Using MRI at the Examination of Patients with Hallux Valgus

The aim: to estimate the use of MRI at the examination of patients with hallux valgus. Materials and methods. We examined 22 patients with hallux valgus getting surgical treatment in the orthopedic department of Irkutsk Scientific Center of Surgery and Traumatology. All the patients were women from 19 to 57 years (32 ± 2.07). All patients had X-ray, MRI and intraoperative examination of the affected foot before the surgery and in postoperative period. All patients had osteosynthesis conducted with the use of biodegradable screws, that allowed to carry out MRI in postoperative period. Results. X-ray examination determined hallux valgus angle (M1P1) - 30.67 ± 0.68° on average, intermetatarsal angle (M1M2) - 14.67 ± 0.66° on average. Proximal articular set angle (PASA) was calculated according to X-ray, MRI and intraoperative data, and the results were compared. PASA calculated by X-ray pictures was 13.67 ± 0.78° on the average. PASA calculated by MRI scans was 21.5 ± 0.35° on the average and significantly exceeded the value obtained with use of X-ray imaging. Considering more precise PASA values obtained with the use of MRI, an optimal surgical procedure was chosen and the expected level of I metatarsal osteotomy was determined before the operation. After the operation we revealed the M1P1 angle correction down to 9,67±0,78°, M1M2 angle correction - down to 10.17 ± 0.56°, i.e. to the normal values. According to the postoperative MRI, PASA correction was conducted down to normal values (4.17 ± 0.09°). The treatment caused complete correction of hallux valgus in all patients. No poor results and hallux valgus relapses was found. Conclusion. MRI as compared to the X-ray allow to define PASA values more precisely by means of the visualization of chondral layer of I metatarsal articular surface. Complex use of X-ray and MRI in hallux valgus patients improves the quality of diagnosis of pathological changes and the treatment outcomes. MRI of the foot should be included in the plan of examination of hallux valgus patients.

МРТ-визуализация, вальгусное отклонение I пальца стопы (hallux valgus), угол наклона суставной поверхности головки I плюсневой кости (PASA), magnetic-resonance imaging, hallux valgus, proximal articular set angle

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