Journal of Foot and Ankle Surgery (Asia Pacific)

Register      Login

VOLUME 12 , ISSUE 2 ( April-June, 2025 ) > List of Articles

REVIEW ARTICLE

A Narrative Review of Weight-bearing Computed Tomography Scans: How have They Influenced the Management of Common Foot and Ankle Pathologies?

Brittany M Ammerman, Amanda I Zeng, Rachel M Thompson, Scott J Ellis

Keywords : Hallux valgus, Progressive collapsing foot deformity, Syndesmosis injury, Total ankle replacement, Weight-bearing computed tomography

Citation Information : Ammerman BM, Zeng AI, Thompson RM, Ellis SJ. A Narrative Review of Weight-bearing Computed Tomography Scans: How have They Influenced the Management of Common Foot and Ankle Pathologies?. J Foot Ankle Surg Asia-Pacific 2025; 12 (2):96-102.

DOI: 10.5005/jp-journals-10040-1389

License: CC BY-NC 4.0

Published Online: 08-04-2025

Copyright Statement:  Copyright © 2025; The Author(s).


Abstract

Weight-bearing computed tomography (WBCT) has significantly advanced the management of foot and ankle pathologies by offering more accurate and comprehensive imaging compared to traditional radiographs and non-WBCT scans. This narrative review seeks to assess how WBCT has influenced the diagnosis, treatment, and postoperative assessment of common foot and ankle conditions, including hallux valgus, progressive collapsing foot deformity (PCFD), syndesmotic instability, and ankle arthritis. By capturing three-dimensional (3D) load-bearing images, WBCT enables more accurate assessments of bone and joint alignments as well as the severity of deformity. In doing so, WBCT enhances the diagnostic process, precision of surgical planning, and assessment of patient outcomes. While WBCT has already provided more insight into foot and ankle biomechanics, further research must be conducted to assess its use in other foot and ankle deformities as well as its potential to redefine foot and ankle pathologies, including their classification systems.


