Dataset Information

Identification of radiographic characteristics associated with pain in hallux valgus patients: A preliminary machine learning study.

ABSTRACT:

Objective

To investigate the association between the structural deformity and foot pain in hallux valgus (HV) patients using a multi-variate pattern analysis (MVPA) approach.

Methods

Plain radiographic metrics were calculated from 36 painful and 36 pain-free HV feet. In analysis 1, univariate analyses were performed to investigate the clinical and radiographic differences between painful and pain-free HV. In analysis 2, we investigated the pattern differences for radiographic metrics between these two groups using a MVPA approach utilizing a support vector machine. In analysis 3, sequential backward selection and exhaustive search were performed as a feature-selection procedure to identify an optimal feature subtype. In analysis 4, hierarchical clustering analysis was used to identify the optimal radiographic HV subtype associated with pain in HV.

Results

We found that: (1) relative to feet with pain-free HV, the painful ones exhibited a higher hallux valgus angle, i.e., the magnitude of distal metatarsal and phalangeal deviation; (2) painful HV could be accurately differentiated from pain-free HV via MVPA. Using sequential backward selection and exhaustive search, a 5-feature subset was identified with optimal performance for classifying HV as either painful or pain-free; and (3) by applying hierarchical clustering analysis, a radiographic subtype with an 80% pain incidence was identified.

Conclusion

The pain in HV is multifactorial and associated with a radiographic pattern measured by various angles on plain radiographs. The combination of hallux valgus angle, inter-phalangeal angle, distal metatarsal articular angle, metatarsal cuneiform angle and metatarsal protrusion distance showed the optimal classification performance between painful and pain-free HV.

SUBMITTER: Wang C

PROVIDER: S-EPMC9399654 | biostudies-literature | 2022

REPOSITORIES: biostudies-literature

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Publications

Identification of radiographic characteristics associated with pain in hallux valgus patients: A preliminary machine learning study.

Wang ChenGuang C Li Chao C Zhang Rui R Li ZhiJun Z Zhang HuaFeng H Zhang Yuan Y Liu Shen S Chi XiaoYue X Zhao Rui R

Frontiers in public health 20220810

<h4>Objective</h4>To investigate the association between the structural deformity and foot pain in hallux valgus (HV) patients using a multi-variate pattern analysis (MVPA) approach.<h4>Methods</h4>Plain radiographic metrics were calculated from 36 painful and 36 pain-free HV feet. In analysis 1, univariate analyses were performed to investigate the clinical and radiographic differences between painful and pain-free HV. In analysis 2, we investigated the pattern differences for radiographic metr ...[more]

PMID: 36033742

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Project description:BackgroundThe severity of hallux valgus is easily appreciated by its clinical appearance, however x-ray measurements are also frequently used to evaluate the condition, particularly if surgery is being considered. There have been few large studies that have assessed the validity of these x-ray observations across a wide spectrum of the deformity. In addition, no studies have specifically focused on older people where the progression of the disorder has largely ceased. Therefore, this study aimed to explore relationships between relevant x-ray observations with respect to hallux valgus severity in older people.MethodsThis study utilised 402 x-rays of 201 participants (74 men and 127 women) aged 65 to 94 years. All participants were graded using the Manchester Scale - a simple, validated system to grade the severity of hallux valgus - prior to radiographic assessment. A total of 19 hallux valgus-related x-ray observations were performed on each set of x-rays. These measurements were then correlated with the Manchester Scale scores.ResultsStrong, positive correlations were identified between the severity of hallux valgus and the hallux abductus angle, the proximal articular set angle, the sesamoid position and congruency of the first metatarsophalangeal joint. As hallux valgus severity increased, so did the frequency of radiographic osteoarthritis of the first metatarsophalangeal joint and a round first metatarsal head. A strong linear relationship between increased relative length of the first metatarsal and increased severity of hallux valgus was also observed.ConclusionsStrong associations are evident between the clinical appearance of hallux valgus and a number of hallux valgus-related x-ray observations indicative of structural deformity and joint degeneration. As it is unlikely that metatarsal length increases as a result of hallux valgus deformity, increased length of the first metatarsal relative to the second metatarsal may be a contributing factor to the development and/or progression of hallux valgus.

