A group of medical workers has developed a mobile application that can diagnose a toe-in gait (intraocular walking) with just X-ray photos.
Toe-in gait is common among children. Diagnostics mainly use a three-dimensional computed tomography (CT). However, as there is a risk of radiation exposure, it is used very limitedly on pediatric patients. EOS, a 3D full-body X-ray that complements this problem, has a low risk of radiation exposure, but the equipment is large and expensive.
It also has the disadvantage of being unable to be used for muscular patients who have difficulty standing for a long time.
3D CT photo (top) and 3D photo reconstructed with mobile diagnostic app
The research team, led by Professor Park Moon-seok of the Orthopedics Department at Seoul National University Bundang Hospital, made a three-dimensional image of the bones based on a two-dimensional X-ray photo and developed statistical feature models and self-correcting techniques that correct this close to actual shapes.
Then, they applied this technology to mobile apps, making it possible to specify the degree of twisting of the calf bone.
The researchers analyzed whether the developed mobile app could be used in actual clinical practice and found it showed clinically significant reliability and validity. As a result of measuring and comparing the angle of bone twisting with 3D images rebuilt with the app and 3D CT images, there was no significant difference with the correlation coefficient between the two diagnostic results remaining at 0.865, they explained.
From left, Professor Park Moon-seok, Subspecialty Fellow Min Jae-jeong, and Dr. Yoon Ki-beom at Seoul National University Bundang Hospital
The team emphasized that using this app can accurately diagnose the cause of the toe-in gait only with X-ray pictures.
"Through this study, we expect to be able to create accurate 3D images with just the usual X-ray images,” Professor Park said. “If medical institutions that could not introduce existing diagnostic devices use this app, they could contribute to identifying the cause of the toe-in gait of adolescent patients and providing appropriate treatment.”
Min Jae-jeong, a subspecialty fellow at the hospital, and Dr. Yoon Ki-beom participated in the study. Their paper was published in the latest issue of the Journal of Bone and Joint Surgery American Volume.