RAD1001: Chapter 6 Part Two Ankle and Tib-Fib (Danielle MXCC)

How many bones make up the ankle?
A. 2 bones — 1 talus and the calcaneus
B. 4 bones — 1 talus plus the tibia plus the fibula plus the calcaneus
C. 3 bones — 1 tarsal + 2 long bones the tibia and fibula
D. 5 bones — 1 talus plus the tibia plus the fibula plus the navicular plus the cuboid

C. 3 bones — 1 tarsal + 2 long bones the tibia and fibula

What is the lateral malleolus?<br>A. Distal end of the tibia that forms the medial ankle bump<br>B. Distal end of the slender fibula that extends well down alongside the talus<br>C. Proximal end of the fibula that articulates with the lateral tibial condyle<br>D. Anterior process of the calcaneus that supports the talus<br>

B. Distal end of the slender fibula that extends well down alongside the talus.

What is the medial malleolus?

A. Distal end of the tibia that forms the medial ankle bump, extending down alongside the medial talus

B. Distal end of the fibula that forms the lateral ankle bump, extending down alongside the lateral talus

C. Posterior projection of the talus that extends downward behind the ankle joint, forming part of the ankle structure

D. Lateral condyle of the tibia that forms the outer knee surface, articulating with the lateral femoral condyle

A. Distal end of the tibia that forms the medial ankle bump, extending down alongside the medial talus

What is the anterior tubercle?

A. Expanded part of the distal posterior tibia that forms the medial malleolus and supports the ankle

B. Ridge on the lateral fibula that articulates with the calcaneus and helps form the lateral ankle joint

C. Expanded part of the distal anterior and lateral tibia that articulates with the upper outer talus and partially overlaps the fibula in front

D. Tubercle on the talus that articulates with the navicular and helps form the medial longitudinal arch

C. Expanded part of the distal anterior and lateral tibia that articulates with the upper outer talus and partially overlaps the fibula in front

What is the tibial plafond?<br>A. Distal fibular surface that forms the lateral wall of the ankle mortise<br>B. Distal tibial surface that forms the roof of the ankle mortise and is concave<br>C. Posterior tibial surface that forms the floor of the ankle mortise<br>D. Anterior talar surface that forms the roof of the subtalar joint<br>

B. Distal tibial surface that forms the roof of the ankle mortise and is concave.

How far posterior is the distal fibula compared with the distal tibia?
A. About 1/8 inch posterior
B. About 1/4 inch anterior
C. About 1/2 inch anterior
D. About 1 cm posterior

D. About 1 cm posterior

How much more distal does the lateral malleolus extend than the medial malleolus?
A. About 1 cm
B. About 1/4 inch
C. About 1/2 inch
D. About 1 inch

A. About 1 cm.

What is a common positioning mistake on a lateral ankle?

A. Flexing the knee too much, causing the tibiotalar joint to become closed and poorly visualized

B. Rotating the leg and superimposing the malleoli, resulting in an image that is not a true lateral

C. Using a mediolateral projection instead of the correct lateromedial projection, resulting in improper positioning

D. Centering too high on the ankle, causing the calcaneus and surrounding ankle structures to be excluded

B. Rotating the leg and superimposing the malleoli, resulting in an image that is not a true lateral

On a true lateral where is the distal fibula?<br>A. Over the anterior half of the tibia<br>B. Anterior to the tibia and separate from it<br>C. Directly over the medial malleolus<br>D. Over the posterior half of the tibia<br>

D. Over the posterior half of the tibia.

What results from over-rotation on a lateral ankle?<br>A. Distal fibula too far anterior on the tibia<br>B. Distal fibula superimposed exactly over the posterior tibia<br>C. Distal fibula too far past the posterior tibia with heel up and away from the IR<br>D. Distal fibula hidden behind the medial malleolus<br>

C. Distal fibula too far past the posterior tibia with heel up and away from the IR.

What results from under-rotation on a lateral ankle?

A. Distal fibula too far anterior on the tibia, with foot and toes up and away from the IR
B. Distal fibula positioned too far posterior on the tibia, with increased separation of the ankle joint structures
C. Distal fibula partially superimposed over the posterior tibia, with the ankle joint appearing slightly distorted
D. Distal fibula projected over the calcaneus, with excessive overlap of the surrounding ankle structures

A. Distal fibula too far anterior on the tibia, with foot and toes up and away from the IR

What is the intermalleolar plane and its angle?

A. A vertical plane passing through both malleoli, positioned approximately 35-45° from the coronal plane.

B. A diagonal horizontal plane passing through the tibial plafond, positioned approximately 25-30° from the sagittal plane.

C. An oblique plane passing through the talar dome, positioned approximately 5 to 10° from the transverse plane depending on body habitus

D. A horizontal plane passing through the midportions of both malleoli, positioned approximately 15–20° from the coronal plane.

D. A horizontal plane passing through the midportions of both malleoli, positioned approximately 15–20° from the coronal plane.

How much rotation brings the intermalleolar plane parallel to the coronal plane?
A. 5–10°
B. 15–20°
C. 30–40°
D. 45–60°

B. 15–20°

What is the mortise?

A. Inferior portions of the femur and tibia which forms a deep, three-sided socket for the patella.

B. Lateral portions of the calcaneus, cuboid, and navicular form a shallow, three-sided socket for the talus.

C. Inferior portions of the tibia and fibula form a deep socket, or three-sided opening, for the superior talus.

D. Superior portions of the talus and navicular form a deep, three-sided opening for the tibia

C. Inferior portions of the tibia and fibula form a deep socket, or three-sided opening, for the superior talus.

What is the classification of the ankle joint?

