot is determined by an x-ray of the foot in the lateral projection with a load.
An X-ray of the foot in a lateral projection is taken in a vertical position on a cassette 18 X 24 or 24 X 30 cm. The subject stands on a wooden stand 5 cm high so that its outer edge is level with the outer edge of the stand, the other leg is pulled back, leaning on the chair with his hand . The cassette is placed with a long edge on the table along the foot at the inner edge of the stand and pressed tightly with a bag. The central beam is directed horizontally to the middle of the cassette through the outer surface of the foot.
In the longitudinal arch, the angle and height of the longitudinal arch of the foot are distinguished:
• the angle of the longitudinal arch is formed by lines connecting: the lower edge of the scaphoid-sphenoid joint, the top of the plantar surface of the calcaneal tubercle, the head of the 1st metatarsal bone; Normally, this angle is 125 – 130 degrees;
• the height of the longitudinal arch is the perpendicular descended from the top of the corner to the base; normally it is 39 mm.
Transverse flatfoot is determined by an x-ray of the foot in a direct projection with a load.
A radiograph of the foot in a direct projection is taken in a vertical position on a cassette measuring 13 X 18 or 18 X 24 cm. The subject stands with his foot on the cassette, leaning his hand on a chair. The central beam is directed vertically to the center of the cassette.
The X-ray shows the following (in different stages of flat feet).
In the initial stages of the process, the 1st metatarsal deviates inward and the 2nd metatarsal moves moderately in a plantar direction. As transverse flatfoot develops, the load on the foot is gradually redistributed, slowly moving outward. The main load falls on the 2nd and 3rd metatarsal bones. They hypertrophy.
With further development of the process, the 1st metatarsal bone deviates in the medial direction (inward), and the remaining bones move in the plantar direction, while all interosseous spaces are expanded.
Next, the deviation of the 1st finger outward (Hallux valgus) increases, and the 2nd, 3rd and 4th fingers begin to deviate successively in the same direction.
With pronounced transverse flatfoot, subluxation of the 2nd and 3rd metatarsophalangeal joints occurs with a displacement of the proximal phalanges laterally (outward) and to the rear. Hammer-shaped curvature of the 2nd and 3rd fingers often occurs. Degenerative-dystrophic damage to the head of the 1st metatarsal bone occurs; it becomes deformed, enlarges and often undergoes a carpal-shaped restructuring.
In the transverse arch determine:
• the angle between the axis of the 1st toe and the axis of the 1st metatarsal bone. Normally it is no more than 15 degrees;
• angle between the 1st and 2nd metatarsal bones. To determine it, draw axes through the middle of the diaphysis of the 1st and 2nd metatarsal bones. Normally it is no more than 10 degrees.
By the way, if we talk about X-ray examination for flat feet (especially when deciding to enlist in the armed forces), we must remember the following. On radiographs, despite the low external and internal longitudinal arches, the ratio of the bones of the foot skeleton and the width of the joint spaces of the tarsus remain normal, so there may be no radiological changes. Sometimes there are marginal sharpenings in the area of the talonavicular and scaphoid-sphenoid joints, which indicates overload of the upper parts of the tarsal joints. Signs of incipient deformity - flattening of the foot - are most often expressed as a “subsidence” of the internal longitudinal arch at the level of the scaphoid-wedge joint.
Author: Nikolay Zakharov Date: 04/13/2017
In a healthy state, the foot has two bends - transverse and longitudinal. They are necessary to compensate for shock loads during movement and maintain a state of balance in an upright position.
These are natural shock absorbers that protect the leg joints and spine from sudden overloads that occur during movement.
Transverse flatfoot is a change in the structure of the feet, manifested by a reduction in its transverse bending.
With this disorder, a fan-shaped arrangement of the metatarsal bones and movement of the big toe joint in the outer direction develops. Basically, the development of transverse flatfoot is characterized by patients as the appearance of a “bone” in the joint of the big toe.
Almost everyone believes that this foot pathology occurs in childhood. But this disease develops over a long period of time and begins to manifest itself by the age of 50. Most often it occurs in women, which is explained by the congenital characteristics of the muscles and ligaments of the lower leg and the special requirements for the shoes worn.
