Toes

• AP/AP axial projection

• PA projection

• AP oblique projection - medial/lateral rotation

• PA oblique projection - medial rotation

• Lateral projection (mediolateral/Lateromedial)

Projections of the toes:

interphalangeal joint spaces

are not best demonstrated on the AP projection

AP projection

When demonstration of these joint spaces is not critical, an __ may be performed

AP axial projection

is recommended to open the joint spaces and reduce foreshortening

Supine/Seated

AP/AP AXIAL PROJECTION Patient Position

3rd MTP Joint

AP/AP AXIAL PROJECTION Reference point

Perpendicular (15 degrees foam wedge) or 15 degrees posteriorly

AP/AP AXIAL PROJECTION Central ray

Phalanges & distal portion of metatarsals

AP Axial (15 degrees)

Open IP joints

AP/AP AXIAL PROJECTION Structures Shown

Prone

PA PROJECTION Patient Position

3rd MTP joint

PA PROJECTION Reference point

Perpendicular

PA PROJECTION Central Ray

IP joint spaces

PA PROJECTION Structures Shown

Supine/seated; rotated 30-45 degrees medially

AP OBLIQUE PROJECTION (MEDIAL ROTATION) Patient Position

3rd MTP joint

AP OBLIQUE PROJECTION (MEDIAL ROTATION) Reference point

Perpendicular

AP OBLIQUE PROJECTION (MEDIAL ROTATION) Central Ray

2nd-5th MTP joint spaces; 1st-3rd toes

AP OBLIQUE PROJECTION (MEDIAL ROTATION) Structures Shown

Supine/seated; rotated 30-45 degrees laterally

AP OBLIQUE PROJECTION (LATERAL ROTATION) Patient Position

3rd MTP joint

AP OBLIQUE PROJECTION (LATERAL ROTATION) Reference point

Perpendicular

AP OBLIQUE PROJECTION (LATERAL ROTATION) Central Ray

3rd-5th toes

AP OBLIQUE PROJECTION (LATERAL ROTATION) Structure Shown

Lateral recumbent; 30 degrees to horizontal

PA OBLIQUE PROJECTION (MEDIAL ROTATION) Patient Position

3rd MTP joint

PA OBLIQUE PROJECTION (MEDIAL ROTATION) Reference point

Perpendicular

PA OBLIQUE PROJECTION (MEDIAL ROTATION) Central Ray

Toes and the distal portion of the metatarsals rotated laterally; 2nd-5th MTP; 1st MTP joint (not always open)

PA OBLIQUE PROJECTION (MEDIAL ROTATION) Structure Shown

Lateral recumbent

LATERAL PROJECTION (LATEROMEDIAL/MEDIOLATERAL) Patient Position

sandbag or sponge

LATERAL PROJECTION (LATEROMEDIAL/MEDIOLATERAL) Part Position (3rd, 4th, 5th) Support elevated heel on

Perpendicular

LATERAL PROJECTION (LATEROMEDIAL/MEDIOLATERAL) Central Ray

phalanges of the toe and IP articulations

LATERAL PROJECTION (LATEROMEDIAL/MEDIOLATERAL) Structures Shown