The radiographic morphology of foot deformities in patients with fibrodysplasia ossificans progressiva

Richard J. Harrison, J. David Pitcher, Mark S. Mizel, H. Thomas Temple, Sean P. Scully

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Background: The most consistent deformities that allow early diagnosis of fibrodysplasia ossificans progressiva are the presence of bilateral short first rays and hallux valgus. The purpose of this study was to describe the radiographic features observed in the feet of patients with fibrodysplasia ossificans progressiva. Methods: The radiographs of 26 feet (15 patients with fibrodysplasia ossificans progressiva) were reviewed to evaluate the radiographic changes that occur in the first ray. Variables analyzed were the hallux valgus (HV) angle, the distal metatarsal articular (DMA) angle, the proximal phalangeal articular (PPA) angle, the intermetatarsal (IM) angle, ratio of the lengths of the first and second metatarsal lengths (MT1:MT2), and the first and second ray length ratio. The length ratios were then subtracted from similar ratios in radiographs of age- and gender-matched normal patients previously reported. Results: The proximal phalanx was consistently shortened but morphologically dissimilar from subject to subject. Asymmetry was noted in some patients with bilateral radiographs. The mean HV angle was 28 degrees, and the mean IM angle was 10 degrees. The mean DMA angle was 33 degrees, and the mean PPA angle was 14 degrees. The MT1:MT2 ratio was 0.89, and the mean first ray to second ray length ratio was 0.87. The mean of the differences in the MT1:MT2 and first and second ray length ratios in patients with fibrodysplasia ossificans progressiva compared to the normal controls were 0.05 and 0.01, respectively. Fusion occurred between the abnormal tibial epiphysis of the proximal phalanx and metatarsal head with advancing age, and 68% of the metatarsal heads were fused with the abnormal proximal phalangeal epiphysis. Conclusions: Foot pathology in patients with fibrodysplasia ossificans progressiva is variable but consistently involves an abnormality of the tibial aspect of the proximal phalangeal epiphysis of the hallux. This results in the clinical observation of hallux valgus in these patients. The first metatarsal is consistently shortened, and fusion between the epiphysis of the abnormal proximal phalanx and the shortened first metatarsal head occurs with advancing age.

Original languageEnglish
Pages (from-to)937-941
Number of pages5
JournalFoot and Ankle International
Volume26
Issue number11
StatePublished - Nov 1 2005
Externally publishedYes

Fingerprint

Myositis Ossificans
Foot Deformities
Metatarsal Bones
Hallux Valgus
Epiphyses
Joints
Foot
Hallux
Early Diagnosis
Observation
Pathology

Keywords

  • Fibrodysplasia Ossificans Progressiva
  • Foot Deformity
  • Hallux Valgus
  • Intermetatarsal Angle
  • Shortened First Ray

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

Cite this

Harrison, R. J., Pitcher, J. D., Mizel, M. S., Thomas Temple, H., & Scully, S. P. (2005). The radiographic morphology of foot deformities in patients with fibrodysplasia ossificans progressiva. Foot and Ankle International, 26(11), 937-941.

The radiographic morphology of foot deformities in patients with fibrodysplasia ossificans progressiva. / Harrison, Richard J.; Pitcher, J. David; Mizel, Mark S.; Thomas Temple, H.; Scully, Sean P.

In: Foot and Ankle International, Vol. 26, No. 11, 01.11.2005, p. 937-941.