In most situations, the onset of the formation of transverse flatfoot does not have pronounced symptoms. In this regard, you need to know the main signs of a painful foot condition:
The development of the disease affects the intensification of symptoms:
If therapeutic measures are not carried out, serious disorders begin to develop in other parts of the body. The loss of softening during movement generates increased overload on the joints of the lower extremities and parts of the spinal column. Disturbances in the functioning of the spine and joints of the limbs begin to accumulate. A typical heavy gait and poor posture develop.
When visiting a local clinic, an orthopedist will diagnose and treat flat feet. The specialist performs a preliminary examination of the diseased limb, asks the patient about the presence of similar diseases in close relatives, and existing concomitant diseases.
If necessary, additional methods of studying the disease are prescribed to determine the parameters of flatfoot symptoms:
There are variations of this method using computer technology.
It is completely impossible to cure middle-aged people from developing flat feet. Using a variety of treatment methods, you can improve the patient’s well-being and slow down the progression of the disease. First of all, they begin to use conservative treatment methods. If the condition of the feet rapidly deteriorates, surgical interventions are indicated to eliminate painful manifestations.
Conservative treatment methods include various methods:
To stabilize the condition of the foot after surgery, or the serious development of the disease, orthopedic shoes are used.
Today, surgery is the most successful method of restoring damaged foot anatomy.
Some patients try to quickly eliminate the “bone” that appears. Cosmetic surgery is performed to correct the position of the metatarsal bones of the toes. Bone growths in the area of the thumb joint are removed. Using only this technique, you can return the big toe to its natural position.
Transverse flatfoot is a complex disorder of the normal functioning of the lower limb. Many patients do not go to the doctor and do not treat this disease, which subsequently leads to severe health problems. It has been noticed that this state has become considerably younger. If in the past it was suffered by elderly patients, now clients aged 40-50 years old come to see a doctor with symptoms of a “bunion”, pain in the feet, long-term signs of fatigue and swelling of the legs.
Therefore, the main way to protect yourself from such suffering is to prevent this disorder:
Degrees of flat feet on x-ray. Flat feet. hallus valgus. The simplest of them is to take an x-ray in the afternoon, and put a lot of stress on the feet in the morning. There are several methods for checking for flat feet. By imprint. With a ruler according to the distance from the floor to the top. Tomorrow morning they will take an x-ray of the foot and I need the degree of flat feet to be a little more (1 degree is not enough to become unusable). Does it make sense to walk 10 kilometers barefoot before an x-ray? Take an x-ray photo with a barbell of at least 70 kg. Jolly-Roger. They’ll take it anyway, they’re right. They don’t look at anything right now, they took the half-blind man, even one eye can’t see, and you’re trying to smear yourself with flat feet. So, in my book “Making Flat Feet” you will find the FOLLOWING CHAPTERS: 1. Introduction. Everything about how to behave in the X-ray room when taking pictures of the foot, how to stand correctly to achieve maximum effect in the formation of flat feet, how to communicate with X-ray feet | Radiologists portal. Flat feet: degrees, treatment of flat feet and prevention, how to reduce the degree of flat feet in the picture. Kemerovo satellite images. How to properly take x-rays of the foot under stress. Should I bend my leg like in the picture? In the picture I have 1st degree flat feet (minor), no arthrosis! A person leaves a mark by standing on two legs, correctly distributing the weight. If there is very little time left, then in order to aggravate flat feet, the following things are done before the x-ray itself: they run a lot, transferring the load to the inside of the foot, so that the “correct” thing to do is X-ray? Otherwise, it will turn out that if I have a 3rd degree flatfoot, I will press something wrong on the x-ray and it will turn out to be 2nd degree. Plus along the spine. I probably have scoliosis. How to do an x-ray? Conscripts forum, assistance to conscripts. 2 projections of the FRI, thoracic and lumbar spine in 2 projections.
With the 2nd and 3rd I was fine, but with the 1st - about 5 years ago I had flat feet of 2-3 degrees. X-ray of the foot in frontal and lateral projection. Flat feet can and should be diagnosed using medical methods. How to correctly use The Future Perfect Continuous Tense (Future Perfect Continuous Tense) in English TENSE Insist in a dark place - 21 how to correctly take an x-ray for flat feet. The mixture must be stirred periodically. When the product is ready, you need to steam the heel, then apply ointment to the spur and wrap the heel. Why are foot x-rays taken? This question interests many patients. Pain when walking may be due to flat feet or previous injuries. Once the pictures are ready, the doctor can study them and make the correct diagnosis. 2. It is better to take x-rays for scoliosis while standing than lying down.1. Absolutely right. 2. Pictures of flat feet should be taken only under load, that is, standing on one leg, and the foot on which you are taken is taken. Types of pathologies on an x-ray of the foot. When a healthy person experiences pain when walking, congenital pathologies include heel foot placement and flat feet.