A. Amphiarthrodial and fibrous, with limited movement and connective tissue support

B. Synarthrodial and cartilaginous, with no movement and cartilage connecting the bones

C. Diarthrodial and freely moveable, with a synovial fibrous capsule and synovial fluid

D. Diarthrodial and fibrous, with free movement and connective tissue connecting the bones

C. Diarthrodial and freely moveable, with a synovial fibrous capsule and synovial fluid

What is the type of the ankle joint?
A. Hinge joint with flexion and extension only
B. Pivot joint with gliding
C. Ball-and-socket joint with flexion
D. Saddle joint with flexion and extension only

D. Saddle or sellar joint with flexion and extension only.

What ligaments support the ankle joint?
A. Tough ligaments extending only from the tibia to the femur
B. Strong ligaments extending from both malleoli to the calcaneus and talus
C. Ligaments extending only from the fibula to the calcaneus and three cuneiforms
D. Long ligaments extending from the talus to the navicular and talus

B. Strong ligaments extending from both malleoli to the calcaneus and talus.

What describes the tibia?

A. Large long bone located on the lateral and posterior aspect of the lower leg, providing structural support and stability to the surrounding bones.

B. Small long bone located on the lateral and anterior aspect of the lower leg, helping stabilize the ankle and support surrounding structures.

C. Small long bone located on the medial and posterior aspect of the lower leg, providing structural support and stability to the ankle joint.

D. Large long bone located on the medial and more anterior aspect of the lower leg, serving as the weight-bearing bone and shin bone.

D. Large long bone located on the medial and more anterior aspect of the lower leg, serving as the weight-bearing bone and shin bone

What are the articulations of the tibia?

A. Fibula at the proximal and distal ends, and femur proximally and talus distally.

B. Femur and patella only at the proximal and distal ends, and talus distally.

C. Talus and calcaneus only at the proximal and distal ends, and femur proximally.

D. Fibula and calcaneus only at the proximal and distal ends, and talus distally.

A. Fibula at the proximal and distal ends, and femur proximally and talus distally.

What describes the fibula?

A. Thicker long bone on the medial and anterior aspect of the leg, and more anterior than the tibia.

B. Thinner long bone on the lateral and more posterior aspect of the leg, and more posterior than the tibia.

C. Large long bone on the lateral and anterior aspect of the leg, and more anterior than the tibia.

D. Small long bone on the medial and posterior aspect of the leg, and more posterior than the tibia.

B. Thinner long bone on the lateral and more posterior aspect of the leg, and more posterior than the tibia.

What are the articulations of the fibula?<br>A. Tibia and femur only at the proximal and distal ends and no talus articulation<br>B. Talus and calcaneus only at the proximal and distal ends and no tibia articulation<br>C. Tibia at the proximal and distal ends and talus distally<br>D. Femur and patella only at the proximal and distal ends and no talus articulation<br>

C. Tibia at the proximal and distal ends and talus distally.

What are the two large processes on the proximal tibia?<br>A. Medial malleolus and lateral malleolus as the two large processes<br>B. Tibial tuberosity and anterior crest as the two large processes<br>C. Intercondyloid eminence and tibial plateau as the two large processes<br>D. Medial condyle and lateral condyle as the two large processes<br>

D. Medial condyle and lateral condyle as the two large processes.

What is another name and definition for the intercondyloid eminence?<br>A. Tibial plateau — smooth concave facets for the femur and two small pointed prominences<br>B. Tibial spine — two small pointed prominences on the superior aspect<br>C. Tibial tuberosity — rough prominence for the patellar tendon and two small pointed prominences<br>D. Fibular notch — triangular notch for the distal fibula and two small pointed prominences<br>

B. Tibial spine — two small pointed prominences on the superior aspect.

What are the two tubercles of the intercondyloid eminence?<br>A. Medial intercondyloid tubercle and lateral intercondyloid tubercle<br>B. Anterior intercondyloid tubercle and posterior intercondyloid tubercle<br>C. Superior intercondyloid tubercle and inferior intercondyloid tubercle<br>D. Lateral intercondyloid tubercle and central intercondyloid tubercle<br>

A. Medial intercondyloid tubercle and lateral intercondyloid tubercle.

What is the tibial plateau?
A. Lower articular surface of the malleoli and includes two facets for the talus and one facet for the fibula
B. Posterior surface of the tibial tuberosity and includes one facet for the patella and one facet for the femur
C. Anterior surface of the distal tibia and includes two facets for the fibula and one facet for the talus
D. Upper articular surface of the condyles, with two smooth, concave facets for the femur that support the knee joint.

D. Upper articular surface of the condyles, with two smooth, concave facets for the femur that support the knee joint.

What is the tibial tuberosity?<br>A. Smooth depression on the posterior tibia just distal to the condyles and attaches the patellar tendon<br>B. Pointed prominence on the lateral fibula just distal to the head and attaches the patellar tendon<br>C. Rough-textured prominence on the mid-anterior surface of the tibia just distal to the condyles<br>D. Flat area on the distal tibia just proximal to the medial malleolus and attaches the patellar tendon<br>

C. Rough-textured prominence on the mid-anterior surface of the tibia just distal to the condyles.

What attaches at the tibial tuberosity?<br>A. Distal attachment of the patellar tendon<br>B. Proximal attachment of the Achilles tendon<br>C. Distal attachment of the quadriceps tendon<br>D. Proximal attachment of the fibular collateral ligament<br>

