distal articular set angle

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distal articular set angle

; DASA angle created by a line perpendicular to the effective cartilage of the proximal phalanx of the hallux and the longitudinal bisection of the proximal phalanx (allowing comparison of the planes of the articular surface of the head of the proximal phalanx and that of the base of the distal phalanx of the toe); normal DASA = 5-9° (see Table 1)
Table 1: Radiographic charting
AngleNormal rangeClinical features
Boehler's angle20-40°Angle between a line drawn from the superior-posterior aspect of the calcaneum and a line drawn from the anterior dorsal aspect of the calcaneum, on a lateral radiograph
Calcaneal inclination angleAngle between a line drawn to the undersurface of the calcaneum (on a lateral radiograph) and the support surface; the greater the calcaneal angle, the more supinated the rearfoot; the lower the angle, the more pronated the rearfoot
CYMA lineLazy S-shaped line that forms the midtarsal joint (talonavicular and calcaneocuboid joints) on a lateral radiograph; the smoothness of the CYMA line is lost in the excessively pronated or supinated foot
Hallux abductus angle0-20°Angle between the longitudinal bisection of the first metatarsal and the longitudinal bisection of the proximal phalanx of the hallux (on a dorsiplantar radiograph)
Hallux interphalangeal angle0-10°Angle between the longitudinal bisection of the proximal phalanx of the hallux and the longitudinal bisection of the distal phalanx of the hallux (on a dorsiplantar radiograph)
Lesser tarsal angle10°Angulation between the longitudinal bisection of the rearfoot and a longitudinal bisection of the lesser metatarsals (on a dorsiplantar radiograph). This angle is increased in a pronated foot, and decreased in a supinated foot
Metatarsus adductus angle10-20°Angle between the longitudinal axis of the second metatarsal and a line perpendicular to a line drawn from reference points on the medial cuneiform to the cuboid (on a dorsiplantar radiograph)
Metatarsus adductus primus angle8-10°Angulation between the bisections of the first and second metatarsal (on a dorsiplantar radiograph) >12° indicates pathology in a rectus foot; 10° indicates pathology in an adductus foot
Parallel pitch lines (PPLs)Lines drawn on a lateral radiograph of the foot: see Figure 1
PPL 1: a line drawn at the inferior margin of the calcaneum that joins the anterior tubercle and the medial tubercle of the posterior tuberosity of the calcaneum
PPL 2: a line drawn parallel to PPL 1 between the bursal projection (or posterior-superior prominence) at the superior margin of the calcaneum and the posterior lip of the talar articular facet
Divergent PPLs are characteristic of a foot with Haglund's deformity
Proximal articular set angle (PASA)0-8°Angle created between a line perpendicular to the longitudinal bisection of the first metatarsal and a line drawn to represent the effective articular cartilage of the head of the first metatarsal (on a dorsiplantar radiograph)
Superior calcaneal tuberosity angleAngle between the posterior tuberosity of posterior margin of the calcaneum and the anterior and medial tuberosities on the inferior margin of the calcaneum (on a lateral radiograph)
Talar declination angleAngle between the longitudinal bisection of the talus and the support surface (on a lateral radiograph); the nearer to the horizontal, the more supinated the rearfoot; the greater the declination of the talus, the more pronated the rearfoot (on a dorsiplantar radiograph)
Tibial sesamoid positionRelationship of the tibial sesamoid and the longitudinal bisection of the first metatarsal; the tibial sesamoid is normally medial to the first metatarsal bisection; christa erosion is likely where the tibial sesamoid abuts or crosses to the lateral part of the first metatarsal (on a dorsiplantar radiograph)
Total angle<75°Sum of the calcaneal inclination angle and superior calcaneal tuberosity angle see Figure 2

Biomechanical evaluation of plain radiographs is primarily made from dorsiplantar

Figure 1: Plantar fascia. MTP, metatarsophalangeal. This article was published in Neale's Disorders of the Foot, Lorimer, French, O'Donnell, Burrow, Wall. Copyright Elsevier, (2006).
Figure 2: Plantar fascia. MTP, metatarsophalangeal. This article was published in Neale's Disorders of the Foot, Lorimer, French, O'Donnell, Burrow, Wall. Copyright Elsevier, (2006).
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