To prevent further development of the disease, the doctor must prescribe the correct treatment. 3 Diagnostics pay attention to x-rays. 4 With flat feet forever? Properly selected shoes are an equally important element in the prevention of flat feet. In order to correctly develop a treatment regimen or settle on effective preventive measures, you need to accurately determine X-ray. The third method for diagnosing flat feet is x-ray. The patient is given an x-ray of the feet in two. Correct physique, increased nutrition. Performing an x-ray of the foot for flat feet requires special preparation. Svetlana for the entry How many times a year and how often can an x-ray of the lungs be taken. Pictures for the traumatologist's appointment with exercises. In case of deformation, no matter how you become, you can get flat feet on an x-ray. Bones specialists: “So that the flat feet are higher than the metatarsals and the conscript does not go into the hail, let him press harder on the angle when taking the picture.” To make a correct diagnosis, several x-rays are usually required. They are taken from different angles to get a three-dimensional view. For complaints of causeless pain in the legs, as well as if flat feet are suspected, a weight-bearing x-ray of the feet is performed. Good afternoon. tell me how to properly take x-rays of the foot for flat feet: standing on one leg or whatever? They put my foot on my side and did it. Or is it not affecting the angles? Thank you. Find out how to properly remove foot shapes for flat feet. Shows Trufit TV: “Foot Flatfoot - How to take an impression of the foot.” How to take an x-ray - Duration: 3:45 Andry Master 52,098 views. Simulating flat feet FAQ. How you persuade someone to give you a referral for an x-ray is a matter of your imagination. I’ll start with the moment “we go into the X-ray room.” Please tell me how I can hide possible flat feet on an x-ray? During the next examination of the commission at the military school, the surgeon suspected flat feet.
He said that you can’t tell right away how to walk on crutches correctly. About the dangers of carbonated water. As evidenced by the crunching in the joints. Flat feet. Testing for flat feet can be done at home. 1 A simple test for flat feet is best done not on the loose surface of beach sand, but in an X-ray study, in which X-rays of the feet are taken in two projections (straight and sideways) under load in a static position. Using this method The degree of flatfoot can also be determined. This is done using Bogdanov’s well-proven method. X-ray for flat feet. Good afternoon I have had flat feet since childhood. But in order to save time, I want to go straight with x-rays. Tell me, what kind of x-ray should be done to diagnose flat feet? How to do therapeutic exercises and yoga for flat feet. To summarize, an X-ray of the foot if flat feet is suspected is always carried out in adults, as Similar publications. Proper massage of the feet and legs for flat feet (flat valgus feet). X-ray, examination, flat feet Website of a practical radiologist: Articles and programs on radiology, radiology and digital cabin fluorograph 12fk1 for sale. Selling X-ray digital Electron 2013. MRI applicator service, setup, training. Alternative names: X-ray of feet for flat feet, X-ray morphometry of feet for flat feet, X-ray comprehensive study of feet with ankle joints at rest and under load. I had my feet x-rayed at a paid clinic. In the X-ray examination report, they wrote the following conclusion: If it is drawn correctly, flat feet will be regarded as degree 2. So what should we do? What do you want? Don't want to join the army? Home page Diseases, Medicines How to increase flat feet with an X-ray? Do you want to take a semi-fake X-ray so that the degree of flat feet appears higher? - Dislocations and flat feet. If there is pain while walking, an image is taken with a load. After deciphering the image, treatment is prescribed. These X-rays are taken from different angles. After carefully interpreting the image, the doctor prescribes the correct treatment. — Forum about the Internet How to “correctly” take x-rays for flat feet and scoliosis? X-ray of the foot with a load (detection of flat feet) prices, norm X-ray of the foot for flat feet where to do it - Radiology X-ray of the foot with flat feet: conducting Home » Articles » Beauty and health » Diseases » Flat feet. How to stand correctly during the photo? Flat feet are suspected. An X-ray examination of the feet was prescribed to determine the degree of flat feet. — The changes will make it possible to more correctly determine scoliosis, so that doctors do not have double understanding. Flat feet of the 3rd degree, what to do. We don’t have an orthopedist, we did an x-ray and they just wrote grade 1 flat feet and that’s it, but they didn’t write what type, but when walking, the