X-RAY views for foot, calcaneum, and ankle joint.

This presentation provides a comprehensive overview of X-ray views used in radiology for assessing foot, calcaneus (heel bone), and ankle joint conditions. The presentation covers various X-ray techniques, and specialized views for injuries.

1. VIEWS FOR FOOT, CALCANEUM
AND ANKLE JOINT
PresentedBy:RamChand(220513019)
Course:MScRIT(2
nd
SEMESTER)
Department:Radio-ImagingTechnology
Faculty:AlliedHealthSciences,SGTUniversity,Gurugram

2. INTRODUCTION
Afoot,ankle,andcalcaneumX-rayisadiagnostictoolused
toassessthebonesandjointsinthelowerlegandfoot.Itisa
safeandeffectivewaytoidentifyconditionsorinjuriesthat
mayrequiretreatment.

3. ANATOMY
Image Sources: Research gate, Pinterest

4. INDICATIONS
•foottrauma
•bonytendernessatthebaseofthemetatarsal
•bonytendernessatthenavicularbone
•inabilitytoweight-bearmorethanfoursteps
•non-traumaticfootpain

5. PREPARATION
•Patienthistoryiscollected
•Patientisaskedtoremoveallradiopaquematerials
•Wearhospitalgown
•Chaperoneisnecessaryforfemalepatient
•Shieldingisprovidedtopatient

6. FOOT SERIES
•Dorsoplantarview
•MedialObliqueview
•Lateralview

7. FOOT (DORSOPLANTER VIEW) POSITIONING
•thepatientmaybesupineor
uprightdependingoncomfort
•theaffectedlegmustbeflexed
enoughthattheplantaraspectof
thefootisrestingontheimage
receptor
Image Sources: Department of Radiology, Apollo Hospital, Bhubaneswar

8. TECHNICAL FACTORS
•centringpoint
•x-raybeamcentredtothebaseofthe3rdmetatarsal
•Orientation:Portrait
•detectorsize:18cmx24cm
•exposure
•50-55kVp
•3-4mAs
•SID:100cm
•Grid:no
ImageSources:Bontrager’s

9. FOOT MEDIAL OBLIQUE VIEW POSITIONING
•thepatientmaybesupineorupright
dependingoncomfort
•theaffectedlegmustbeflexedenough
thattheplantaraspectofthefootisresting
ontheimagereceptor
•thefootismediallyrotateduntilthe
plantarsurfacesitsata45°angletothe
imagereceptor
Image Sources: Department of Radiology, Apollo Hospital, Bhubaneswar

10. TECHNICAL FACTORS
•centringpoint
•x-raybeamcentredtothebaseofthe3rdmetatarsal
•thebeamwillbeperpendiculartotheimagereceptor
•Orientation:Portrait
•detectorsize:18cmx24cm
•exposure
•50-55kVp
•3-4mAs
•SID:100cm
•Grid:no
ImageSources:Bontrager’s

11. FOOT LATERAL VIEW POSITIONING
•thepatientmaybesupineoruprightdependingon
comfort
•theaffectedlegisexternallyrotateduntilthedistallimbis
paralleltothetable,inmanycases,thepatientwillhave
tohalfrollontotheaffectedside
•thelateralaspectofthefootwillbeincontactwiththe
imagereceptor
•thenon-affectedsideiskeptposteriortopreventover
rotation
•thefootisinslightdorsiflexion
•theplantersurfaceshouldbeperpendiculartotheimage
receptor
Image Sources: Department of Radiology, Apollo Hospital, Bhubaneswar

12. TECHNICAL FACTORS
•centringpoint
•baseofmetatarsalsormidfoot
•Orientation:Landscape
•detectorsize:18cmx24cm
•exposure
•50-60kVp
•4-6mAs
•SID:100cm
•Grid:no
ImageSources:Bontrager’s

13. CALCANEUM
SERIES
•Axialview
•Lateralview

14. AXIAL VIEW OF CALCANIUM POSITIONING
•Thepatientisseatedonxraytable
withlegsextended.
•Affectedsideankleisdorsiflexed
placingtheheelonthecassette.
•Thepatientisaskedtoholdthe
anklebythehelpofabandage
clothslingoverthefoot.
•Patientisimmobilizedsideis
markedandbeamiscollimated.

15. TECHNICAL FACTORS
•centringpoint
•Middlesoleofthefoot
•Orientation:Portrait
•detectorsize:18cmx24cm
•exposure
•50-60kVp
•3-5mAs
•SID:100cm
•Grid:no
ImageSources:Bontrager’s

16. LATERAL VIEW OF CALCANIUM POSITIONING
•Thepatientisseatedonxraytable
withlegsextended.
•Recumbent,onaffectedside,knee
flexedwithunaffectedlimbbehind,
topreventover-rotation
•Placesupportunderkneeandleg
asneededforatruelateral
•Dorsiflexfootsotheplantarsurface
isnear90°tolegifpossible.