Research output: Contribution to journalArticle

Harrison, RJ, Pitcher, JD, Mizel, MS, Thomas Temple, H & Scully, SP 2005, 'The radiographic morphology of foot deformities in patients with fibrodysplasia ossificans progressiva', Foot and Ankle International, vol. 26, no. 11, pp. 937-941.
Harrison RJ, Pitcher JD, Mizel MS, Thomas Temple H, Scully SP. The radiographic morphology of foot deformities in patients with fibrodysplasia ossificans progressiva. Foot and Ankle International. 2005 Nov 1;26(11):937-941.
Harrison, Richard J. ; Pitcher, J. David ; Mizel, Mark S. ; Thomas Temple, H. ; Scully, Sean P. / The radiographic morphology of foot deformities in patients with fibrodysplasia ossificans progressiva. In: Foot and Ankle International. 2005 ; Vol. 26, No. 11. pp. 937-941.
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abstract = "Background: The most consistent deformities that allow early diagnosis of fibrodysplasia ossificans progressiva are the presence of bilateral short first rays and hallux valgus. The purpose of this study was to describe the radiographic features observed in the feet of patients with fibrodysplasia ossificans progressiva. Methods: The radiographs of 26 feet (15 patients with fibrodysplasia ossificans progressiva) were reviewed to evaluate the radiographic changes that occur in the first ray. Variables analyzed were the hallux valgus (HV) angle, the distal metatarsal articular (DMA) angle, the proximal phalangeal articular (PPA) angle, the intermetatarsal (IM) angle, ratio of the lengths of the first and second metatarsal lengths (MT1:MT2), and the first and second ray length ratio. The length ratios were then subtracted from similar ratios in radiographs of age- and gender-matched normal patients previously reported. Results: The proximal phalanx was consistently shortened but morphologically dissimilar from subject to subject. Asymmetry was noted in some patients with bilateral radiographs. The mean HV angle was 28 degrees, and the mean IM angle was 10 degrees. The mean DMA angle was 33 degrees, and the mean PPA angle was 14 degrees. The MT1:MT2 ratio was 0.89, and the mean first ray to second ray length ratio was 0.87. The mean of the differences in the MT1:MT2 and first and second ray length ratios in patients with fibrodysplasia ossificans progressiva compared to the normal controls were 0.05 and 0.01, respectively. Fusion occurred between the abnormal tibial epiphysis of the proximal phalanx and metatarsal head with advancing age, and 68{\%} of the metatarsal heads were fused with the abnormal proximal phalangeal epiphysis. Conclusions: Foot pathology in patients with fibrodysplasia ossificans progressiva is variable but consistently involves an abnormality of the tibial aspect of the proximal phalangeal epiphysis of the hallux. This results in the clinical observation of hallux valgus in these patients. The first metatarsal is consistently shortened, and fusion between the epiphysis of the abnormal proximal phalanx and the shortened first metatarsal head occurs with advancing age.",
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N2 - Background: The most consistent deformities that allow early diagnosis of fibrodysplasia ossificans progressiva are the presence of bilateral short first rays and hallux valgus. The purpose of this study was to describe the radiographic features observed in the feet of patients with fibrodysplasia ossificans progressiva. Methods: The radiographs of 26 feet (15 patients with fibrodysplasia ossificans progressiva) were reviewed to evaluate the radiographic changes that occur in the first ray. Variables analyzed were the hallux valgus (HV) angle, the distal metatarsal articular (DMA) angle, the proximal phalangeal articular (PPA) angle, the intermetatarsal (IM) angle, ratio of the lengths of the first and second metatarsal lengths (MT1:MT2), and the first and second ray length ratio. The length ratios were then subtracted from similar ratios in radiographs of age- and gender-matched normal patients previously reported. Results: The proximal phalanx was consistently shortened but morphologically dissimilar from subject to subject. Asymmetry was noted in some patients with bilateral radiographs. The mean HV angle was 28 degrees, and the mean IM angle was 10 degrees. The mean DMA angle was 33 degrees, and the mean PPA angle was 14 degrees. The MT1:MT2 ratio was 0.89, and the mean first ray to second ray length ratio was 0.87. The mean of the differences in the MT1:MT2 and first and second ray length ratios in patients with fibrodysplasia ossificans progressiva compared to the normal controls were 0.05 and 0.01, respectively. Fusion occurred between the abnormal tibial epiphysis of the proximal phalanx and metatarsal head with advancing age, and 68% of the metatarsal heads were fused with the abnormal proximal phalangeal epiphysis. Conclusions: Foot pathology in patients with fibrodysplasia ossificans progressiva is variable but consistently involves an abnormality of the tibial aspect of the proximal phalangeal epiphysis of the hallux. This results in the clinical observation of hallux valgus in these patients. The first metatarsal is consistently shortened, and fusion between the epiphysis of the abnormal proximal phalanx and the shortened first metatarsal head occurs with advancing age.

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