August 15, 2014
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MRI reveals range of soft-tissue abnormalities in treatment-resistant clubfoot

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Patients with treatment-resistant clubfoot exhibited a range of soft-tissue abnormalities on MRI, according to study results.

MRI of the lower extremities was acquired for 20 patients with clubfoot treated with the Ponseti method, of which seven had treatment-responsive clubfoot and 13 had treatment-resistant clubfoot. Researchers recorded demographic information and physical examination findings and performed a descriptive analysis of the soft-tissue abnormalities for both patient cohorts.

The percentage difference in cross-sectional area between the affected limb and the unaffected limb in terms of muscle, subcutaneous fat, intracompartment fat and total area was calculated for patients with unilateral clubfoot. The researchers used the Wilcoxon signed-rank test to compare interleg differences in cross-sectional areas in the intracompartment adiposity index (IAI) between treatment-responsive and treatment-resistant groups.

According to study results, patients with treatment-resistant clubfoot experienced more extensive soft-tissue abnormalities compared with patients with treatment-responsive clubfoot, including excess epimysial fat and intramuscular fat replacement and unique patterns of hypoplasia in specific muscle groups.

Compared with patients with treatment-responsive clubfoot, the researchers found patients with unilateral treatment-resistant clubfoot experienced a significantly greater difference in muscle and intracompartment fat area between the affected and unaffected limb, as well as a corresponding higher interleg IAI ratio.

Disclosure: Gurnett and Dobbs received grant support from Mallinckrodt Institute of Radiology.