P3 POSI PROJECTIONS (lower extremities)

PP: Supine/Seated; knee flexed; 15o foam wedge under foot

RP: 3rd MTP joint

CR: ┴ (15o foam wedge) or 15o posteriorly

SS: Phalanges & distal portion of metatarsals

AP/ AP AXIAL PROJECTION (TOES)

PP:

RP:

CR:

SS:

IP JOINTS ARE PARALLEL TO CR ANGLE

PP: Prone; dorsal aspect against IR

RP: 3rd MTP joint

CR: ┴

SS: MTP & IP joint spaces are well visualized

PA PROJECTION (TOES)

IP JOINTS ARE ___ TO CR ANGLE

PP:

RP:

CR:

SS:

PP: Supine/seated; knee flexed; plantar surface 30-45o from IR (lower leg & foot rotated medially )

RP: 3rd MTP joint

CR: ┴

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

AP OBLIQUE PROJECTION (MEDIAL ROT.) (TOES)

PP: w angle

RP:

CR:

SS:

PP: Supine/seated; knee flexed; plantar surface 30-45o from IR (lower leg & foot rotated laterally)

RP: 3rd MTP joint

CR: ┴

SS: 4rd-5th toes; MTP joints overlapped

AP OBLIQUE PROJECTION (LATERAL ROT.) (TOES)

PP: w angle

RP:

CR:

SS:

PP: Lateral recumbent (affected side down); affected limb partially extended; ball of foot 30o to horizontal

RP: 3rd MTP joint

CR: ┴

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

PA OBLIQUE PROJECTION (MEDIAL ROT.) (TOES)

PP: w what side down// ball of foot ____o to horizontal

RP:

CR:

SS:

PP: Lateral recumbent; toe in true lateral

RP: IP joint (1st toe); proximal IP joint (2nd -4th toes)

CR: ┴

SS: Phalanges in profile; open IP joints spaces

Lateromedial Projection: on the unaffected side- great toe and 2nd toe

Mediolateral Projection: on the affected side-3rd, 4th, and 5th toe

Lateral Projection (TOES)

PP:

RP: _____ (1st toe); ______ (2nd -4th toes)

CR:

SS:

Lateromedial Projection: on the _____ side- _____toe &_____ toe

Mediolateral Projection: on the _____ side- __, __, __ toe

WHAT ARE THE 5 PROJECTIONS OF THE TOE (8 in total if u breakdown)

what are the projection/ methods of the sesamoids

15-20

PP: Prone; dorsiflex great toe; ankle elevated; ball of foot ┴ to IR RP: 1st MTP joint

CR: ┴

SS: MT head & sesamoids in profile

LEWIS METHOD (tangential proj.) (sesamoids)

PLANTAR SURFACE OF FOOT ____ ANGLE FROM VERTICAL.

_____ perpendicular to IR

PP:

RP:

CR:

SS:

PP: Seated (more comfortable); plantar surface 75o to IR; toe flexed & hold w/ strip gauze bandage; medial border is vertical and plantar surface of foot ┴ to IR

RP: 1st MTP head

CR: ┴

SS: MT head & sesamoids in profile

HOLY METHOD (TANGENTIAL PROJ) (SESAMOIDS)

PP: ______; plantar surface ____ to IR; toe flexed & hold w/ ______; medial border is vertical

RP:

CR:

SS:

PP: Lateral recumbent (unaffected side down); knees flexed; limb partially extended; foot in lateral position; 1st MTP joint ┴ to IR

RP: Prominence of 1st MTP joint

CR: 40o toward the heel

SS: Sesamoids projection axiolaterally with slight overlap

CAUSTON METHOD (TANGENTIAL PROJ.) ( SESAMOID)

PP: _______(____side down); _____ ┴ to IR

RP:

CR:

SS:

PP: Supine; knee flexed; plantar surface against IR RP: 3rd MTP base

CR: ┴ or 10o posteriorly

SS: Metatarsals & Tarsals (┴);

