Introduction: The x-ray test, introduced at the beginning of the XX century, originated a succession of descriptions of alterations in the different secondary ossification nuclei of the long bones, systematically considered as osteocondrosis cases. Osteocondrosis is a wide concept including etiological, pathological, histological, clinical and radiological data, there being no unique criterium about the concept in the literarure. There are no clear data in the literature about the prevalence of radiological alterations in the forefoot ossification nuclei. In most cases such ‘alterations’ are rather anatomical variants in the development and growth of the ossification nuclei.

The aim of the present study was to determine the different radiological alterations observed in our series and their possible relation with other variables (sex, foot pathology and forefoot morphology).

Material and Methods: A serie of 971 dorso-plantar radiographs from 225 patients were retrospectively analysed. The presence, or lack, of each nucleus and its radiological aspect were observed. The different alterations of the nuclei were classified as: normal, sclerotic, sclerotic and notch, sclerotic and flattened, sclerotic and fragmented, and fragmented. Likewise, a statistical analysis was performed relating the alterations of each nucleus with the forefoot morphology (digital and metatarsal formulae) and the main pathologies motivating the x-ray examination (traumatism, our control group; flatfoot; hallux valgus; clubfoot).

Results: We could not find any asymmetry or dimorphism in our series. The prevalence of different alterations of each nucleus was higher in younger children, excepting in the ossification nucleus of the proximal phalanx.

In the 46.3% of the cases there are radiological alterations in the ossification nucleus of the proximal phalanx. In such cases, the 79.2% were sclerotic.

In the flatfoot patients a higher frequency regarding the apperance of radiological alterations was shown significant (p< 0.05) for first cuneiform, proximal metatarsal, and proximal phalanx nuclei.

In the cases with evident alterations of the proximal or distal metatarsal nuclei, the 100% of the cases was related to egyptian digital formula.

The retrospective study did not provide us with additional clinical information about symptoms that could define osteocondrosis in each case.

Conclusions: There is a higher prevalence regarding to radiological alterations of the ossification nuclei of the first radio of the foot.

The biomechanical alterations of the gait in the flat-foot patients, or its treatment (insole), could be related to radiological alterations of such nuclei.

Introduction: The study of appearance and development of the different ossification nuclei of the skeleton in the diverse segments of the locomotor apparatus is relevant for fields of medicine, such as Human Anatomy, Paediatry, Endocrinology, Forensic Medicine, Traumatology and Orthopaedic Surgery, among others.

A number of studies show significant differences regarding their results due to the heterogeneity of methods and scientific and geographic fields originating each series.

The present study is intended to show the age of appearance and complete fusion of the different ossification nuclei of the first radio of the foot in a present Mediterranean sample of children and its relation with several morphometric and clinical parameters.

Material and Methods: We report a retrospective study where 971 x-ray dorso-plantar images from 225 patients were analysed.

A descriptive and qualitative assessment allowed us to determine the existence or lack of each ossification nucleus of the first radio of the foot. Risser’s scale, adapted by us, was applied in the following way: 0, lack; I, rudimentary nucleus; II, well formed nucleus; III, partial fusion to diaphysis; IV, complete fusion.

Likewise, a statistical analysis was performed relating the ages of appearance and fusion of each nucleus with the forefoot morphology (digital and metatarsal formulae) and the main pathologies motivating the x-ray examination (traumatism, our control group; flatfoot; hallux valgus; clubfoot).

Results: Data about the age of appearance and fusion of each nucleus of the first radio of the foot were quantified.

As a general rule, the age of appearance of each nucleus was earlier in girls. A delay in the age of appearance of the proximal metatarsal epiphysis in clubfoot patients (3.33 years) was observed in comparison with the control group (1.96 years).

In general, there was no relation between sex and the fusion (partial and total) of each nucleus of the first radio of the foot. The exception was the age of appearance of the distal metatarsal epiphysis (when this incostant nucleus was present), earlier in boys (9.49 years) than girls (11.21 years).

A delay in the age of fusion of the proximal and distal metatarsal epiphyses and the proximal phalanx epiphysis was observed in hallux valgus patients.

In patients with egyptian foot, there seems to be a delay in the age of fusion of the distal metatarsal and distal phalanx epiphyses.

Conclusions: The different ages of appearance and partial and total fusion of each ossification secondary nucleus of the first radio of the foot are detailed in the present comunication. A delay in the age of fusion of the secondary nucleus of the first radio of the foot would contribute to determine significantly forefoot morphology (egyptian formula) and even its pathology (hallux valgus).

Objectives: Nowadays estimating paediatric bone age is done using methods based on standards from the 50’s and 70’s. These methods are often difficult to perform, they require experience in the analysis of multiple bones and are based on subjective measures. Many times, the age calculated stands within a wide range of age interval. We investigate a new method based on AP foot X-rays.

Material and Methods: 971 radiographs taken from 220 paediatric patients (0–18 years old) were analyzed. 34 different ratios were designed by measuring ossification centres of the bones of the first and second foot rays. These ratios were statistically studied searching for the relation with variables as gender, laterality, foot pathology and forefoot formulae. Finally, regression lines and curves from each ratio were calculated as well as their correlation with chronological age.

Results: The best suited correlations are obtained with the ratios calculated from the epiphysis of the proximal phalange of the first and second toes. With them, multiple regression analysis is able to establish an equation that estimates bone age, with a chronological age correlation of 0,86 for general population, 0,85 for boys and 0,90 for girls (p< 0,01). It is applicable for either feet, and valid for every forefoot formula or pathologic feet.

Conclusions: This new method is designed to estimate bone age in children using either plain radiographs or digital images. The method is objective, precise, universal and easy to calculate. It proves a good correlation in children between 1 and 13 years old. It is based on a modern population and adjusted with lineal regression equations to both genders.