Greg M. OsgoodDelaram ShakoorJakrapong OrapinJianzhong QinIman KhodarahmiGaurav K. ThawaitJames R. FickeLew C. SchonShadpour DemehriSecond Affiliated Hospital of Suzhou UniversityUnion Memorial HospitalFaculty of Medicine, Ramathibodi Hospital, Mahidol UniversityThe Johns Hopkins School of Medicine2019-08-282019-08-282018-01-01Foot and Ankle Surgery. (2018)14609584126877312-s2.0-85056350556https://repository.li.mahidol.ac.th/handle/20.500.14594/47196© 2018 European Foot and Ankle Society Background: To investigate the reliability and reproducibility of syndesmosis measurements on weightbearing (WB) cone-beam computed tomography (CBCT) images and compare them with measurements obtained using non-weightbearing (NWB) images. Methods: In this IRB-approved, retrospective study of 5 men and 9 women with prior ankle injuries, simultaneous WB and NWB CBCT scans were taken. A set of 21 syndesmosis measurements using WB and NWB images were performed by 3 independent observers. Pearson/Spearman correlation and intra-class correlation (ICC) were used to assess intra- and inter-observer reliability, respectively. Results: We observed substantial to perfect intra-observer reliability (ICC = 0.72–0.99) in 20 measurements. Moderate to perfect agreement (ICC = 0.45–0.97) between observers was noted in 19 measurements. Conclusion: Measurements evaluating the distance between tibia and fibula in the axial plane 10 mm above the plafond had high intra- and inter-observer reliability. Mean posterior tibio-fibular distance, diastasis, and angular measurement were significantly different between WB and NWB images.Mahidol UniversityMedicineSCOPUS10.1016/j.fas.2018.10.003