TMT joint (10o)

AP/ AP AXIAL PROJECTION (FOOT)

PP:

RP:

CR:

SS:

AP PROJ. OF FOOT

PP: Supine; knee flexed; leg rotated medially; plantar surface of foot 30o to IR

RP: 3rd MTP base

CR: ┴

SS: • Cuboid in profile

• Sinus tarsi (well demonstrated)

• Interspaces b/n:

• cuboid & calcaneus;

• cuboid & 4th & 5th MT

• Talus & navicular bone

AP OBLIQUE PROJECTION (MEDIAL ROT.) (FOOT)

PP: w angle

RP:

CR:

SS: •

• Interspaces b/n:

PP: Supine; knee flexed; leg rotated laterally; plantar surface of foot 30o to IR

RP: 3rd MT base

CR: ┴

SS: • Navicular in profile •

Interspaces b/n:

• 1st & 2nd Metatarsal

• Medial & intermediate cuneiforms

• Separates 1st-2nd Metatarsal bases

• No superimposition of the medial and intermediate cuneiform

AP OBLIQUE (LATERAL ROT.) (FOOT)

PP: w angle

RP:

CR:

SS: •

Interspaces b/n:

•

•

•

•

GRASHEY METHOD

PA OBLIQUE PROJECTION OF THE FOOT IS WHAT METHOD

PP: Prone; foot elevated on sandbags; folded towel under the knee; adjust the elevated foot; heel rotated medially 30o

RP: 3rd Metatarsal Base

CR: ┴

SS: Interspaces between 1st and 2nd Metatarsal

• NAVICULAR

PA OBLIQUE PROJECTION (MEDIAL ROT.) (FOOT)

PP: w angle

RP:

CR:

SS:

PP: Prone; foot elevated on sandbags; folded towel under the knee; adjust the elevated foot; heel rotated laterally 20o

RP: 3rd Metatarsal Base

CR: ┴

SS: 2nd-3rd, 3rd-4th, 4th-5th Metatarsal

• CUBOID

• 5TH MT TUBEROSITY (same as ap medial oblique)

PA OBLIQUE PROJECTION (LATERAL ROT.) (FOOT)

PP: w angle

RP:

CR:

SS:

AP MEDIAL OBLIQUE (FOOT)

AP LATERAL OBLIQUE FOOT

PP: lat, recumbent Dorsiflex foot (┴ to lower leg); leg & foot in lateral position; lateral side of foot against IR;

RP: 3rd MT base

CR: Perpendicular

SS: Entire foot in profile, the ankle joint, and the distal ends of the tibia and fibula

LATERAL PROJECTION (MEDIOLATERAL) (FOOT)

PP:

RP:

CR:

SS:

LATEROMEDIAL

WHAT IS THE RECOMMENDED LATERAL PROJ. OF THE FOOT?

LATEROMEDIAL

WHAT LAT. PROJ OF THE FOOT PROVIDES NEARLY EXACT/ TRUE LATERAL IMAGE OF THE FOOT

MEDIOLATERAL

WHAT LAT. PROJECTION OF THE FOOT IS ROUTINELY USED BECAUSE ITS A COMFORTABLE POSITION TO PUT A PX IN?

PP: lateral recumbent, Dorsiflex foot (┴ to lower leg); leg & foot in lateral position; lateral side of foot against IR;

RP: 3rd MT base

CR: Perpendicular

SS: Entire foot in profile, the ankle joint, and the distal ends of the tibia and fibula

Lateral Projection (MEDIOLATERAL) (FOOT)

PP: _______, _____foot (__ to lower leg); leg & foot in lateral position; _____ (M/L) side of foot against IR;

RP:

CR:

SS:

LATERAL PROJ. MEDIOLATERAL, FOOT

PP: LPO/RPO (affected side up); medial surface against IR; plantar surface of foot ┴ to IR