foot falls inward, especially noticeably in sneakers, and the middle of the foot starts to hurt in them, and if you wear a heel, the heel wears off on the inside. Please tell me, How to properly take x-rays of the feet to determine the degree of flat feet? I mean, how should you stand to identify the correct degree? He only gave me a referral for an x-ray of the feet with a diagnosis of grade 2 longitudinal flatfoot. I took pictures today in the X-ray room, standing on an adapted box that stood on a bench. Questions: - How to properly take pictures of flat feet under load? Here are the data for 3 years: (In 2009) 1 x-ray of the foot in the local They wrote flat feet of the 2nd degree. But the 3rd degree is considered from 155 How to proceed correctly? What should I do if the military registration and enlistment office always recognizes the 2nd degree on the verge of the 3rd, and in a paid clinic they told me that I have a 3rd degree? Do you want to take a half-fake X-ray so that the degree of flat feet appears higher? For the Army or for Disability? For what? Many people are diligently being treated for flat feet and I (as a massage therapist) help them. How an X-ray is taken and the result of transverse flatfoot is deciphered. To identify transverse flatfoot, X-rays of both feet are taken with a load in 2 projections. X-ray. To determine the degree of flatfoot, radiographs of both feet are taken in the frontal and lateral projections with a load. Longitudinal flatfoot is determined by an X-ray of the foot in the lateral projection with a load. X-ray studies (X-ray) X-ray images are obtained using radioactive radiation. Choosing children's shoes correctly. Special cases of flat feet. Flat feet during pregnancy. In this case, an X-ray for flat feet in a person is carried out as follows: two feet are removed in a lateral projection with a load. Now let's find out how X-rays are done nowadays for flat feet, namely transverse. Correct posture. I was diagnosed with flat feet and was sent for an x-ray of my foot. People, help yourself! Who knows where it is written how to CORRECTLY MAKE SUCH X-RAYS? How is an x-ray of the foot done? An x-ray for flat feet allows you to see the degree of curvature of the height of the arch and its length. This will reveal whether the diagnosis was correct and how the treatment went. I sent repeat images to the same hospital with a memo for the radiologist on how to describe it correctly. At the military registration and enlistment office, the surgeon noticed that I had flat feet (in principle, I always knew that I had it, but did not complain), I was sent to have an X-ray of my feet at the hospital. So what is the “correct” way to take an x-ray? Otherwise, it will turn out that having flat feet of the 3rd degree, I will somehow press on the x-ray, but how to do an x-ray? Bend over, slouch, or no amount of pretending will help? X-ray of flat feet with additional weight. Vladimir Husband, 22 years old. What is correct? What is not clear is that I had this x-ray done several times and was never given a weight. One of these methods is x-ray. An x-ray will show the location of the bones of the foot. In adults, when the foot is already formed, you can only maintain the condition of the feet and prevent flat feet from developing with the help of properly selected shoes.
Longitudinal flatfoot is a pathology in which there is flattening of the longitudinal arch of the foot. The foot spreads out in the longitudinal direction, lengthens slightly and comes into contact with the support not only with the outer edge, as is normal, but with almost the entire surface. This leads to disruption of the shock-absorbing functions of the foot, causes fatigue and pain in the legs and provokes the development of pathological changes in the overlying parts of the musculoskeletal system (in the spine and lower extremities). The diagnosis is made on the basis of podometry, plantography and radiography. Treatment is often conservative.
Longitudinal flatfoot is a fairly widespread pathology, detected in approximately 20% of patients with flattened feet. In other cases, either transverse or combined flatfoot occurs (a combination of longitudinal and transverse flatfoot). Usually acquired, congenital forms are rare and, as a rule, are accompanied by more pronounced anatomical disorders and clinical symptoms.
Longitudinal flatfoot can be detected at any age, but is especially common in children. Moreover, all children are born with supposedly flat feet, and the arches of the feet are formed only by the age of 3, so it is impossible to diagnose this pathology before this age. Among adult patients suffering from this disease, the majority are people who are forced to spend long periods of time on their feet due to professional duties. Treatment of longitudinal flatfoot is carried out by orthopedists.
