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Ultrasound Measurements of Torsions in the Tibia and Femur

¹ Department of Health, Nutrition, and Exercise Sciences, University of Delaware, 150 Rust Arena, 541 South College Avenue, Newark, DE 19716. E-mail address for D. Hudson: dhudson{at}udel.edu

Investigation performed at the Department of Health, Nutrition, and Exercise Sciences, University of Delaware, Newark, Delaware

The authors did not receive grants or outside funding in support of their research for or preparation of this manuscript. They did not receive payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, educational institution, or other charitable or nonprofit organization with which the authors are affiliated or associated.

Methods: In vitro ultrasound measurements of torsion in 118 matched dried tibiae and femora were compared with direct anatomical measurements with use of simple regression. The second part of the study involved repeated in vivo ultrasound measurements made on twenty adult limbs to determine the clinical reliability of our methods.

Results: The in vitro ultrasound measurements of femoral and tibial torsion were significantly related to the anatomical measurements (p < 0.001 for both). The inter-rater correlation coefficients between three examiners were 0.84 for both the tibial and femoral measurements, and the intra-rater correlation coefficients ranged from 0.86 to 0.98. The in vivo measurements were similar to the in vitro measurements, and the intra-rater correlation coefficients for repeated measures were 0.91 and 0.93 for femoral and tibial torsion, respectively.

Conclusions: Ultrasound is a viable tool for measuring torsion of the tibia and femur. In order to minimize measurement errors, the ultrasound measurement should be used to calculate the predicted value of torsion with use of the regression equation.

Clinical Relevance: Abnormal torsion in the tibia and femur have been linked to osteoarthritis in the knee. Precise, safe, and quick measurements of torsion are needed for clinical decision-making and for use in long-term studies.

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