A. Distal attachment of the patellar tendon.

What can happen to the tibial tuberosity in children?<br>A. It can fuse with the fibula — Osgood-Schlatter disease and separate from the tibia<br>B. It can separate from the body of the tibia — Osgood-Schlatter disease<br>C. It can rotate posteriorly — Ewing sarcoma and separate from the tibia<br>D. It can disappear completely — clubfoot and separate from the tibia<br>

B. It can separate from the body of the tibia — Osgood-Schlatter disease.

What is the anterior crest?<br>A. Rounded ridge on the fibula extending from the head to the lateral malleolus and supports the ankle<br>B. Sharp ridge on the posterior tibia extending from the condyles to the fibular notch and supports the ankle<br>C. Flat border on the distal tibia extending from the medial malleolus to the talus and supports the ankle<br>D. Sharp ridge on the body of the tibia extending from the tibial tuberosity to the medial malleolus<br>

D. Sharp ridge on the body of the tibia extending from the tibial tuberosity to the medial malleolus.

What is the slope of the tibial plateau and its direction?<br>A. Both articular facets slope anteriorly 10–20° in relation to the long axis of the tibia<br>B. Both articular facets slope laterally 30–40° in relation to the long axis of the tibia<br>C. Both articular facets slope posteriorly 10–20° in relation to the long axis of the tibia<br>D. Both articular facets slope medially 5–10° in relation to the long axis of the tibia<br>

C. Both articular facets slope posteriorly 10–20° in relation to the long axis of the tibia.

Why does the tibial plateau slope matter?<br>A. Important for AP knee imaging to demonstrate an open joint space<br>B. Important for lateral ankle imaging to demonstrate an open mortise and joint space<br>C. Important for AP tib-fib imaging to demonstrate fibular overlap and joint space<br>D. Important for weight-bearing ankle imaging to demonstrate clubfoot and joint space<br>

A. Important for AP knee imaging to demonstrate an open joint space.

How does the distal tibia compare with the proximal tibia?<br>A. Larger than the proximal extremity and ends at the lateral malleolus and fibular notch<br>B. Equal in size to the proximal extremity and ends at the tibial tuberosity and anterior crest<br>C. Smaller than the proximal extremity and ends at the fibular head and fibular neck<br>D. Smaller than the proximal extremity and ends at the medial malleolus<br>

D. Smaller than the proximal extremity and ends at the medial malleolus.

What is the shape of the medial malleolus?<br>A. Crescent-shaped process palpated on the lateral ankle and forming the lateral malleolus<br>B. Pyramid-shaped process that is easily palpated on the medial aspect of the ankle<br>C. Flat process palpated on the posterior ankle and forming the posterior malleolus<br>D. Round process palpated on the anterior ankle and forming the anterior malleolus<br>

B. Pyramid-shaped process that is easily palpated on the medial aspect of the ankle.

What is the fibular notch?<br>A. Rounded notch on the medial distal tibia for the talus and distal tibiofibular joint<br>B. Triangular ridge on the posterior distal tibia for the calcaneus and distal tibiofibular joint<br>C. Flattened triangular notch on the lateral aspect of the distal tibia for articulation with the distal fibula<br>D. Deep groove on the anterior distal fibula for the tibia and distal tibiofibular joint<br>

C. Flattened triangular notch on the lateral aspect of the distal tibia for articulation with the distal fibula.

What is the fibular head?<br>A. Proximal expanded end of the fibula that articulates with the posteroinferior aspect of the lateral condyle of the tibia<br>B. Distal expanded end of the fibula that forms the lateral malleolus and articulates with the talus<br>C. Tapered area below the fibular head that joins the tibia and forms the proximal tibiofibular joint<br>D. Pointed end of the fibula that articulates with the calcaneus and forms the lateral malleolus<br>

A. Proximal expanded end of the fibula that articulates with the posteroinferior aspect of the lateral condyle of the tibia.

What is the apex of the fibula?<br>A. Flattened end of the fibular head and proximal tibiofibular joint<br>B. Pointed end of the fibular head and proximal tibiofibular joint<br>C. Tapered area below the fibular head and proximal tibiofibular joint<br>D. Enlarged distal end of the fibula and proximal tibiofibular joint<br>

B. Pointed end of the fibular head and proximal tibiofibular joint.

What is the fibular neck?<br>A. Pointed end of the fibular head and proximal tibiofibular joint<br>B. Expanded proximal end of the fibula and proximal tibiofibular joint<br>C. Long slender portion between the extremities and proximal tibiofibular joint<br>D. Tapered area just below the head and proximal tibiofibular joint<br>

D. Tapered area just below the head and proximal tibiofibular joint.

What is the fibular body?<br>A. Tapered area just below the head and proximal tibiofibular joint<br>B. Enlarged distal end of the fibula and proximal tibiofibular joint<br>C. Long slender portion between the two extremities and proximal tibiofibular joint<br>D. Pointed end of the fibular head and proximal tibiofibular joint<br>

C. Long slender portion between the two extremities and proximal tibiofibular joint.

What describes the lateral malleolus?<br>A. Enlarged distal end of the tibia and more anterior than the medial malleolus and forms the lateral ankle bump<br>B. Enlarged distal end of the fibula with a distinct bump on the lateral ankle and more distal and posterior than the medial malleolus<br>C. Small proximal end of the fibula and less distal than the medial malleolus and forms the lateral ankle bump<br>D. Flat process of the calcaneus and more medial than the medial malleolus and forms the lateral ankle bump<br>

B. Enlarged distal end of the fibula with a distinct bump on the lateral ankle and more distal and posterior than the medial malleolus.