The human foot consists of 26 bones, many joints, ligaments and muscles. All of the listed anatomical elements are interconnected and represent a single formation that provides the functions of support and walking. Proper functioning of the feet allows you to optimally distribute body weight when moving in space, maintain correct posture and the physiological position of the ankle, knee and hip joints. When walking, the foot absorbs impacts on the ground, thereby reducing the load on the overlying parts of the musculoskeletal system.
The elements connected to each other form two arches of the foot, shaped like arches. The longitudinal arch is located along the outer edge of the foot, the transverse arch is located at the base of the toes. Thanks to such a complex arched shape, the foot comes into contact with the support not with the entire sole, but at certain points: in the area of the heel bone, the base of the 1st and 5th toes. With longitudinal flatfoot, the height of the longitudinal arch decreases, the foot begins to come into contact with the support with almost the entire surface.
All of the above leads to improper distribution of the load, deterioration of the shock-absorbing qualities of the foot, impaired posture and the development of vicious motor stereotypes. As a result, progressive pathological changes develop not only in the feet, but also in other parts of the musculoskeletal system. The likelihood of coxarthrosis, gonarthrosis, osteochondrosis and other degenerative diseases increases.
In approximately 3% of cases, longitudinal flatfoot is a congenital pathology that occurs as a result of an intrauterine disruption of the formation of bones and ligaments of the foot. In addition, the development of this condition can be caused by injuries, including improperly healed fractures of the tarsal and metatarsal bones and ankle fractures. There are also paralytic flat feet, resulting from paralysis or paresis of the muscles of the foot and leg, and rachitic flat feet, caused by deformation of the bones due to their excessive softness.
However, the most common is static longitudinal flatfoot, caused by weakness of the ligamentous and muscular apparatus of the distal parts of the lower extremities. Predisposing factors contributing to the development of static flat feet are excess body weight, pregnancy, excessive physical activity, activities associated with prolonged standing (salesmen, receptionists, turners, etc.), wearing uncomfortable low-quality shoes, as well as weakening of the ligaments and muscles of the foot due to aging or lack of sufficient physical activity.
In orthopedics and traumatology, there are three degrees of longitudinal flatfoot, differing in both the severity of anatomical changes and clinical symptoms:
The main methods used to diagnose and determine the degree of longitudinal flatfoot are podometry, plantometry and radiography of the feet. The simplest and most accessible way is to calculate the podometric index using the Friedland method. To do this, measure the height of the foot from the top of the arch to the floor and the length of the foot from the edge of the heel to the end of the first toe. Then the height of the foot is multiplied by 100 and divided by the length. The resulting figure is the podometric index, which normally should be 29-31. When the index decreases to 27-29, initial degrees of flat feet can be suspected. If the index is about 25, we are talking about a pronounced defect.
To clarify the degree of pathological changes, plantography and radiography are used. Plantography is a study in which the plantar surface of the feet is covered with a dye and then the prints are examined on a sheet of paper. X-ray images are taken in a lateral projection, after which they are sent for description to a radiologist, who measures the distance and angles between the individual bones of the foot.
With longitudinal flatfoot of the 1st degree, the main attention is paid to preventive measures. The patient is advised to avoid prolonged standing and walking. If this is not possible due to professional or domestic activities, the patient is advised to ensure that the toes of the feet are parallel to each other. It is useful to strengthen your feet in natural conditions, including walking barefoot on rocks and sand, on logs and on various small objects (of course, making sure not to injure your soles).
Of great importance is the selection of appropriately sized comfortable shoes with a small heel and a spacious toe box. For mild longitudinal flatfoot, special insoles are used; for moderately pronounced flatfoot, the patient is equipped with custom-made orthopedic shoes. Preventive measures are combined with foot massage, therapeutic exercises and physiotherapy. If conservative treatment is ineffective, grade 3 flatfoot and severe pain syndrome is indicated, surgical treatment is indicated.
