Reliability of the Maestro radiographic measuring tool

Foot Ankle Int. 2010 Oct;31(10):884-91. doi: 10.3113/FAI.2010.0884.


Introduction: Maestro et al. presented a detailed preoperative measuring and classification technique for the forefoot. The purpose of this paper was to determine if the PACS system will allow the Maestro measuring technique and classification system to be reliable and precise.

Materials and methods: This radiographic study was conducted on 73 subjects (36 females, 37 males, age 30.4 ± 9.9) who had given informed consent. The geometrical progression was measured for each foot of each subject by the two observers according to the measuring methodology of Maestro. The intraclass correlation coefficient (ICC), and the 95% lower confidence limit (95% LCL) were calculated for the geometrical progression variables of the lesser metatarsals. Once the feet were classified by each observer, the accordance in classification of the feet was analyzed between the two observers.

Results: The radiographic measuring technique of Maestro was a reliable method for analyzing the mathematical progression of the lesser metatarsals through the use of the PACS system. A 92.6% concordance in the classification of the radiological forefoot morphotypes was found between the two observers.

Conclusion: We found Maestro et al.'s measuring technique and classification system precise and reproducible using PACS digital radiographs. It is hoped that utilization of this technique will lead to better forefoot outcomes and patient satisfaction.

MeSH terms

  • Adult
  • Female
  • Forefoot, Human / anatomy & histology*
  • Forefoot, Human / diagnostic imaging*
  • Humans
  • Male
  • Metatarsal Bones / anatomy & histology*
  • Metatarsal Bones / diagnostic imaging*
  • Metatarsalgia / diagnostic imaging
  • Radiography
  • Reference Values
  • Reproducibility of Results