What are the distal femur articulations?<br>A. Medial and lateral condyles articulate with the tibial plateau and the intercondyloid eminence fits within the intercondylar fossa<br>B. Medial and lateral condyles articulate with the fibula and the intercondyloid eminence fits within the tibial plateau<br>C. Medial and lateral condyles articulate with the talus and the intercondyloid eminence fits within the fibular notch<br>D. Medial and lateral condyles articulate with the patella and the intercondyloid eminence fits within the intercondylar fossa<br>

A. Medial and lateral condyles articulate with the tibial plateau and the intercondyloid eminence fits within the intercondylar fossa.

Does the patella articulate with the tibia?<br>A. Yes and through the tibial plateau and intercondylar fossa<br>B. Yes and through the tibial tuberosity and intercondylar fossa<br>C. Yes and through the fibular head and intercondylar fossa<br>D. No and it articulates only with the femur<br>

D. No and it articulates only with the femur.

What is the classification and type of the femorotibial joint?<br>A. Amphiarthrodial and fibrous with flexion and extension only and no gliding or rotation<br>B. Diarthrodial and hinge with no gliding or rotation and flexion and extension only<br>C. Diarthrodial and synovial and bicondylar with flexion and extension plus some gliding and rotation when the knee is partially flexed<br>D. Synarthrodial and cartilaginous with gliding only and flexion and extension only<br>

C. Diarthrodial and synovial and bicondylar with flexion and extension plus some gliding and rotation when the knee is partially flexed.

What is the classification and type of the proximal tibiofibular joint?<br>A. Diarthrodial and synovial and plane or gliding with limited gliding between the lateral condyle and head of the fibula<br>B. Amphiarthrodial and fibrous with no movement between the lateral condyle and head of the fibula<br>C. Diarthrodial and hinge with flexion and extension between the lateral condyle and head of the fibula<br>D. Synarthrodial and cartilaginous with rotation between the lateral condyle and head of the fibula<br>

A. Diarthrodial and synovial and plane or gliding with limited gliding between the lateral condyle and head of the fibula.

What is the classification and type of the distal tibiofibular joint?<br>A. Diarthrodial and synovial with a joint cavity and free gliding between the tibia and fibula<br>B. Amphiarthrosis with limited movement and fibrous and syndesmosis with bones almost in direct contact<br>C. Diarthrodial and plane with free gliding and a joint cavity between the tibia and fibula<br>D. Amphiarthrodial and cartilaginous with a joint cavity and limited movement between the tibia and fibula<br>

B. Amphiarthrosis with limited movement and fibrous and syndesmosis with bones almost in direct contact.

What is a tri-malleolar fracture?<br>A. Fracture involving only the lateral malleolus and posterior tibia<br>B. Fracture involving only the medial malleolus and posterior tibia<br>C. Fracture involving only the posterior tibia and lateral malleolus<br>D. Common ankle fracture involving the lateral and medial and posterior aspects<br>

D. Common ankle fracture involving the lateral and medial and posterior aspects.

What is Ewing sarcoma?<br>A. Bone tumor seen in adults with a sunburst look on x-rays and onion peel margins<br>B. Inflammation of the tibial tuberosity in children with a sunburst look on x-rays<br>C. Bone tumor seen in children with an onion peel look on x-rays<br>D. Congenital inward turning of the foot at the ankle with an onion peel look on x-rays<br>

C. Bone tumor seen in children with an onion peel look on x-rays.

What is Osgood-Schlatter disease?<br>A. Bone tumor seen in children with an onion peel look and anterior proximal tibia inflammation<br>B. Inflammation of the anterior proximal tibia usually from the patellar tendon detaching from the anterior tibial tuberosity<br>C. Congenital condition where the foot turns inward and anterior proximal tibia inflammation<br>D. Fracture involving three ankle aspects and anterior proximal tibia inflammation<br>

B. Inflammation of the anterior proximal tibia usually from the patellar tendon detaching from the anterior tibial tuberosity.

What is clubfoot?<br>A. Congenital condition where a baby's foot or feet turn inward and downward at the ankle<br>B. Inflammation of the tibial tuberosity from tendon detachment and inward turning at the ankle<br>C. Bone tumor seen in children with onion peel look and inward turning at the ankle<br>D. Fracture involving lateral and medial and posterior aspects and inward turning at the ankle<br>

A. Congenital condition where a baby's foot or feet turn inward and downward at the ankle.

Which ankle projections are covered?<br>A. AP and lateral only and no oblique or stress views<br>B. AP and AP oblique only and no mortise or stress views<br>C. AP and AP oblique with medial or lateral rotation and AP oblique mortise and lateral and AP stress views and AP weight-bearing<br>D. AP and lateral and AP stress only and no oblique or weight-bearing views<br>

C. AP and AP oblique with medial or lateral rotation and AP oblique mortise and lateral and AP stress views and AP weight-bearing.