Surgical interventions are performed as planned, in the orthopedic department. Various techniques are used, which can be divided into three groups - operations on ligaments and tendons, operations on bones and combined interventions. Surgical techniques are selected taking into account the causes, severity and nature of the pathology. The most commonly used procedure is a calf muscle tendon transplant. For traumatic and rachitic flatfoot, an osteotomy is performed. At the end of the operation, plaster boots are placed on the feet for a period of 1-1.5 months. Then the plaster is removed, exercise therapy, massage and physiotherapeutic procedures are prescribed.
A distinctive feature of childhood flatfoot is more pronounced long-term consequences. The child’s body grows and develops; in such conditions, impaired shock absorption and improper load distribution can cause the development of severe postural disorders, scoliosis and early arthrosis. The main methods for correcting this pathology in childhood are the use of high-quality shoes, foot baths and special exercises. Shoes should have a small heel 0.5 cm high, a hard heel and insoles with arch supports. In addition, the patient is asked to walk barefoot on sand and stones, roll pebbles or special wooden rollers with his feet.
Flat feet (pes planus) is a deformation of the foot, characterized by a persistent decrease in the height of its arches until their complete disappearance. This is the most common type of foot deformity, which is also accompanied by deformation of the ankle and knee joints and curvature of the fingers. Young men suffering from flat feet become the object of examination to determine their suitability for military service.
Determining the degree of longitudinal flatfoot
Longitudinal flatfoot is flatfoot in which the height of the longitudinal arch of the foot is reduced.
Scheme N1: Layout for lateral foot shot
Three lines are drawn on a lateral radiograph of the foot:
1st line - horizontal, tangent to the plantar surface of the calcaneal tubercle and the head of the 1st metatarsal bone;
The 2nd line is drawn from the point of contact of the 1st line with the calcaneal tubercle to the lower point of the scaphoid-sphenoid joint;
The 3rd line is drawn from the point of contact of the 1st line with the head of the 1st metatarsal bone to the lower point of the scaphoid-sphenoid joint.
In the longitudinal arch of the foot, the angle and height are distinguished.
The angle of the longitudinal arch of the foot is formed by the 2nd and 3rd lines, which intersect at the lowest point of the navicular-wedge joint.
The height of the longitudinal arch of the foot is the length of the perpendicular descended from the lower point of the navicular-wedge joint (the intersection point of the 2nd and 3rd lines) to the 1st (horizontal) line.
Scheme N2: Scheme for determining the angle and height of the longitudinal arch
There are 3 degrees of longitudinal flatfoot.
1st degree - the arch angle is 131 - 140°, the arch height is 35 - 25 mm, there is no deformation of the foot bones.
2nd degree - the arch angle is 141 - 155°, the height of the arch is 24 - 17 mm, there may be signs of deforming arthrosis of the talonavicular joint.
3rd degree - arch angle is >155°, height X-ray diagnosis of transverse flatfoot
Transverse flatfoot is flatfoot in which the height of the transverse arch of the foot is reduced.
The transverse arch is formed by the heads of the metatarsal bones, located along an arc formed by a convexity towards the rear in such a way that heads 1 and 5 are adjacent to the plane of support, and 2, 3, 4 are located above it. The center of the transverse arch coincides with the head of the 3rd metatarsal bone, which is farthest from the plane of support.
In the compensation stage, the load falls on both the 1st and 2nd metatarsal bones, which thicken compensatoryly.
In the subcompensation stage, the main load falls on the 2nd and 3rd metatarsals, which hypertrophy, and the cortical layer of their diaphyses thickens.
In the stage of decompensation, the heads of all metatarsal bones are located in the same horizontal plane, the load on them drops evenly, and the working hypertrophy of the 2nd and 3rd metatarsal bones disappears.
Scheme N3: Positioning for a direct photograph of the foot
On the radiograph of the foot in a direct projection (scheme N4); determine the angle of deviation of the 1st metatarsal bone, the angle of deviation of the 1st toe and the angle of divergence of the metatarsal bones.
The angle of deviation of the 1st metatarsal bone is formed by the axial lines of the diaphysis of the 1st and 2nd metatarsal bones; it is open anteriorly and normally does not exceed 11°.
The angle of deviation of the 1st finger is formed by the axial lines of the diaphysis of the 1st metatarsal bone and the proximal phalanx of the 1st finger; normally does not exceed 18°.
The angle of divergence of the metatarsal bones is formed by the lines of the diaphyses of the 1st and 5th metatarsals; normally does not exceed 18°.