17. TECHNICAL FACTORS
•centringpoint
•Midcalcaneus,inferiortomedialmalleolus
•Orientation:Portrait
•detectorsize:18cmx24cm
•exposure
•50-60kVp
•3-5mAs
•SID:100cm
•Grid:no
ImageSources:Bontrager’s

18. ANKLE SERIES
•APview
•Lateralview
•Specialprojections
•Mortiseview
•Stressview

19. ANKLE AP VIEW POSITIONG
•thepatientmaybesupineorsitting
uprightwiththeirlegstraightenonthe
table
•thefootisindorsiflexion
•thetoeswillbepointingdirectly
towardtheceiling
Image Sources: Department of Radiology, Apollo Hospital, Bhubaneswar

20. TECHNICAL FACTORS
•centringpoint
•themidpointofthelateralandmedialmalleoli
•Orientation:Portrait
•detectorsize:24cmx30cm
•exposure
•50-60kVp
•3-5mAs
•SID:100cm
•Grid:no
ImageSources:Bontrager’s

21. ANKLE LATERAL VIEW POSITIONG
•patientisinalateralrecumbentpositiononthe
table
•thelateralaspectofthekneeandanklejoint
shouldbeincontactwiththetableresultinginthe
tibialyingparalleltothetable
•thelegcanbebentorstraight
•footindorsiflexion
•placetheoppositelegbehindtheinjuredlimbto
avoidover-rotation
Image Sources: Department of Radiology, Apollo Hospital, Bhubaneswar

22. TECHNICAL FACTORS
•centringpoint
•thebonyprominenceofthemedialmalleolusofthedistaltibia
•Orientation:Portrait
•detectorsize:18cmx24cm
•exposure
•50-60kVp
•3-5mAs
•SID:100cm
•Grid:no
ImageSources:Bontrager’s

23. SPECIAL PROJECTIONS
MORTISE VIEW STRESS VIEW
Thisprojectionisusetoassessthe
articulationoftheTibialPlafondandtow
MalleoliwiththeTalarDome
Stressviewisimportantintheevaluationof
theLigamentousTears,jointstabilityand
fractureunions
ImageSources:Bontrager’s

24. ANKLE MORTISE VIEW POSITIONG
•thepatientmaybesupineorsittinguprightwith
thelegstraightenedonthetable
•thelegmustberotatedinternally15°to20°,thus
aligningtheintermalleolarlineparalleltothe
detector.Thisusuallyresultsinthe5thtoebeing
directlyinlinewiththecentreofthecalcaneum
•internalrotationmustbefromthehip;isolated
rotationoftheanklewillresultinanon-diagnostic
image
•footshouldbeinslightdorsiflexion
ImageSources:Bontrager’s

25. TECHNICAL FACTORS
•centringpoint
•themidpointofthelateralandmedialmalleoli
•Orientation:Portrait
•detectorsize:24cmx30cm
•exposure
•50-60kVp
•3-5mAs
•SID:100cm
•Grid:no
ImageSources:Bontrager’s

26. ANKLE STRESS VIEW POSITIONG
•thepatientmaybesupineorsitting
uprightwiththelegstraightenedonthe
table
•thelegmustberotatedinternally15°to
20°
•thesecondperson(oftenrequesting
physician)willthenplacetheankleinto
supinationandexternalrotation
ImageSources:Bontrager’s

27. TECHNICAL FACTORS
•centringpoint
•themidpointofthelateralandmedialmalleoli
•Orientation:Landscape
•detectorsize:24cmx30cm
•exposure
•50-60kVp
•3-5mAs
•SID:100cm
•Grid:no
ImageSources:Bontrager’s

28. BIBLIOGRAPHY
https://courseware.cutm.ac.in/teachers/sambangi-
satyananda-shiva-sagar/
https://radiopaedia.org/articles/
Bontrager’s HANDBOOK OF RADIOGRAPHIC POSITIONING AND
TECHNIQUES
FOOTNOTES
Disclosure. This topic is more often based on the practical
aspects under authorized personnel.

29. QUESTIONS
Can you identify the following figure positionings?
A B
Image Sources: Department of Radiology, Apollo Hospital, Bhubaneswar

30. QUESTIONS
What is Tibial Plafond?
ImageSources:Bontrager’s
A tibial plafondfracture (also known as a pilon fracture) is a fracture of the
distal end of the tibia

31. THANK
YOU