Which tib-fib projections are covered?<br>A. AP and AP oblique mortise and no lateral view<br>B. Lateral and AP stress and no AP view<br>C. AP weight-bearing and lateral and no AP view<br>D. AP and lateral<br>

D. AP and lateral.

What is the rotation for an AP ankle?<br>A. None for a true AP with the foot pointing straight up<br>B. Medial rotation of 45° with the foot pointing straight up<br>C. Medial rotation of 15–20° with the foot pointing straight up<br>D. Lateral rotation of 15–20° with the foot pointing straight up<br>

A. None for a true AP with the foot pointing straight up.

What is the rotation for an AP oblique ankle?<br>A. No rotation with the leg and foot together<br>B. Medial rotation of 45° with the leg and foot together<br>C. Medial rotation of 15–20° with the leg and foot together<br>D. Lateral rotation of 45° with the leg and foot together<br>

B. Medial rotation of 45° with the leg and foot together.

What is the rotation for an AP oblique mortise view?<br>A. No rotation with the intermalleolar plane parallel to the IR<br>B. Medial rotation of 45° with the intermalleolar plane parallel to the IR<br>C. Medial rotation of 15–20° with the intermalleolar plane parallel to the IR<br>D. Lateral rotation of 15–20° with the intermalleolar plane parallel to the IR<br>

C. Medial rotation of 15–20° with the intermalleolar plane parallel to the IR.

What is the projection type for a lateral ankle?<br>A. Anteroposterior projection of the ankle<br>B. Posteroanterior projection of the ankle<br>C. Lateromedial projection of the ankle<br>D. Mediolateral projection of the ankle<br>

D. Mediolateral projection of the ankle.

What is the purpose of an AP stress view?<br>A. Demonstrate the mortise in weight bearing and evaluate joint separation<br>B. Verify ligamentous tears and evaluate joint separation<br>C. Evaluate the tibial plateau slope and evaluate joint separation<br>D. Compare both knees in flexion and evaluate joint separation<br>

B. Verify ligamentous tears and evaluate joint separation.

What is the purpose of an AP weight-bearing view?<br>A. Compare both ankle joints and show the relationship of the distal tibia and fibula with weight bearing<br>B. Verify ligamentous tears with stress and show the relationship of the distal tibia and fibula with weight bearing<br>C. Demonstrate the fibular notch in profile and show the relationship of the distal tibia and fibula with weight bearing<br>D. Evaluate the patellar tendon attachment and show the relationship of the distal tibia and fibula with weight bearing<br>

A. Compare both ankle joints and show the relationship of the distal tibia and fibula with weight bearing.

What is the patient position for an AP ankle?<br>A. Prone with affected extremity flexed and ankle centered to IR<br>B. Upright with weight on both feet and ankle centered to IR<br>C. Lateral recumbent with knee flexed 45° and ankle centered to IR<br>D. Supine or seated with affected extremity fully extended<br>

D. Supine or seated with affected extremity fully extended.

What is the part position for an AP ankle?<br>A. Foot pointing medially with lateral malleolus higher than medial and ankle centered to IR and no dorsiflexion<br>B. Foot pointing laterally with ankle centered to IR and no dorsiflexion and long axis of part aligned to IR<br>C. Foot pointing straight up with lateral malleolus lower than medial and ankle centered to IR and right-angle dorsiflexion and long axis of part aligned to IR<br>D. Foot plantar flexed with long axis perpendicular to IR and ankle centered to IR and no dorsiflexion<br>

C. Foot pointing straight up with lateral malleolus lower than medial and ankle centered to IR and right-angle dorsiflexion and long axis of part aligned to IR.

What should be avoided with dorsiflexion in a trauma patient?<br>A. Do NOT force dorsiflexion<br>B. Force dorsiflexion to 90°<br>C. Rotate the leg 45° medially<br>D. Elevate the heel from the IR<br>

A. Do NOT force dorsiflexion.

What is the CR for an AP ankle?<br>A. Perpendicular through the medial malleolus and ankle joint<br>B. Perpendicular through the ankle joint and midway between malleoli<br>C. 15–20° cephalic through the ankle joint and midway between malleoli<br>D. Perpendicular through the base of the fifth metatarsal and ankle joint<br>

B. Perpendicular through the ankle joint and midway between malleoli.

What is the SID for an AP ankle?<br>A. 30 inches for the AP ankle<br>B. 36 inches for the AP ankle<br>C. 48 inches for the AP ankle<br>D. 40 inches for the AP ankle<br>

D. 40 inches for the AP ankle.

What is the technique for an AP ankle?<br>A. 60 kVp and 1.8 mAs with AEC and free plate<br>B. 80 kVp and 2.5 mAs with AEC and free plate<br>C. 70 kVp and 1.8 mAs and no AEC and free plate<br>D. 70 kVp and 2.5 mAs with AEC and free plate<br>

C. 70 kVp and 1.8 mAs and no AEC and free plate.

What is the IR size and collimation for an AP ankle?<br>A. 10 × 12 lengthwise and include half of metatarsals and 1/3 of distal tib-fib<br>B. 8 × 10 lengthwise and include half of metatarsals and 1/3 of distal tib-fib<br>C. 14 × 17 lengthwise and include all metatarsals and all distal tib-fib<br>D. 10 × 12 crosswise and include only the ankle joint and 1/3 of distal tib-fib<br>

A. 10 × 12 lengthwise and include half of metatarsals and 1/3 of distal tib-fib.

What is the marker placement for an AP ankle?<br>A. Correct side marker medial to part in anatomical position and lateral to part if possible<br>B. Correct side marker lateral to part in anatomical position if possible<br>C. No marker needed for ankle exams and lateral to part if possible<br>D. Marker placed anterior to part in anatomical position and lateral to part if possible<br>

B. Correct side marker lateral to part in anatomical position if possible.

What are the evaluation criteria for an AP ankle?<br>A. Distal 1/3 tib-fib and both malleoli and entire talus and all metatarsals and no rotation<br>B. Proximal 1/3 tib-fib and both malleoli and entire talus and half of metatarsals and no rotation<br>C. Distal 1/3 tib-fib and both malleoli and entire talus and half of metatarsals and no rotation<br>D. Distal 1/3 tib-fib and both malleoli and entire calcaneus and half of metatarsals and no rotation<br>

C. Distal 1/3 tib-fib and both malleoli and entire talus and half of metatarsals and no rotation.

What is the mortise status on an AP ankle?<br>A. Medial mortise joint CLOSED and lateral mortise joint OPEN on the lateral malleolar side<br>B. Both mortise joints OPEN on the medial and lateral malleolar sides<br>C. Both mortise joints CLOSED on the medial and lateral malleolar sides<br>D. Medial mortise joint OPEN on the medial malleolar side and lateral mortise joint CLOSED on the lateral malleolar side<br>

D. Medial mortise joint OPEN on the medial malleolar side and lateral mortise joint CLOSED on the lateral malleolar side.