Scheme N4: Scheme for determining the angles of the transverse arch of the foot
1. Lagunova I.G. X-ray anatomy of the skeleton. - M.: Medicine, 1981.
2. X-ray diagnostics of flat feet and club feet: Methodological recommendations for radiology students / Novokuznetsk State Institute for Advanced Training of Physicians. - Novokuznetsk, 1987.
3. Sadofeva V.I. X-ray functional diagnosis of diseases of the musculoskeletal system in children. - L.: Medicine, 1986.
X-ray of the foot is an X-ray examination performed to evaluate the condition of the distal row of tarsal bones, metatarsal bones and the joints of the foot formed by these bones. In traumatology, the technique is used for fractures and fracture dislocations. In orthopedics, the procedure is used for flat feet, club feet, other congenital and acquired foot deformities, and degenerative diseases. In oncology, the method is prescribed for tumors of the bones of the foot, in purulent surgery - if there is suspicion of the spread of purulent processes to the bone tissue. A standard study is performed in two (direct and oblique or direct and lateral) or three (direct, oblique and lateral) projections.
The main indication for radiography of the foot in traumatology is fractures of the metatarsal bones. Less commonly, the technique is used in the process of diagnostic search for less common fractures of the tarsal bones and fracture-dislocations of the bones of the foot. In orthopedics, a diagnostic procedure is prescribed for clubfoot, flatfoot, Hallux valgus, and other acquired and congenital deformities. In oncology and purulent surgery, the study is indicated for suspected tumors, damage to the bones of the foot with deep forms of panaritium, phlegmon of the foot and other purulent processes.
To take a direct photograph, the patient is placed on his back with his legs bent at the knee joints. The feet rest on the surface of the table. To perform oblique x-rays, the patient is placed on his healthy side. Legs bend. Place a pillow between your knees so that your foot is at an angle to the table surface. Lateral photographs of the foot in traumatology and orthopedics are taken less frequently, since in this projection the tarsal bones overlap each other and are poorly visible on radiographs. The lateral view is used to evaluate the condition of the arch of the foot or to identify metatarsal fractures. To perform a lateral X-ray, the patient is placed on the affected side with the legs bent, while the healthy leg is brought forward.
In Moscow, an x-ray of the foot costs 1,448 rubles. (average). The procedure can be completed at 211 addresses.
Flat feet is a chronic disease of the musculoskeletal system, the essence of which is the flattening of the arches of the feet. As a result of such pathological changes, normal walking mechanics are disrupted, which is why a number of unpleasant and health-threatening complications develop in the knee, hip joints and spine.
Flat feet are very common today. If we look at statistical data, we can see that approximately 50% of the country's population suffers from this disease of varying severity. Women get sick 4 times more often than men. In some cases, flat feet are congenital, but most often this deformity is acquired.
An orthopedic surgeon diagnoses and treats flat feet. But anyone who wants to check themselves or their child for such a problem can determine flat feet at home. Let's consider the most accessible home diagnostic methods.
Any doctor begins the diagnostic process with a survey and examination of the patient. This can easily be done at home. You need to pay close attention not only to the foot, but also to the shoes of a person who is suspected of having flat feet. Under normal conditions (in the absence of flat feet), the outer part of the shoe wears out first, but if a person has a flat foot, then the inside of the shoe and the heel will wear out first.
Typical shoe wear for flat feet - check with yourself!
You also need to pay attention to other signs that may indicate problems with the shape of the foot (they are nonspecific and are inherent in other types of foot deformities, not just flat feet):
It is important to understand! The above symptoms may indicate that a person has flat feet, but they can also be signs of other diseases. Therefore, if you experience such problems, do not be lazy to consult a doctor to determine the true cause of the discomfort and prescribe the correct treatment.
With its help, you can quickly check flat feet at home. Medical experts call this rapid diagnostic method plantography. The essence of the technique is to obtain a foot print on paper and study it. To do this, you need to treat the foot with any available homemade dyes, for example, Lugol's solution (an aqueous solution of iodine), brilliant green, ink, paints for drawing on paper. If you do not want to paint your feet, you can use any rich cream for this purpose, which will leave an imprint on the paper.
After such preparation, you need to leave a mark on paper. At the same time, one cannot strive to take the correct posture; a person must become as he does in ordinary everyday life. The weight should be evenly distributed on both legs.
