{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T11:14:34Z","timestamp":1783509274021,"version":"3.55.0"},"reference-count":21,"publisher":"MDPI AG","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,9]]},"abstract":"<jats:sec id=\"st1\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Hallux valgus is a progressive foot deformity that commonly affects middle-aged women. The aim of this study was to develop a novel method using only top-view photographs to assess hallux valgus severity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"st2\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A top-view digital photograph was taken of each foot of 70 female participants. Two straight lines were drawn along the medial edge of the great toe and forefoot, and the included angle (termed\n                      <jats:italic>bunion angle<\/jats:italic>\n                      ) was measured using a free software program. Each foot was also assessed by a clinician using the Manchester scale as no (grade 1), mild (grade 2), moderate (grade 3), or severe (grade 4) deformity.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"st3\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The mean bunion angles of the 140 feet were 6.7\u00b0, 13.5\u00b0, and 16.2\u00b0 for Manchester grades 1, 2, and 3, respectively (no foot was in grade 4). The reliability was excellent for both intrarater (intraclass correlation coefficient [ICC] = 0.93\u20130.95) and interrater (ICC = 0.90) assessments. Receiver operating characteristic curves determined the optimal bunion angle cutoff value for screening hallux valgus to be 9\u00b0, which gives 89.2% sensitivity and 74.2% specificity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"st4\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The bunion angle is a reliable, clinician-free method that can potentially be integrated into a smartphone app for easy and inexpensive self-assessment of hallux valgus.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.7547\/19-167","type":"journal-article","created":{"date-parts":[[2021,12,3]],"date-time":"2021-12-03T16:36:23Z","timestamp":1638549383000},"source":"Crossref","is-referenced-by-count":0,"title":["A Clinician-Free Method Using Top-View Photography for Screening and Monitoring Hallux Valgus"],"prefix":"10.3390","volume":"111","author":[{"given":"Daniel 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