What superimposition is present on an AP ankle?<br>A. Some superimposition of distal fibula and tibia and talus<br>B. No superimposition of distal fibula and tibia and talus<br>C. Complete superimposition of distal fibula and tibia and calcaneus<br>D. Superimposition of only the medial malleolus and talus<br>

A. Some superimposition of distal fibula and tibia and talus.

What is the part position for an AP oblique ankle at 45 degrees?<br>A. Leg and foot rotated laterally 45° and ankle centered and foot dorsiflexed to right angle<br>B. Leg extended and ankle centered and foot dorsiflexed to right angle and leg and foot rotated medially 45°<br>C. Leg rotated medially 45° while foot remains straight and ankle centered and foot dorsiflexed to right angle<br>D. Foot rotated medially 45° while leg remains straight and ankle centered and foot dorsiflexed to right angle<br>

B. Leg extended and ankle centered and foot dorsiflexed to right angle and leg and foot rotated medially 45°.

What is an important caution for AP oblique ankle rotation?<br>A. The foot must rotate while the leg remains straight or the joint will not be in oblique position<br>B. The leg must rotate while the foot remains straight or the joint will not be in oblique position<br>C. The ankle must be plantar flexed during rotation or the joint will not be in oblique position<br>D. The leg must rotate WITH the ankle or the joint will not be in oblique position<br>

D. The leg must rotate WITH the ankle or the joint will not be in oblique position.

What is the distal tibiofibular joint evaluation for an AP oblique ankle at 45 degrees?<br>A. Joint space closed with complete overlap and minimal overlap<br>B. Joint space open with marked overlap and minimal overlap<br>C. Joint space open with no or only minimal overlap<br>D. Joint space narrowed with no overlap and minimal overlap<br>

C. Joint space open with no or only minimal overlap.

What is the malleolus and talus superimposition for an AP oblique ankle at 45 degrees?<br>A. Lateral malleolus and talus show no or slight superimposition and medial malleolus and talus partially superimposed<br>B. Lateral malleolus and talus fully superimposed and medial malleolus and talus not superimposed<br>C. Lateral malleolus and talus partially superimposed and medial malleolus and talus fully superimposed<br>D. Lateral malleolus and talus not superimposed and medial malleolus and talus not superimposed<br>

A. Lateral malleolus and talus show no or slight superimposition and medial malleolus and talus partially superimposed.

What is the part position for the mortise view?<br>A. Leg and foot rotated medially 45° and ankle centered and foot dorsiflexed to right angle and intermalleolar plane parallel with IR<br>B. Leg and foot rotated laterally 15–20° and ankle centered and foot dorsiflexed to right angle and intermalleolar plane parallel with IR<br>C. No rotation with foot plantar flexed and ankle centered and foot dorsiflexed to right angle and intermalleolar plane parallel with IR<br>D. Leg extended and ankle centered and foot dorsiflexed to right angle and leg and foot rotated medially 15–20° with the intermalleolar plane parallel with IR<br>

D. Leg extended and ankle centered and foot dorsiflexed to right angle and leg and foot rotated medially 15–20° with the intermalleolar plane parallel with IR.

What are the evaluation criteria for the mortise view?<br>A. Entire ankle mortise open and only lateral mortise joint visible and malleoli in profile<br>B. Entire ankle mortise open and well visualized and open lateral AND medial mortise joints with malleoli in profile and minimal superimposition of distal tibiofibular joint<br>C. Entire ankle mortise closed and malleoli in profile and minimal superimposition of distal tibiofibular joint<br>D. Entire ankle mortise open and complete superimposition of distal tibiofibular joint and malleoli in profile<br>

B. Entire ankle mortise open and well visualized and open lateral AND medial mortise joints with malleoli in profile and minimal superimposition of distal tibiofibular joint.

What extra structure must be seen on the mortise view?<br>A. Femoral condyles plus distal 1/3 tib-fib and both malleoli and entire talus and half of metatarsals<br>B. Tibial tuberosity plus entire talus and half of metatarsals and both malleoli and distal 1/3 tib-fib<br>C. Tibial plafond plus distal 1/3 tib-fib and both malleoli and entire talus and half of metatarsals<br>D. Fibular head plus entire calcaneus and sinus tarsi and both malleoli and distal 1/3 tib-fib<br>

C. Tibial plafond plus distal 1/3 tib-fib and both malleoli and entire talus and half of metatarsals.

What is the patient position for a lateral ankle?<br>A. Turned toward affected side and flex knee 45° and leg and ankle in lateral position<br>B. Supine with knee extended and leg in AP position and ankle in lateral position<br>C. Prone with knee flexed 90° and leg in lateral position and ankle in AP position<br>D. Upright with weight on affected side and ankle in AP position and knee flexed 45°<br>

A. Turned toward affected side and flex knee 45° and leg and ankle in lateral position.

What is the part position for a lateral ankle?<br>A. Anteroposterior with ankle centered and foot plantar flexed and plantar aspect perpendicular to IR<br>B. Lateromedial with ankle centered and foot dorsiflexed and plantar aspect perpendicular to IR<br>C. Mediolateral with ankle centered and foot plantar flexed and plantar aspect perpendicular to IR<br>D. Mediolateral with ankle centered and foot dorsiflexed to right angle and plantar aspect perpendicular to IR and long axis aligned to IR<br>

D. Mediolateral with ankle centered and foot dorsiflexed to right angle and plantar aspect perpendicular to IR and long axis aligned to IR.

