Chapter_06 Toes to femur 2025

Chapter 6: Lower Limb Anatomy and Procedures

Toes, Foot, Calcaneus, and Ankle

  • Focus on anatomy and related radiographic procedures

Foot Anatomy

  • Composition: 26 bones divided into:

    • Tarsals

    • Metatarsals (5 bones of the instep)

    • Phalanges (14 bones)

  • Phalanges: 2 in great toe, 3 in other toes; movements in interphalangeal joints.

Tarsal Bones

  • 7 Tarsal Bones:

    • Calcaneus (heel bone)

    • Talus (highest position)

    • Navicular

    • Cuboid

    • Three cuneiforms (medial, intermediate, lateral)

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Metatarsals

  • Five Metatarsals (numbered 1-5, starting from great toe)

    • Base (proximal end) and Head (distal end)

    • Metatarsophalangeal(MTP) joints: classified as ellipsoidal joints

Ankle Anatomy

  • Ankle Joint:

    • Articulates between the talus and malleoli of tibia and fibula; classified as a synovial hinge joint.

Special Considerations

  • X-ray Precautions: Use gloves, clean cassettes after use; feet are difficult to image clearly.

  • Patient Preparation: Remove artifacts (shoes, socks) to visualize anatomy clearly.

Radiographic Procedures

  • Essential projections for toes, foot, calcaneus, and ankle to assess skeletal integrity and injuries.

  • Toes: AP axial, AP oblique, and lateral projections detailed for clear imaging.

Imaging Techniques

  • AP Axial Toes: Proper positioning and CR angling to reduce foreshortening and open joint spaces.

  • Lateral Projections: Ensure separation of toes to avoid superimposition.

  • Foot and Calcaneus Projections: Include specific angles and CR positioning to visualize joint and bone structures effectively.

Common Fractures and Disorders

  • Common Injuries: Jones fracture (fifth metatarsal avulsion), stress fractures, and complications from gout and diabetes affecting lower limbs.

Gout

  • Important as it affects the foot's joint, particularly the big toe (podagra).

Notes for Practical Application

  • Students are encouraged to review procedures on the foot, ankle, and leg during lab sessions and practice critical imaging techniques for accuracy.