An appropriate method for predicting the femoral angle on whole-body X-ray images from full-spine X-ray images

The importance of lower-limb compensation in patients with spinal malalignment due to spinal pathologies has been emphasized. The latest whole-body X-ray images (WBX) have enabled evaluations of whole-body alignment from head to toe. However, WBX is still not commonly available. Thus, the present st...

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Veröffentlicht in:Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association 2024-03, Vol.29 (2), p.489-493
Hauptverfasser: Ito, Kenyu, Nakashima, Hiroaki, Kagami, Yujiro, Ouchida, Jun, Satake, Kotaro, Tsushima, Mikito, Tomita, Hiroyuki, Ode, Yukihito, Nagatani, Yasuhiro, Imagama, Shiro, Kanemura, Tokumi
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container_title Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association
container_volume 29
creator Ito, Kenyu
Nakashima, Hiroaki
Kagami, Yujiro
Ouchida, Jun
Satake, Kotaro
Tsushima, Mikito
Tomita, Hiroyuki
Ode, Yukihito
Nagatani, Yasuhiro
Imagama, Shiro
Kanemura, Tokumi
description The importance of lower-limb compensation in patients with spinal malalignment due to spinal pathologies has been emphasized. The latest whole-body X-ray images (WBX) have enabled evaluations of whole-body alignment from head to toe. However, WBX is still not commonly available. Thus, the present study aimed to examine an alternative measurement method of the femoral angle on usual full-spine X-ray images (FSX) that approximates the femoral angle on WBX. A total of 50 patients (age, 52.8 ± 25.3 years; female, n = 26; male, n = 24) underwent WBX and FSX. The following parameters were measured on lateral view X-rays: WBX and FSX femoral angle (angle between the femoral axis and a perpendicular line); FSX femoral distance (distance from the center of femoral head to the distal femur on FSX); WBX intersection length (length between the center of the femoral head and the intersection point [the point at which the line connecting the center of the femoral head and the midpoint of the femoral condyle intersects the center line of the femur] on WBX). The WBX femoral angle, and FSX femoral angle were 0.16 ± 4.2°, and −0.53 ± 4.1°, respectively. The FSX femoral distance was 102.7 ± 41.1 mm. An ROC curve analysis revealed that the cut-off value of the FSX femoral distance associated with minimal difference in the WBX and FSX femoral angles (
doi_str_mv 10.1016/j.jos.2023.02.007
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The latest whole-body X-ray images (WBX) have enabled evaluations of whole-body alignment from head to toe. However, WBX is still not commonly available. Thus, the present study aimed to examine an alternative measurement method of the femoral angle on usual full-spine X-ray images (FSX) that approximates the femoral angle on WBX. A total of 50 patients (age, 52.8 ± 25.3 years; female, n = 26; male, n = 24) underwent WBX and FSX. The following parameters were measured on lateral view X-rays: WBX and FSX femoral angle (angle between the femoral axis and a perpendicular line); FSX femoral distance (distance from the center of femoral head to the distal femur on FSX); WBX intersection length (length between the center of the femoral head and the intersection point [the point at which the line connecting the center of the femoral head and the midpoint of the femoral condyle intersects the center line of the femur] on WBX). The WBX femoral angle, and FSX femoral angle were 0.16 ± 4.2°, and −0.53 ± 4.1°, respectively. The FSX femoral distance was 102.7 ± 41.1 mm. An ROC curve analysis revealed that the cut-off value of the FSX femoral distance associated with minimal difference in the WBX and FSX femoral angles (&lt;3°) was 73 mm (sensitivity 83.3%, specificity 87.5%, AUC 0.80). The WBX intersection length was 105.3 ± 27.3 mm. To calculate the femoral angle on FSX that approximates the WBX femoral angle, the femoral distance on FSX ≥73 mm is preferable. 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The latest whole-body X-ray images (WBX) have enabled evaluations of whole-body alignment from head to toe. However, WBX is still not commonly available. Thus, the present study aimed to examine an alternative measurement method of the femoral angle on usual full-spine X-ray images (FSX) that approximates the femoral angle on WBX. A total of 50 patients (age, 52.8 ± 25.3 years; female, n = 26; male, n = 24) underwent WBX and FSX. The following parameters were measured on lateral view X-rays: WBX and FSX femoral angle (angle between the femoral axis and a perpendicular line); FSX femoral distance (distance from the center of femoral head to the distal femur on FSX); WBX intersection length (length between the center of the femoral head and the intersection point [the point at which the line connecting the center of the femoral head and the midpoint of the femoral condyle intersects the center line of the femur] on WBX). 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source Alma/SFX Local Collection
subjects Femoral angle
Full-spine X-ray image
Lower extremity alignment
Whole-body alignment
Whole-body X-ray image
title An appropriate method for predicting the femoral angle on whole-body X-ray images from full-spine X-ray images
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