Background/Objectives: The purpose of this study was to evaluate the reliability and diagnostic accuracy of smartphone-based photogrammetry for the assessment of pes planus and to determine its agreement with standard radiographic measurements. Methods: This prospective diagnostic study included 100 skeletally mature patients (50 males, 50 females; mean age 43.4 years) who underwent standardized lateral weight-bearing foot radiographs and smartphone-based foot photography. The calcaneal pitch angle (CPA) was measured on radiographs, and a corresponding photographic arch pitch angle (P-APA) was measured from standardized smartphone photographs using digital software (Angle Meter iOS v1.9.8). Three independent observers performed each measurement twice. Inter- and intra-observer reliability was assessed using intraclass correlation coefficients (ICC). Agreement between methods was evaluated with Pearson correlation, Lin’s concordance correlation coefficient (CCC), Bland–Altman analysis, and Deming regression. Receiver operating characteristic (ROC) analysis was performed to determine the diagnostic accuracy of calibrated P-APA, with the radiographic threshold of 18° serving as the reference standard for pes planus classification. Results: All measurements demonstrated excellent intra- and inter-observer reliability (ICC ≥ 0.900). P-APA values were systematically higher than radiographic values (31.8° ± 4.3 vs. 21.8° ± 5.5; p < 0.001). A strong correlation was observed between the two methods (r = 0.799, p < 0.001), but concordance was poor (CCC = 0.222). Bland–Altman analysis revealed a mean bias of +10.1° with wide limits of agreement (3.8° to 16.4°). Deming regression yielded the calibration equation Radiographic CPA = (P-APA × 1.371) − 21.883. ROC analysis of calibrated values yielded an AUC of 0.885 (95% CI, 0.820–0.951), with an optimal cutoff of 22.8° (sensitivity, 100%; specificity, 61.1%), corresponding to 32.6° on the uncalibrated photographic scale. Conclusions: Conventional weight-bearing radiography remains the reference standard for diagnosis and clinical decision-making in pes planus. The smartphone-derived photographic arch pitch angle is a non-equivalent surrogate measure that shows substantial systematic bias and limited agreement with radiographic calcaneal pitch, and therefore cannot replace weight-bearing radiographs. Smartphone photogrammetry may be used only as a complementary tool for preliminary screening or telemedicine support; any positive or equivocal findings require radiographic confirmation.

Background/Objectives: The modified Budin radiographic technique is a practical alternative to CT for measuring femoral neck anteversion (FNA); however, the impact of hip abduction angle on its accuracy remains unclear. This experimental study examined how varying abduction angles affect agreement between modified Budin measurements and CT. Methods: Twenty-seven dry adult femora underwent CT scanning, and FNA was measured using a validated three-slice superimposition method as the reference standard. Modified Budin radiographs were obtained at 20°, 30°, and 40° of femoral abduction. Two orthopedic surgeons independently measured FNA on all images twice, with at least 15 days between measurements. Intra- and interobserver reliability were assessed using the intraclass correlation coefficient (ICC). Mean values per femur were analyzed. Agreement with CT was evaluated using Pearson correlation, Bland–Altman analysis, and absolute error comparisons across abduction angles. Results: Reliability was excellent across all modalities (ICC, 0.982–0.998). Mean CT-derived FNA was 10.0° ± 8.5°, compared with 9.1° ± 8.0° at 20°, 8.3° ± 7.8° at 30°, and 7.8° ± 7.5° at 40° of abduction (p < 0.001). Correlation with CT was strong at all positions, but systematic underestimation increased with abduction angle. Among the tested positions, 20° abduction showed the smallest bias, the narrowest limits of agreement, and the lowest absolute error. Conclusions: Hip abduction angle significantly influences the accuracy of the modified Budin view. Under controlled experimental conditions, 20° abduction provided the closest agreement with CT among the tested positions. These findings suggest that lower abduction angles may improve geometric accuracy, although clinical feasibility and performance must be confirmed in vivo before routine clinical application can be recommended.

Sinding-Larsen-Johansson syndrome (SLJS) is a rare cause of anterior knee pain in young athletes and is often underdiagnosed due to low clinical suspicion and poorly recognized features. A 9-year-old female tennis player presented with anterior knee pain; radiographs showed patellar fragmentation, and MRI confirmed edema at the patellar tendon insertion. Conservative management with rest resulted in the complete resolution of symptoms and return to sport. This case highlights the clinical and radiological features of SLJS in a 9-year-old athlete, emphasizing the importance of MRI in confirming the diagnosis and facilitating timely management.

This study aimed to evaluate the association of blood parameters and ratios with knee prosthesis loosening in patients after knee arthroplasty. A total of 221 patient files having knee prosthesis attempting to our clinic between 2018 and 2022 were retrospectively examined. Patients were divided into 2 groups as loosening (n = 108; 48.9%) and not loosening (n = 113; 51.1%) groups. Monocyte/high-density lipoprotein (HDL) ratio monocyte-to-HDL ratio (MHR), Neutrophil/lymphocyte ratio, Albumin/ C-reactive protein (CRP) ratio, albumin-to-C-reactive protein ratio (ACR), Eosinophile-to- lymphocyte ratio, mean platelet volume /PLT ratio mean platelet volume-to-platelet ratio, Monocyte -to-lymphocyte ratio, Platelet/lymphocyte ratio (PLR) and Hemoglobin/Platelet ratio (HPR) parameters of patients were evaluated. HDL, albumin, hemoglobin, ACR, PLR and HPR levels were significantly higher in loosening patients ( P < .05). CRP, neutrophile, lymphocyte, monocyte and MHR means were significantly higher in no-loosening patients ( P < .05). Loosening was significantly correlated with gender ( R = 0.141; P < .05), HDL ( R = 0.474; P < .01), albumin ( R = 0.349; P < .01), CRP (r = −0.466; P < .01), neutrophile (r = −0.167; P < .05), lymphocyte (r = −0.240; P < .01), monocyte (r = −0.380; P < .01), hemoglobin ( R = 0.254; P < .01), MHR (r = −0.513; P < .01), ACR ( R = 0.496; P < .01), PLR ( R = 0.142; P < .05) and HPR ( R = 0.204; P < .01). Binary logistic regression analysis showed that MHR (B = −0.415; P < .01), ACR (B = 0.048; P < .01), and HPR (B = 30.640; P < .05) were significantly associated with knee prosthesis loosening at the multivariate level. ROC analysis demonstrated statistically significant discriminative performance for MHR, area under the curve ([AUC] = 0.798; P < .01), ACR (AUC = 0.786; P < .01), and HPR (AUC = 0.618; P < .01). For MHR 6.2481 cutoff level, sensitivity was 72.2% and specificity was 10.6%. For ACR 8.6380 cutoff level, sensitivity was 84.3% and specificity was 59.3%. For HPR 0.0506 cutoff level, sensitivity was 63.9% and specificity was 54.0%. MHR, ACR, and HPR were significantly associated with aseptic loosening after total knee arthroplasty and may be considered potential associated markers rather than definitive predictors.