After receiving the foot print, they need to be examined in detail and compared with the accepted age norm. You should know that age plays an important role in assessing the results, since the foot prints of a child of different ages and an adult normally differ significantly.
The maximum limit of the standard print width by age is normal
The technique for assessing the plantogram in children is as follows. On the resulting sheet of paper with a foot print, you need to draw 2 perpendicular lines - line AB (drawn through the two tangents of the outermost points of the inside of the sole)
The second line CD is drawn perpendicular to the segment AB exactly halfway between the two tangent points described above. This perpendicular must be divided into 3 even segments. After this, you can evaluate the result obtained from the point of view of the age norm indicated in the figure above.
In adults, it is easier to evaluate the plantogram. However, the technique is practically no different from that described. But the resulting perpendicular needs to be divided in half, and not 3 parts. If the print occupies less than half of the segment, this is considered normal, and if it occupies more than 50% of the segment, then flat feet can be suspected.
Plantogram assessment in adults
This technique allows you to obtain only approximate data on the condition of the arches of the feet, that is, it is a screening technique. If, based on the results of plantography, you suspect the presence of flat feet, then you need to seek medical help for an accurate diagnosis.
This technique is also called the Friedland technique. It consists of performing a series of simple calculations to obtain the Friedland podometric index. Allows you to determine both transverse and longitudinal flat feet, as well as its degree.
To get the desired figure, you need to calculate the index of the longitudinal arch of the foot, which is equal to the ratio of its height to length, expressed as a percentage. The length is measured from the edge of the big toe to the edge of the heel, the height is measured from the edge of the navicular bone to the surface of the foot support.
Method of measuring the foot to determine the podometric index
Normally, this index is 29-31%; if you get numbers below 29, then there is flattening of the foot, which indicates the development of flat feet. Also, using the Friedland index, you can determine the degree of flatfoot (parameters for calculating the degree of pathology are indicated in the table below).
To determine transverse flatfoot at home, you need to calculate the transverse index of the arch of the foot - the ratio, as a percentage, of the width of the foot to its length. The width should be measured at the level of the metatarsal bones (from the first to the fifth). Under normal conditions, this figure does not exceed 40%; if the result is higher, then this indicates a flattening of the transverse arch.
The X-ray method for diagnosing flat feet is considered very accurate, but it will not be possible to carry out such a diagnosis completely independently, since X-ray images of the feet are needed in two projections, taken under load with the patient standing.
Although this information may be needed by people who live in small towns where it is possible to take X-rays, but there is no opportunity to get advice from an orthopedic specialist. It is this doctor who must evaluate the images, carry out a series of calculations, and determine the type and degree of flatfoot. But if you really want to, you can sort out the pictures yourself and at home.
As already mentioned, the first stage of diagnosis is obtaining x-rays of the feet in a standing position (static load) in the anteroposterior and lateral projection.
To evaluate the images and make a conclusion about the presence of a flat foot, you need to determine the height of the arch of the foot and the angle of its longitudinal arch.
On the x-ray of the lateral projections of the feet (as shown in the diagram above), 3 lines are drawn:
The angle of the longitudinal arch of the foot is formed by the first and third lines, which intersect at the lowest point of the scaphoid joint.
The height of the longitudinal arch of the foot is a perpendicular segment of the navicular-wedge joint lowered from the lowest point (the point of intersection of lines 2 and 3) to the first (horizontal) line.
The following table will help you evaluate these two indicators and diagnose transverse flatfoot.
To diagnose transverse flatfoot, you need to evaluate the radiograph in the anteroposterior projection, in a standing position (static load). It is necessary to determine 2 indicators:
The diagram below will help you do this correctly.
You can evaluate these two indicators, as well as diagnose transverse flatfoot and its degree using the table below.
The X-ray method for diagnosing flat feet is currently considered the most accurate. It is with its help that such a diagnosis is made in most cases. At first glance, it may seem that all this is very complicated and cannot be done at home, but if a person has at least basic knowledge of geometry, then with the help of the above diagrams and tables he can do this no worse than a specialist.
Thus, if, according to the tests described above, you have signs of flat feet, you should definitely seek specialized medical help. After all, today there are more modern and accurate methods for diagnosing flat feet and other deformities, which will give the doctor maximum useful information about your disease, allow you to select individual orthopedic insoles and create an effective treatment plan and secondary prevention.