The Foot

The Views  AP  Oblique  Lateral

Things to know  Cassette size:  10x12 lengthwise divided in half and 8 x 10  Shield  Marker  Hold still  Measures:

Part Position for AP  Place patient supine on table with foot exposed. (No Shoe or sock)  Flex the knee to place foot flat on IR  Center foot to IR with long axis of foot with long axis of IR.

Central Ray  Angled 10 degrees posterior toward heel  For every 5 Degrees angle drop SID by 1 in.  Center to Base of third metatarsal  SID 40 inches  Collimate to outer borders on all four sides

Seen on Radiograph  Entire foot  All phalanges, metatarsals, navicular, cuneiforms and cuboid.  No rotation as seen by the bases of the first and second metatarsals separated.  3-5 metatarsals are slightly overlapped

Oblique  Use the other half of cassette  Shield  Hold still  Marker in light field

Part position for Oblique  With foot flat against the IR.  Rotate foot medially degrees

Center to Base of third metatarsal SID 40 inches

Seen on Radiograph  Entire foot  From phalangles to Calcaneus  3-5 metatarsals are free of imposition  Joint space around cuboid is open  The Sinus tarsi is seen.

Lateral Foot  8 X 10 or 10x12 for larger foot  Turn diagonally  Measures 8  4  Mark  Shield  Hold still

Part position  Turn patient on side so the lateral portion of foot is in contact with IR  Flex knee of affect foot  Place opposite leg behind the injured leg.  Place the plantar surface of foot perpendicular to IR.  Do not over rotate.

40 SID To Medial cuneiform

Seen on Radiograph  Entire foot  1 inch of distal tib/fib  Metatarsals superimposed  Tibiotalar joint is open  Distal fibular is superimposed by distal tibia..

Lets work on the Heel

Things to knows  Cassette size:8 x 10 crosswise divided in half  Measures: 10 5  Done on table top  2 Views Axial and Lateral

Position of Part for Axial  Patient seated on table with leg fully extended  Place the back of heel on IR  Dorsiflex foot until plantar surface is perpendicular with IR  Can use gauze or something to assist patient with position.

Angle 40 Degrees celphald Base of third metatarsal SID 40 Inches

Seen on Radiograph  Entire calcaneus  Open talocalcaneal joint.

Lateral View  Other half of cassette  Measures 10

Part position  Roll patient with affected side down  Center heel to IR  Plantar surface perpendicular to film  same as lateral foot

SID 40 1 inch below the medial malleolous

Seen on Radiograph  Calcaneus in profile  Open joint space of calcaneus and cuboid  Imposition of distal tib/fib

Ankle

Views  Ap  Lateral  Internal and external Obliques

Things to know  Cassette: 10 x 12 crosswise divided in half  Measures 8  6  Shield  Marker  Hold still

Part Position for AP  Place patient supine on table  Do not flex foot allow it to be in a natural position  Point toes up to ensure a true AP of lower leg and ankle.

40 SID Perpendicular to a point mid-way between malleoli

Seen on Radiograph  The Distal tib/fib  The lateral and medial malleoli  The talus  Proximal half of metatarsals

Lateral  The other half of the 10x 12 cassette  Shield  Marker  Hold still

Part Position  Rotate patient on side of affect foot  Place unaffected leg behind affected leg  Dorsiflex foot for a true 90 degree angle

40 SID Perpendicular to the medial malleolus

Seen on Radiograph  Distal third of tib/fib superimposed  The talus  The calcaneus  The navicular and cuboid  Tibotalar joint open

Obliques 10 x12 cassette divided in half Shield Marker Hold still

Part Position for oblique  Start like on an AP  Patient supine and heel against cassette toes up  Center ankle to center of Cassette  Rotate leg medially (internal) 45 degrees  Rotate leg laterally (external) 45 degrees

40 SID Perpendicular to mid- way between malleoli

40 SID Perpendicular to mid- way between malleoli

Seen on internal oblique  Distal third of tib/fib  the malleoli  the talus and proximal half of metatarsals  tibiofibular joint open  the lateral malleoli and talus joint open  the medial malleoli and talus partially imposed.

Seen on external oblique  The Calcaneal sulcus  The superior portion of the calcaneus  The distal tib/fib superimposed anterior