RAD 110 - Ch 6 Toes, Foot, & Ankle - Positioning

Toes Routine

- AP

- Oblique

- Lateral

AP Toes

What projection is this?

Evaluation Criteria for AP Toes

- CR 10° to 15° posterior to MTP joint

- Digits and minimum of distal ½ of metatarsal demonstrated

- No overlap of soft tissues

- IP and MTP joints appear open

- Optimal exposure factors

AP Second Digit

What projection is this?

Evaluation Criteria AP Toes Digit

- 15° wedge, CR perpendicular to IR

- Digits and minimum of distal ½ of metatarsal demonstrated

- No overlap of soft tissues

- IP and MTP joints appear open

- Optimal exposure factors

AP Oblique Medial Rotation

What projection is this?

AP Oblique Lateral Rotation

What projection is this?

Evaluation Criteria for AP Oblique

- Digits and minimum of distal ½ of metatarsal demonstrated

- IP and MTP joints appear open

- Increased concavity on one side of shaft

- Heads of metatarsals not overlapped

- Optimal exposure factors

Lateral First Digit

What projection is this?

Evaluation Criteria for Lateral First Digit

- Lateromedial

- CR to IP

- Digits presented in true lateral position

- IP and MTP joints appear open

- Digit free of superimposition

- Optimal exposure factors

Lateral Fourth Digit

What projection is this?

Evaluation Criteria for

Lateral Fourth Digit

- CR to PIP

- Mediolateral

- Digits presented in true lateral position

- IP and MTP joints appear open

- Digit free of superimposition

- Optimal exposure factors

Tangential Sesamoids Supine

What projection is this?

Tangential Sesamoids Prone

What projection is this?

Evaluation Criteria for Tangential Sesamoids

- Sesamoids free of superimposition

- Minimum of three metatarsals seen

- Optimal exposure factors

Foot Routine

- AP

- Oblique

- Lateral

AP Foot

What projection is this?

Evaluation Criteria for AP Foot

- CR 10° angled posteriorly

- CR to base of 3rd MT

- Entire foot visualized

- No rotation of metatarsals

- MTP joints generally open

- Optimal exposure factors

AP Oblique Foot

What projection is this?

Evaluation Criteria for AP Oblique Foot

- 30° to 40° medial rotation

- CR to base of third MT

- Entire foot visualized

- Third through fifth metatarsals free of superimposition

- Tuberosity demonstrated at base of fifth metatarsal

- Optimal exposure factors

Evaluation Criteria for Alternate Lateral Oblique Foot

- 30° lateral rotation

- CR to base of third MT

- Demonstrates base of first MT and medial tarsals

Mediolateral Foot

What projection is this?

Evaluation Criteria for Mediolateral Foot

- True lateral

- CR to midcuneiform (base of third MT)

- Entire foot visualized

- Tibiotalar joint demonstrated

- Metatarsals superimposed

- Optimal exposure factors

Lateromedial Foot

What projection is this?

Evaluation Criteria for Lateromedial Foot

- True lateral

- CR to midcuneiform (base of third MT)

- Entire foot visualized

- Metatarsals superimposed

- Optimal exposure factors

AP Weight Bearing Foot

What projection is this?

Evaluation Criteria for AP Weight Bearing Foot

- CR 15 posterior

- CR to base of MTs

- Bilateral feet demonstated

- Phalanges and MTs not rotated

Lateral Weight Bearing Foot

What projection is this?

Evaluation Criteria for Lateral Weight Bearing Foot

- Horizontal beam

- Entire foot demonstrated

- Plantar surfaces of MTs superimposed

- Optimal exposure factors

Calcaneus Routine

- Plantodorsal (axial)

- Lateral

Plantodorsal (Axial) Calcaneus

What projection is this?

Evaluation Criteria Plantodorsal (Axial) Calcaneus

- CR 40° to cephalad

- CR to base of third MT to emerge posterior to malleoli

- Entire calcaneus visualized

- No rotation

- Optimal exposure factors

Mediolateral Calcaneus

What projection is this?

Evaluation Criteria Mediolateral Calcaneus

- CR 1 inch (2.5 cm) inferior to medial malleolus

- Calcaneus and talus visualized

- No rotation

- Optimal exposure factors

Ankle Routine

- AP

- AP Mortise

- 45º Oblique

- Lateral

AP Ankle

What projection is this?

Evaluation Criteria AP Ankle

- AP

- CR midway between malleoli

- Distal ⅓ of tibia and fibula demonstrated

- Proximal ½ of metatarsals included

- Medial and superior aspect of ankle joint open

AP Mortise Ankle

What projection is this?

Evaluation Criteria AP Mortise Ankle

- Intermalleolar line parallel to IR

- Ankle rotated 15-20 degrees medial rotation

- CR midway between malleoli

- Entire ankle mortise open

- Distal ⅓ of tibia and fibula demonstrated

- Proximal ½ of metatarsals included

- Optimal exposure factors

AP 45º Oblique Ankle

What projection is this?

Evaluation Criteria AP 45º Oblique Ankle

- 45° medial rotation

- CR midway between malleoli

- Distal tibiofibular joint open

- Distal ⅓ of tibia and fibula demonstrated

- Proximal ½ of metatarsals included

- Optimal exposure factors

Lateral Ankle (Mediolateral)

What projection is this?

Lateral Ankle (Lateromedial)

What projection is this?

Evaluation Criteria Lateral Ankle

- CR Centered to Medial Malleolus

- Entire talus and calcaneus visualized

- Lateral malleolus superimposed over posterior half of tibia

- Optimal exposure factors

AP Stress Ankle (Inversion)

What projection is this?

AP Stress Ankle (Eversion)

What projection is this?

Evaluation Criteria AP Stress Ankle

- Distal aspect of tibia and fibula demonstrated

- Ankle joint to center of collimation field

- Optimal exposure factors