Project description:IntroductionPsychological factors are linked to pain and function in various musculoskeletal conditions, but their impact on hallux valgus is unclear. Health-related quality of life declines with increasing severity of hallux valgus, affecting not only foot pain and physical function, but also general health, vitality and mental health. Previous studies have reported inconsistent associations between psychological factors, such as anxiety and depression, and surgical outcomes, which might relate to variability in measurement approaches. Understanding the associations between psychological factors, including anxiety, depression, pain catastrophizing and kinesiophobia, and hallux valgus-related pain and function may inform more holistic pre-operative care. Therefore, we aimed to assess these associations in adults with hallux valgus pre-surgery.MethodsA pre-operative cross-sectional study was conducted with 41 adults scheduled for hallux valgus surgery. Participants completed questionnaires measuring continuous psychological variables: depression, anxiety and stress (Depression Anxiety Stress Scale-21, a tool for general psychological distress), kinesiophobia (Tampa Scale for Kinesiophobia, which assesses fear of movement associated with pain) and pain catastrophizing (Pain Catastrophizing Scale, a tool used to evaluate maladaptive pain-coping strategies). Continuous outcomes were evaluated using the Manchester-Oxford Foot Questionnaire for foot function, pain and social interaction. Multiple linear regressions explored the associations between these psychological factors and the outcomes.ResultsWhen all exposure variables were considered simultaneously, pain catastrophizing emerged as a significant predictor of foot pain and foot function. A one-unit increase in the pain catastrophizing score was associated with a 1.41-point increase in foot pain (β = 1.41, 95% confidence intervals (CIs) 0.73-2.09 and p < 0.001) and a 1.83-point increase in worse foot function (β = 1.83, 95% CI 1.12-2.54 and p < 0.001).ConclusionAssessing pain catastrophising pre-operatively is recommended for individuals with hallux valgus, although more structured education may be needed to support health professionals in assessing psychological factors. Future research should evaluate the longitudinal impact of pain catastrophizing on post-operative outcomes and explore other contributing factors, such as comorbidities, lifestyle variables and sex differences, to refine screening and treatment strategies.

Project description:BackgroundHallux valgus (HV) is a very common deformity of the first metatarsophalangeal joint that often requires surgical correction. However, the association between structural HV deformity and related foot pain and disability is unclear. Furthermore, no previous studies have investigated concerns about appearance and difficulty with footwear in a population with HV not seeking surgical correction. The aim of this cross-sectional study was to investigate foot pain, functional limitation, concern about appearance and difficulty with footwear in otherwise healthy adults with HV compared to controls.MethodsThirty volunteers with HV (radiographic HV angle >15 degrees) and 30 matched controls were recruited for this study (50 women, 10 men; mean age 44.4 years, range 20 to 76 years). Differences between groups were examined for self-reported foot pain and disability, satisfaction with appearance, footwear difficulty, and pressure-pain threshold at the first metatarsophalangeal joint. Functional measures included balance tests, walking performance, and hallux muscle strength (abduction and plantarflexion). Mean differences (MD) and 95% confidence intervals (CI) were calculated.ResultsAll self-report measures showed that HV was associated with higher levels of foot pain and disability and significant concerns about appearance and footwear (p < 0.001). Lower pressure-pain threshold was measured at the medial first metatarsophalangeal joint in participants with HV (MD = -133.3 kPa, CI: -251.5 to -15.1). Participants with HV also showed reduced hallux plantarflexion strength (MD = -37.1 N, CI: -55.4 to -18.8) and abduction strength (MD = -9.8 N, CI: -15.6 to -4.0), and increased mediolateral sway when standing with both feet with eyes closed (MD = 0.34 cm, CI: 0.04 to 0.63).ConclusionsThese findings show that HV negatively impacts on self-reported foot pain and function, and concerns about foot appearance and footwear in otherwise healthy adults. There was also evidence of impaired hallux muscle strength and increased postural sway in HV subjects compared to controls, although general physical functioning and participation in physical activity were not adversely affected.

Dataset Information

Identification of radiographic characteristics associated with pain in hallux valgus patients: A preliminary machine learning study.

Objective

Methods

Results

Conclusion

Publications

Identification of radiographic characteristics associated with pain in hallux valgus patients: A preliminary machine learning study.

Similar Datasets

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