What is the CR for a lateral ankle?<br>A. Perpendicular to the ankle joint and entering at the lateral malleolus<br>B. Perpendicular to the ankle joint and entering at the medial malleolus<br>C. 15–20° cephalic and entering at the medial malleolus and ankle joint<br>D. Perpendicular to the tibia and entering at the fibular head and ankle joint<br>

B. Perpendicular to the ankle joint and entering at the medial malleolus.

What is the technique for a lateral ankle?<br>A. 70 kVp and 1.8 mAs with AEC and free plate<br>B. 60 kVp and 1.25 mAs with AEC and free plate<br>C. 70 kVp and 1.25 mAs and no AEC and free plate<br>D. 80 kVp and 2.5 mAs with AEC and free plate<br>

C. 70 kVp and 1.25 mAs and no AEC and free plate.

What is the marker placement for a lateral ankle?<br>A. Anterior to part in anatomical position if possible<br>B. Posterior to part in anatomical position if possible<br>C. Medial to part in anatomical position if possible<br>D. No marker needed for lateral ankle if possible<br>

A. Anterior to part in anatomical position if possible.

What is the fibula position on a lateral ankle?<br>A. Distal fibula superimposed over the anterior half of the tibia and no rotation<br>B. Distal fibula superimposed over the posterior half of the tibia with no rotation<br>C. Distal fibula completely anterior to the tibia and no rotation<br>D. Distal fibula completely posterior to the calcaneus and no rotation<br>

B. Distal fibula superimposed over the posterior half of the tibia with no rotation.

Which bones and joints must be seen on a lateral ankle?<br>A. Entire talus and entire calcaneus and tibiotalar joint open only and sinus tarsi<br>B. Entire talus and entire calcaneus and subtalar joint open only and sinus tarsi<br>C. Entire talus and entire calcaneus and sinus tarsi only and tibiotalar joint<br>D. Entire talus and entire calcaneus and talus and calcaneus in profile and tibiotalar joint open and subtalar joint and sinus tarsi<br>

D. Entire talus and entire calcaneus and talus and calcaneus in profile and tibiotalar joint open and subtalar joint and sinus tarsi.

Which midfoot bones must be seen on a lateral ankle?<br>A. Femoral condyles and patella and tibial tuberosity and talar dome<br>B. Medial malleolus and lateral malleolus and talar dome and calcaneal tuberosity<br>C. 5th metatarsal tuberosity and navicular and cuboid<br>D. Calcaneal tuberosity and sustentaculum tali and navicular and cuboid<br>

C. 5th metatarsal tuberosity and navicular and cuboid.

What is the part position for an AP stress view?<br>A. Same as lateral and turn only the plantar aspect into dorsiflexion and physician places the foot in extreme positions<br>B. Same as AP and turn only the plantar aspect of the foot into inversion or eversion and the physician places the foot in extreme positions<br>C. Same as mortise and turn only the plantar aspect into rotation and physician places the foot in extreme positions<br>D. Same as AP and turn only the heel into dorsiflexion and physician places the foot in extreme positions<br>

B. Same as AP and turn only the plantar aspect of the foot into inversion or eversion and the physician places the foot in extreme positions.

What radiation safety applies to an AP stress view?<br>A. Wear lead gloves if exposing while holding and can use tape or gauze around the ball of the foot<br>B. Wear lead apron only and hold the foot with bare hands and use tape around the ball of the foot<br>C. Use no immobilization and expose during active motion and use gauze around the ball of the foot<br>D. Use fluoroscopy instead of tape or gauze and hold the foot with bare hands<br>

A. Wear lead gloves if exposing while holding and can use tape or gauze around the ball of the foot.

What is a key requirement for an AP stress view?<br>A. Active motion during each exposure and no immobilization of the stress position<br>B. Partial immobilization with the foot free and no immobilization of the stress position<br>C. Rapid removal of stress before exposure and no immobilization of the stress position<br>D. Immobilization of the stress position for each exposure with no motion<br>

D. Immobilization of the stress position for each exposure with no motion.

What is the patient position for an AP weight-bearing view?<br>A. Supine on a low platform with heels lifted from IR and toes straight and weight on one foot<br>B. Upright with toes pointing outward and weight on one foot and heels lifted from IR<br>C. Upright on a low platform or block and standing with heels pushed back against IR and toes straight and weight evenly distributed<br>D. Lateral recumbent with affected ankle against IR and toes straight and weight evenly distributed<br>

C. Upright on a low platform or block and standing with heels pushed back against IR and toes straight and weight evenly distributed.

What are the evaluation criteria for an AP weight-bearing view?<br>A. Both ankle joints and relationship of distal tibia and fibula with weight bearing and medial mortise open and lateral mortise closed and distal tibia and talus partially superimpose distal fibula<br>B. Both knee joints and relationship of femur and tibia with weight bearing and medial mortise open and lateral mortise closed and distal tibia and talus partially superimpose distal fibula<br>C. Both ankle joints and relationship of calcaneus and cuboid with weight bearing and medial mortise open and lateral mortise closed and distal tibia and talus partially superimpose distal fibula<br>D. Both ankle joints and relationship of talus and navicular with weight bearing and medial mortise open and lateral mortise closed and distal tibia and talus partially superimpose distal fibula<br>

A. Both ankle joints and relationship of distal tibia and fibula with weight bearing and medial mortise open and lateral mortise closed and distal tibia and talus partially superimpose distal fibula.