RP: 3rd MTP base

CR: Perpendicular

SS: True lateral projection of foot • Metatarsals more superimposed than mediolateraL

LATERAL PROJECTION (LATEROMEDIAL) (FOOT)

PP: ____ (___(A/UN) side up); ___ surface against IR; plantar surface of foot ┴ to IR

RP:

CR:

SS: _______

• ____ more superimposed than mediolateral

LATEROMEDIAL

IN THIS LATERAL PROJ. OF THE FOOT THE METATARSALS ARE MORE SUPERIMPOSED

PP: Upright (natural position);

feet elevated (use blocks);

IR b/n feet; weight equally distributed on each foot

RP: Point above 3rd MT base

CR: Horizontal

SS: Structural longitudinal planus). status of arch (pes The right and left ides are examined for comparison

LATERAL PROJECTION (LATEROMEDIAL) (WEIGHTBEARING METHOD) (FOOT)

PP:

feet _____(use _____);

___ b/n feet; weight equally distributed on each foot

RP:

CR:

SS:

LATEROMEDIAL

THE LATERAL PROJ. WEIGHT BEARING METHOD IS MEDIOLATERAL OR LATEROMEDIAL

20-40 DEGREES

BOHLERS ANGLE

AP MEDIAL OBLIQUE FOOT

PA LATERAL OBLIQUE FOOT

what oblique projections demonstrate 5th MT tuberosity

LAT. PROJ. WEIGHT BEARING METHOD. LATEROMEDIAL

WHAT BEST DEMONSTRATE FLAT FOOT OR PES PLANUS

PP: Upright; both feet against IR; weight equally distributed on each foot

RP: between feet at 3rd MT base level

CR: 10o or 15o posteriorly

SS: Accurate evaluation & comparison of Metatarsal & tarsals

AP AXIAL PROJ. WEIGHT BEARING METHOD

PP: _____; ___ feet against IR; weight equally distributed on each foot

RP: ______

CR: ___ or______

SS:

BOHLER’S CRITICAL ANGLE

AP AXIAL PROJ. WEIGHT BEARING METHOD

WHAT PROJ. BEST DEMONSTRATES HALLUX VALGUS AND LISFRANC INJURY

AP AXIAL PROJECTION

(WEIGHT BEARING COMPOSITE METHOD)

WHICH PROJECTION OF THE FOOT NEEDS 2 EXPOSURES

PP: Upright; 2 exposures

• First Exposure: unaffected foot step backward (to prevent superimposition of leg shadow on ankle joint); tube in fronT

• - For exposure of forefoot (phalanges & Metatarsal)

• Second Exposure: unaffected foot step forward; tube behind; exposure factor increase -

• - For hindfoot (talus & calcaneus

RP: For the 1st exposure: 3rd MT base

For the 2nd exposure: level of lateral malleolus

CR: For the 1st exposure: 15o posteriorly For the 2nd exposure: 25o anteriorly

SS: Full outline of the foot free of the leg

AP AXIAL PROJECTION

(WEIGHT BEARING COMPOSITE METHOD)

PP:_____; ___ exposures

• First Exposure: unaffected foot step ____(to prevent superimposition of leg shadow on ankle joint); tube in____

• - For exposure of___ (___ & _____)

• Second Exposure: unaffected foot step ____; tube behind; exposure factor ____

• - For _____ (____ & ____)

RP: For the 1st exposure: ______

For the 2nd exposure: _______

CR: For the 1st exposure: _____

For the 2nd exposure: _____

SS: _______

AP AXIAL PROJECTION

(WEIGHT BEARING COMPOSITE METHOD)

