Tarsal Coalition

Purpose

Detect, characterize, and classify tarsal coalitions

Tag(s)

 

Panel

 Musculoskeletal

TOUCH-AI ID

 TAI-05180016

Originator

 Jay Patti

Panel Chair

 Jay Patti

Panel Reviewers

 Musculoskeletal Panel

License

 Creative Commons 4.0

Status  Public Commenting

Clinical Implementation


Value Proposition

Tarsal coalition is a common congenital abnormality that is sometimes a cause of chronic midfoot pain. It is often difficult to see on radiograph but can be definitively confirmed on more expensive exams such as CT and MRI. There are multiple types of tarsal coalition, each with a different appearance on radiograph. The successful identification and classification of a coalition might limit further more expensive imaging as well as expedite care for the patient. The AI meeting this use case would help to reduce false-negative rates, patient risk, and medical legal risk for the radiologists.

Narrative(s)

A 25-year-old patient presents with chronic midfoot pain, and an x-ray is taken in the primary care office or orthopedist’s office. Either the clinician or the related algorithm detects the presence of tarsal coalition, which triggers this use case. The algorithm evaluates the image and characterizes the tarsal coalition. The radiologist is informed of this categorization at the time of interpretation.

Workflow Description

An image obtained from the modality is sent to PACS and the AI engine. The image is analyzed by the engine. The system classifies tarsal bone coalition as osseous, fibrous, or cartilaginous. A message is sent to PACS from the engine with the classification information. If the location of the joint is also identified, the location information can be sent to PACS to highlight the region the engine identified.

Considerations for Dataset Development


Procedures(s): X-ray, Lower extremity

View(s): {AP, Oblique, Lateral}

 

Sex at Birth: {Male, Female}

 

Age (years): [10,90]

Technical Specifications


Inputs

DICOM Study

Procedure

XRAY, Lower Extremity

Views

AP, Oblique, Lateral

Data Type

DICOM

Modality

XRAY

Body Region

Lower Extremity

Anatomic Focus

Foot

 

Primary Outputs

Tarsal Coalition Detection

RadElement ID

RDE260

Definition

The presence of tarsal coalition

Data Type

Categorical

Value Set

0-Unknown

1-Tarsal Coalition Present

2-Tarsal Coalition Absent

Units

N/A

Secondary Outputs

Tarsal Coalition Characterization

RadElement ID

RDE261

Definition

If tarsal coalition exists, characterize the coalition

Data Type

Categorical

Value Set

0-Unknown

1-Osseous

2-Fibrous

3-Cartilaginous

Units

N/A

 

Tarsal Coalition Classification

RadElement ID

RDE262

Definition

If tarsal coalition exists, classify the type of coalition.

Data Type

Categorical

Value Set

0-Unknown 

1-Calcaneonavicular

2-Talocalcaneal

3-Calcaneicuboid

4-Talonavicular

5-Cubonavicular

Units

N/A

Public Commenting


Use cases are meant to be a primary vehicle for distributing clinical information to the developer community. They pinpoint precise scenarios within radiology workflows where potential automation could add noticeable value and establish standards for interpreting and passing corresponding common data elements. Implementing effective standards requires the perspective from all stakeholders. So to that end, we encourage your feedback on use cases.

To submit comments, please email DSIUseCases@acr.org with the use case title(s) and relevant comments by January 1, 2019. If more convenient, you may also download this use case and comment directly on the PDF. Just attach the PDF copy on the email.