1 - Serviço de Radiologia, Hospital Dona Estefânia, Centro Hospitalar Universitário de Lisboa Central, Lisboa;
2 - Serviço de Radiologia, Hospital Dona Estefânia, Centro Hospitalar Universitário de Lisboa Central, Lisboa;
- Publicação sob a forma de poster electrónico EPOS da European Society of Radiology no European Congress of Radiology 2021 (3/3/2021-7/3/2021)
Resumo:
Objectives: Description of the techniques used in the radiological assessment of pes planovalgus, the morphological alterations found in the initial assessment of this deformity, the lesions that are frequently associated with it and the main findings in its post-operative assessment.
Materials and methods: Bibliographical research, review, and selection of the most relevant articles about radiological assessment of the deformity in pes planovalgus. Selection of original sample images of radiological studies of patients with pes planovalgus treated in a tertiary hospital.
Results: The deformity in pes planovalgus includes several morphological alterations, with highlight to the abnormal flattening of the medial longitudinal plantar arch of the foot, calcaneal valgus, and the instability of tarsal joints. It affects 20% of the adult population, in a congenital or acquired form, with 15% of patients being symptomatic. The radiological assessment starts with the lateral radiogram of the foot in a standing position in order to characterise the relations between the different bone pieces and to exclude frequently associated alterations, such as tarsal bars and tarsal subluxations. The magnetic resonance of the foot is useful to exclude concomitant lesions of the periarticular soft tissues, such as the posterior tibial tendon, the Spring ligament, or the medial plantar nerve. The presence of associated lesions and the failure of conservative treatment are indications for surgical therapy, with medial arch reinforcement or calcaneus alignment osteotomies. The post-operative imaging assessment aims to evaluate the outcomes and exclude complications from these procedures.
Conclusions: The radiological assessment of deformities in pes planovalgus plays a crucial role in the initial characterisation and in the post-operative assessment of this entity. The radiologist must know the alterations belonging to this deformity, the frequently associated anomalies and the characteristics of the main surgical interventions used in its correction.
Palavras Chave: Pes, Planovalgus, Músculo-esquelético, Pediatria, Radiologia