Comparison of Hallux Valgus Deformity Evaluation on Printed Versus Digital X-Rays

Background: Evaluation of hallux valgus deformity was traditionally made on a printed X-ray image. In the last two decades, digital X-ray systems have begun to replace the analog images, and images are not routinely printed anymore. Clinicians have to evaluate X-rays on digital images viewed on the computer monitors. This study compares the intra- and inter-observer reliability of foot deformity evaluation on printed images with measurements on computer monitors with the guidance of dedicated software. Methods: Fifteen pre-operative X-rays reports of patients who were candidates for a surgical correction of hallux valgus deformity, were evaluated by ten orthopedic surgeons. Each surgeon had two evaluation sessions on each modality, printed and computer monitor with the guidance of dedicated software. Results: We found that the hallux valgus deformity evaluations on computer monitors had significantly lower inter- and intra-observer variations than the evaluations performed on printed images. This study validates the use of digital X-ray measurements on computer monitors with the guidance of dedicated software. for evaluation of hallux valgus deformity. Conclusion: Clinician can use digital images with the guidance of dedicated software to evaluate for deformities without a need to print the images.