AP PROJ. TOES

AP PROJ. TOES

AP

IN THIS PROJ. OF THE TOES THE IP JOINTS ARE NOT SEEN

AP AXIAL PROJ. TOES

AP PROJ. TOES

PA PROJ. TOES

AP OBLIQUE PROJ. (MEDIAL ROT.) TOES

AP PROJ. LAT ROT. TOES

PA OBLIQUE (MEDIAL ROT) TOES

LATERAL PROJ (LATEROMEDIAL) TOES

LATERAL PROJ. (MEDIOLATERAL) TOES

TANGENTIAL PROJ. LEWIS METHOD

TANGENTIAL PROJ. HOLLY METHOD

TANGENTIAL PROJ. CAUSTION METHOD

AP AXIAL FOOT

AP PROJ. FOOT

AP OBLIQUE PROJ. MEDIAL ROT. FOOT

ap oblique projection lateral rotation

PA OBLIQUE PROJECTION: GRASHEY METHOD

AP OBLIQUE LAT. ROT

PA OBLIQUE FOOT MED. ROT IS THE SAME AS _______

LATERAL PROJ. MEDIOLATERAL (FOOT)

LATERAL PROJ. LATEROMEDIAL (FOOT)

1.) AP/AP AXIAL

2.) AP OBLIQUE (MEDIAL & LATERAL ROT.)

3.) PA OBLIQUE: GRASHEY METHOD (MEDIAL & LAT. ROT.)
4.) LATERAL PROJ (MEDIOLATERAL, LATEROMEDIAL)

5.) LATERAL (WEIGHT BEARING METHOD)

6.) AP AXIAL (WEIGHT BEARING METHOD)

7.) AP AXIAL (WEIGHT BEARING COMPOSITE METHOD)

what are the projections of the foot

WHAT ARE THE PROJECTIONS/ METHODS FOR CONGENITAL CLUBFOOT

EQUINUS, ADDUCTION, SUPINATION

Talipes equinovarus

]• 3 Deviations

(equinus)

Plantar flexion and inversion of the calcaneus

adduction

Medial displacement of the forefoot

supination

Elevation of the medial border of the foot

Davis and Hatte

stated that even slight rotation of the foot can result in marked alteration in the radiographically projected relation of the ossification centers

PP: Supine; hips & knees flexed; foot flat on IR; ankles slightly extended; legs are vertical

RP: Tarsals

CR: 15o posteriorly

SS: Degree of forefoot adduction & calcaneus inversion (equinus)

AP PROJECTION: ____ METHOD (CC)

PP:

RP:

CR:

SS:

AP PROJECTION; KITE METHOD; (CC)

PP: Lateral recumbent; uppermost limb flexed & draw forward

RP: Midtarsal area

CR: Perpendicular

SS: Anterior talar subluxation Degree of plantar flexion (equinus)

LATERAL PROJECTION (MEDIOLATERAL) (KITE METHOD) (CC)

PP: _____; uppermost limb flexed & draw ____

RP: _____

CR: ____

SS: __& __

PP: Erect & Bending forward position; plantar surface against IR

RP: Lower leg

CR: 40o anteriorly

SS: Suroplantar projection or an axial view of congenital clubfoot

Freiberger-Hersh-Harrison:

CR 35o, 45o & 55o for demonstration of sustentaculum talar joint fusion

DORSOPLANTAR AXIAL PROJECTION (KANDEL METHOD) (CC)

PP:___ &______; plantar surface against IR

RP: _____

CR: ___

SS:

_____-____-Harrison:

CR __o, __o & _o for demonstration of__ joint fusion

AP PROJECTION; KITE METHOD (CC)

DORSOPLANTAR AXIAL PROJECTION (KANDEL METHOD) (CC)

PP: Supine/Seated; leg fully extended; dorsiflex foot w/ strip of gauze; foot ┴ to IR

RP: 3rd MT base

CR: 40o cephalad to long axis of foot

SS: Calcaneus & subtalar joint

AXIAL PROJECTION (PLANTODORSAL) (CALCANEUS)

PP: ; leg fully extended; foot w/ strip of gauze; foot ┴ to IR

RP:

