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Published in: Skeletal Radiology 2/2023

31-08-2022 | Scientific Article

Angle of BRINK — a new way to measure Haglund’s deformity

Authors: Neha Nischal, Kakarala Chandra Lalita, Karthikeyan P. Iyengar, Ian Reilly, Rajesh Botchu

Published in: Skeletal Radiology | Issue 2/2023

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Abstract

Introduction

Haglund’s deformity, an abnormality of the postero-superior corner of the calcaneum, is a common, critically debated cause of posterior heel pain. Several radiological indices such as Fowler-Philip angle, Ruch pitch, Chauveaux-Liet angle, calcaneal pitch angle, parallel pitch lines, and XY ratio have been described to measure this deformity. However, most of these lack specificity and have variable intra- and inter-observer reliability.

Purpose

The study aims to describe a new radiological “angle of BRINK” (Botchu-Reilly-Iyengar-Nischal-Kakarala) to measure Haglund’s deformity.

Patient and methods

We performed a retrospective cohort analysis, assessing 20 weight-bearing lateral ankle radiographs of patients with Haglund’s deformity (Haglund’s cohort) and 100 radiographs without the deformity (normal cohort).
Demographic details and angle of BRINK to measure Haglund’s deformity were measured for each patient. Statistical analysis was performed using t-test and inter-observer reliability was calculated using kappa coefficient.

Results

The mean angle of BRINK to measure Haglund’s deformity in the normal cohort was 20.04° (SD 4.88), and in the Haglund’s cohort was 25.1° (SD 3.3). This was statistically significant with a p-value of less than 0.0001. There was excellent intra- and inter-observer reliability with kappa value of 0.8.

Conclusion

Our proposed radiological angle of BRINK to measure Haglund’s deformity is simple and easy to calculate on standard weight-bearing radiographs. Contrary to the traditional measurements used to estimate the deformity, it has shown a good intra- and inter-observer reliability and can support surgical decision-making process for management of patients with symptomatic Haglund’s deformity.
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Metadata
Title
Angle of BRINK — a new way to measure Haglund’s deformity
Authors
Neha Nischal
Kakarala Chandra Lalita
Karthikeyan P. Iyengar
Ian Reilly
Rajesh Botchu
Publication date
31-08-2022
Publisher
Springer Berlin Heidelberg
Published in
Skeletal Radiology / Issue 2/2023
Print ISSN: 0364-2348
Electronic ISSN: 1432-2161
DOI
https://doi.org/10.1007/s00256-022-04169-4

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