What is the part position for an AP tib-fib?<br>A. AP with 15–20° medial rotation and femoral condyles perpendicular to IR and foot dorsiflexed 90° and IR extends 1–2 inches beyond joints<br>B. True AP without rotation and femoral condyles parallel with IR and foot dorsiflexed 90° and IR extends 1–2 inches beyond joints and IR can be turned diagonal<br>C. AP with 45° medial rotation and foot plantar flexed and femoral condyles parallel with IR and IR extends 1–2 inches beyond joints<br>D. Lateral with patella perpendicular to IR and foot dorsiflexed and femoral condyles parallel with IR and IR extends 1–2 inches beyond joints<br>

B. True AP without rotation and femoral condyles parallel with IR and foot dorsiflexed 90° and IR extends 1–2 inches beyond joints and IR can be turned diagonal.

What should be done if both knee and ankle joints will not fit on one image?<br>A. Take two images of the knee only and no ankle image<br>B. Take one image of the ankle only and no knee image<br>C. Take a large image of the entire leg with reduced SID and no separate images<br>D. Take a small image of the area furthest from the injury<br>

D. Take a small image of the area furthest from the injury.

What are the SID and technique for an AP tib-fib?<br>A. 30 inches and 60 kVp and 1.8 mAs and no AEC and free plate and 14 × 17 lengthwise or diagonal<br>B. 40 inches and 80 kVp and 2.5 mAs and no AEC and free plate and 14 × 17 lengthwise or diagonal<br>C. 40 inches which can increase to 48 inches to reduce divergence and 70 kVp and 2.5 mAs and no AEC and free plate and 14 × 17 lengthwise or diagonal<br>D. 48 inches and 70 kVp and 1.8 mAs and no AEC and free plate and 14 × 17 lengthwise or diagonal<br>

C. 40 inches which can increase to 48 inches to reduce divergence and 70 kVp and 2.5 mAs and no AEC and free plate and 14 × 17 lengthwise or diagonal.

What are the evaluation criteria for an AP tib-fib?<br>A. Entire tibia and fibula with knee and ankle joints and rotation and proximal and distal tib-fib articulations separated and fibula midshaft free of superimposition<br>B. Entire tibia and fibula with knee and ankle joints and no rotation and proximal and distal tib-fib articulations moderately overlapped and fibula midshaft free of superimposition and intercondylar eminence centered in intercondylar fossa<br>C. Entire tibia and fibula with knee only and no rotation and fibula midshaft superimposed and intercondylar eminence centered in intercondylar fossa<br>D. Entire tibia and fibula with ankle only and no rotation and intercondylar eminence off center and fibula midshaft free of superimposition<br>

B. Entire tibia and fibula with knee and ankle joints and no rotation and proximal and distal tib-fib articulations moderately overlapped and fibula midshaft free of superimposition and intercondylar eminence centered in intercondylar fossa.

What is the part position for a lateral tib-fib?<br>A. Recumbent on affected side and lateral surface of leg on IR and patella perpendicular to IR and femoral condyles superimposed and perpendicular to IR and knee may be flexed and foot dorsiflexed<br>B. Supine with lateral surface of leg on IR and patella parallel to IR and femoral condyles superimposed and perpendicular to IR and knee may be flexed and foot dorsiflexed<br>C. Prone with medial surface of leg on IR and femoral condyles not superimposed and patella perpendicular to IR and knee may be flexed and foot dorsiflexed<br>D. Upright with lateral surface of leg on IR and patella parallel to IR and femoral condyles superimposed and perpendicular to IR and knee may be flexed and foot dorsiflexed<br>

A. Recumbent on affected side and lateral surface of leg on IR and patella perpendicular to IR and femoral condyles superimposed and perpendicular to IR and knee may be flexed and foot dorsiflexed.

What are the evaluation criteria for a lateral tib-fib?<br>A. Entire tibia and fibula with both joints and rotation and tibial tuberosity not in profile and proximal fibular head fully superimposed and distal fibula seen through anterior half of tibia<br>B. Entire tibia and fibula with both joints and no rotation and proximal fibular head fully superimposed and distal fibula seen through anterior half of tibia and posterior femoral condyle borders superimposed<br>C. Entire tibia and fibula with both joints and no rotation and distal fibula seen through anterior half of tibia and posterior femoral condyle borders superimposed and tibial tuberosity in profile<br>D. Entire tibia and fibula with both joints and no rotation and tibial tuberosity in profile and proximal fibular head partially superimposed by tibia and distal fibula seen through posterior half of tibia and posterior femoral condyle borders superimposed<br>

D. Entire tibia and fibula with both joints and no rotation and tibial tuberosity in profile and proximal fibular head partially superimposed by tibia and distal fibula seen through posterior half of tibia and posterior femoral condyle borders superimposed.

What are the breathing instructions for all ankle and tib-fib projections?<br>A. Suspend respiration on inspiration and use shallow breathing during exposure<br>B. Suspend respiration on expiration and use shallow breathing during exposure<br>C. Not applicable because all are extremity exams<br>D. Use shallow breathing during exposure and suspend respiration on inspiration<br>

C. Not applicable because all are extremity exams.