Toes and Foot

LABEL

1. Phalanges (14)

2. Metatarsals (5)

3. Tarsals (7)

Big toe = digit 1

Sesamoid bones

Where are they?

Embedded in tendons

Present near joints

Plantar surface of foot

Naming the tarsals & alternate names

Come To Colorado (the) Next 3 Christmases

Calcaneus/Os Calcis

Talus/Astrangulus

Cuboid

Navicular/Scaphoid

3 Cuneiforms (1,2,3 or medial, intermediate, lateral)

LABEL

1. Cuneiforms, 1-medial 2- intermediate 3-lateral

2. Navicular

3. Talus

4. Cuboid

5. Calcaneus

LABEL

1. Intermediate Cuneiform

2. Medial Cuneiform

3. Navicular

4. Talus

5. Calcaneus

Arches of the foot

-2 Longitudinal arch : medial and lateral

-Transverse arch

Determine movements

1. Dorsiflexion

2. Plantar flexion

3. Inversion (varus)

4. Eversion (valgus)

Interphalangeal (IP, DIP, PIP)

Hinge

Metatarsophalangeal (MTP) joint

Condyloid

Intertarsal

Gliding

Technical factors for lower extremity

Low to medium KV (50-80)

Small focal spot

Grids for anatomy that measures over 10 cm (knee)

Always wear gloves

Shoes & socks off, pants legs rolled up or pants removed

AP Foot- dorsoplantar

plantar surface on IR

Angle tube 10 degrees posteriorly/towards heel - because of arches

CR = base of 3rd metatarsal

MTP joints open

Metatarsals seperated

Symmetrical concavity on phalanges & metatarsals

Medial aspect well visualized (1st and 2nd cuneiform)

Calcaneus and Talus superimposed

AP Oblique Foot

30 degree medial rotation

CR = base of 3rd metatarsal

No tube angle

Plantar surface on IR with knee bent

Lateral aspect of foot best visualized 

• Cuboid, lateral cuneiform

• Tuberosity/base of 5th metatarsal in profile

3rd-5th metatarsals free from superimposition

Asymmetrical concavity

Mediolateral foot

True lateral may need to roll patient *best for foreign body

Dorsiflex foot

CR = to medial cuneiform (level base of 3rd metatarsal)

Tibiotalar joint demonstrated

Metatarsals & phalanges superimposed

Calcaneous in profile

Cubiod and base of fifth more inferior

AP Weight bearing feet

CR = 10 to 15 posterior/towards the heel

CR = base of metatarsals

ARCHES

Usually bilateral

Lateral Weight bearing feet

Horizontal beam

Evaluate arches

CR= to point above 3rd metatarsals

Usually lateromedial projection

Weight bearing oblique foot

2 options

• Oblique pts foot

• Angle tube

AP Toes

CR = perpendicular with angle sponge or axial 10 degrees posterior to metatarsophalangeal joint

Digits and minimus of distal ½ of metatarsal demonstrated

No overlap of soft tissues

IP and MTP joints appear open

Symmetrical concavity

AP Oblique toes

try to get a 30 degree rotation

Digits 1-2 → medial rotation

Digits 3-5 → lateral rotation

CR= perpendicular to MTP

No tube angle

IP and MTP joints open

Increased concavity on one side of shaft-asymmetric concavity

Head of metacarpals not overlapped

Lateral toes 1st-2nd digit

Lateromedial

CR= Interphalangeal joint

Asymmetric concavity

Metatarsals superimposed 

IP and MTP joints appear open

Mediolateral 3rd-5th digits

CR = Proximal interphalangeal joint

Asymmetric concavity

Metatarsals superimposed 

IP and MTP joints appear open