CR:

SS: &

AXIAL PROJECTION (PLANTODORSAL) (CALCANEUS)

P: Prone; ankle elevated; dorsiflex ankle; foot ┴ to IR; IR vertical

RP: Dorsal surface of ankle joint

CR: 40o caudad

SS: Calcaneus, subtalar joint & sustentaculum tali

AXIAL PROJECTION (DORSOPLANTAR) (CALCANEUS)

PP:

RP:

CR:

SS:

AXIAL PROJECTION (DORSOPLANTAR) (CALCANEUS)

PP: Supine/ LATERAL RECUMB; patient turn toward affected side; plantar surface // to IR

RP: 1 in distal to medial malleolus (at subtalar joint)

CR: ┴

SS: Calcaneus & ankle joint; sinus tarsi

LATERAL PROJECTION: MEDIOLATERAL (CALCANEUS)

PP: _____/ _______; patient turn toward ___ (A/UN) side; plantar surface __ to IR

RP:

CR:

SS:

LATERAL PROJECTION, MEDIOLATERAL (CALCANEUS)

PP: Upright; posterior surface of heel at edge of IR; unaffected forward foot one step (to prevent superimposition of leg shadow)

RP: Level of 5th MT base

CR: 45o anteriorly

SS: Calcaneotalar coalition

AXIAL PROJECTION: DORSOPLANTAR (WEIGHT BEARING COALITION METHOD) (LILIENFIELD METHOD)

PP: __; posterior surface of heel at ___ of IR; ___ forward foot one step (to prevent superimposition of leg shadow)

RP:

CR:

SS:

PP: Upright; leg perpendicular to IR; calcaneus center to IR

RP: Lateral malleolus

CR: 45o caudad (medially)

SS: the calcaneal tuberosity and is useful in diagnosing stress of the calcaneus or fractures tuberosity

LATEROMEDIAL OBLIQUE PROJ. ( WEIGHT BEARING METHOD) (CALCANEUS)

PP:

RP:

CR:

SS:

LATEROMEDIAL OBLIQUE PROJ. ( WEIGHT BEARING METHOD) (CALCANEUS)

the calcaneal tuberosity and is useful in diagnosing stress of the calcaneus or fractures tuberosity

1.) AXIAL PROJ. (PLANTODORSAL)

2.) AXIAL PROJ. (DORSOPLANTAR)

3.) LATERAL PROJ. (MEDIOLATERAL)

4.) AXIAL PROJ.; DORSOPLANTAR ( WEIGHT BEARING COALITION METHOD) (LILIENFIEL METHOD)

5.) LATEROMEDIAL OBLIQUE PROJECTION (WEIGHT BEARING METHOD)

WHAT ARE THE PROJECTIONS/ METHODS FOR THE CALCANEUS

PP: Semisupine; foot & leg rotated 45o medially; knee flexed

RP: 1 in. distal & 1 in. anterior to lateral malleolus

CR: ┴

SS: Anterior subtalar articulation

LATEROMEDIAL OBLIQUE PROJECTION (ISHERWOOD METHOD)

Medial Rotation Foot

PP: ____ foot & leg rotated ___o medially; knee flexed

RP:

CR:

SS:

LATEROMEDIAL OBLIQUE PROJECTION (ISHERWOOD METHOD)

PP: Seated or semi-lateral recumbent (more comfortable); leg, foot & ankle rotated 30o medially; dorsiflex foot; 30o foam wedge

RP: 1 in. distal & 1 in. anterior to lateral malleolus

CR: 10o cephalad

SS: Middle subtalar articular surface & “end on” projection of sinus tarsi

AP AXIAL OBLIQUE PROJECTION; ISHERWOOD METHOD

MEDIAL ROTATION ANKLE

PP:

RP:

CR:

SS: &

AP AXIAL OBLIQUE; ISHERWOOD METHOD

MEDIAL ROT OF ANKLE