PDF Share
  1. Conti MS, Ellis SJ. Weight-bearing CT scans in foot and ankle surgery. J Am Acad Orthop Surg 2020;28(14):e595–e603. DOI: 10.5435/JAAOS-D-19-00700
  2. Barg A, Bailey T, Richter M, et al. Weightbearing computed tomography of the foot and ankle: emerging technology topical review. Foot Ankle Int 2018;39(3):376–386. DOI: 10.1177/1071100717740330
  3. de Cesar Netto C, Myerson MS, Day J, et al. Consensus for the use of weightbearing CT in the assessment of progressive collapsing foot deformity. Foot Ankle Int 2020;41(10):1277–1282. DOI: 10.1177/1071100720950734
  4. Kimura T, Kubota M, Suzuki N, et al. Weightbearing computed tomography and 3-dimensional analysis of mobility changes of the first ray after proximal oblique osteotomy for hallux valgus. Foot Ankle Int 2021;42(3):333–339. DOI: 10.1177/1071100720962471
  5. Kimura T, Kubota M, Taguchi T, et al. Evaluation of first-ray mobility in patients with hallux valgus using weight-bearing CT and a 3-D analysis system a comparison with normal feet. J Bone Joint Surg Am 2017;99(3):247–255. DOI: 10.2106/JBJS.16.00542
  6. Kim Y, Kim JS, Young KW, et al. A new measure of tibial sesamoid position in hallux valgus in relation to the coronal rotation of the first metatarsal in CT scans. Foot Ankle Int 2015;36(8):944–952. DOI: 10.1177/1071100715576994
  7. Conti MS, Willett JF, Garfinkel JH, et al. Effect of the modified lapidus procedure on pronation of the first ray in hallux valgus. Foot Ankle Int 2020;41(2):125–132. DOI: 10.1177/1071100719883325
  8. Conti MS, Patel T, Zhu J, et al. Association of first metatarsal pronation with patient-reported outcomes and recurrence rates in hallux valgus. Foot Ankle Orthop 2022;7(1):2473011421S0015. DOI: 10.1177/2473011421s00154
  9. Probasco W, Haleem AM, Yu J, et al. Assessment of coronal plane subtalar joint alignment in peritalar subluxation via weight-bearing multiplanar imaging. Foot Ankle Int 2015;36(3):302–309. DOI: 10.1177/1071100714557861
  10. Cody EA, Williamson ER, Burket JC, et al. Correlation of talar anatomy and subtalar joint alignment on weightbearing computed tomography with radiographic flatfoot parameters. Foot Ankle Int 2016;37(8):874–881. DOI: 10.1177/1071100716646629
  11. De Cesar Netto C, Godoy-Santos AL, Saito GH, et al. Subluxation of the middle facet of the subtalar joint as a marker of peritalar subluxation in adult acquired flatfoot deformity: a case-control study. J Bone Joint Surg Am 2019;101(20):1838–1844. DOI: 10.2106/JBJS.19.00073
  12. Schmidt E, Silva T, Baumfeld D, et al. The rotational positioning of the bones in the medial column of the foot: a weightbearing CT analysis. Iowa Orthop J 2021;41(1):103–109.
  13. Andres L, Donners R, Harder D, et al. Association between weightbearing CT and MRI findings in progressive collapsing foot deformity. Foot Ankle Int 2024;45(5):526–534. DOI: 10.1177/10711007241231221
  14. Krähenbühl N, Kvarda P, Susdorf R, et al. Assessment of progressive collapsing foot deformity using semiautomated 3D measurements derived from weightbearing CT scans. Foot Ankle Int 2022;43(3): 363–370. DOI: 10.1177/10711007211049754
  15. Carvalho K, de Cesar Netto C, Mansur NS, et al. Surgical correction of peritalar subluxation and patient-reported outcomes: a prospective comparative outcome study in flexible progressive collapsing foot deformity. Foot Ankle Orthop 2022;7(2). DOI: 10.1177/2473011421S00524
  16. de Cesar Netto C, Saito GH, Roney A, et al. Combined weightbearing CT and MRI assessment of flexible progressive collapsing foot deformity. Foot Ankle Surg 2021;27(8):884–891. DOI: 10.1016/j.fas.2020.12.003
  17. Raheman FJ, Rojoa DM, Hallet C, et al. Can weightbearing cone-beam CT reliably differentiate between stable and unstable syndesmotic ankle injuries? A systematic review and meta-analysis. Clin Orthop Relat Res 2022;480(8):1547–1562. DOI: 10.1097/CORR.0000000000002171
  18. Hagemeijer NC, Chang SH, Abdelaziz ME, et al. Range of normal and abnormal syndesmotic measurements using weightbearing CT. Foot Ankle Int 2019;40(12):1430–1437. DOI: 10.1177/1071100719866831
  19. Netto C de C, Lalevee M, Shamrock AG, et al. Diagnostic accuracy of weightbearing CT in detecting subtle chronic syndesmotic instability: a prospective comparative study. Foot Ankle Orthop 2022;7(1):2473011421S0001. DOI: 10.1177/2473011421s00015
  20. Bhimani R, Ashkani-Esfahani S, Lubberts B, et al. Utility of volumetric measurement via weight-bearing computed tomography scan to diagnose syndesmotic instability. Foot Ankle Int 2020;41(7):859–865. DOI: 10.1177/1071100720917682
  21. Thompson MJ, Consul D, Umbel BD, et al. Accuracy of weightbearing CT scans for patient-specific instrumentation in total ankle arthroplasty. Foot Ankle Orthop 2021;6(4). DOI: 10.1177/24730114211061493
  22. Berlet GC, McCoy AMM, Consul D, et al. Accuracy of weightbearing CT vs non-weightbearing CT scans for patient-specific instrumentation in total ankle arthroplasty. Foot Ankle Orthop 2022;7(1). DOI: 10.1177/2473011421S00109
  23. Lintz F, Mast J, Bernasconi A, et al. 3D, weightbearing topographical study of periprosthetic cysts and alignment in total ankle replacement. Foot Ankle Int 2020;41(1):1–9. DOI: 10.1177/1071100719891411
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.