Ankle

Views

• Ap

• Lateral

• Internal and external Obliques

Things to know

• Page 224 in book

• Cassette: 10 x 12 crosswise divided in half

• Measures 8

• 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.

Central Ray

• 40 SID

• Perpendicular to a point mid-way between malleoli

• Collimate to lateral skin borders and included distal tib/fib and proximal half of metatarsals.

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

Part Position

• Rotate patient on side of affect foot

• Place unaffected leg behind affected leg

• Dorsiflex foot for a true 90 degree angle

Central ray

• 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

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

Central ray

• 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

The lower legTib/fib

the Views

• AP

• Lateral

Things to know

• Cassette size: 14 X 17 turned diagonally

• one cassette per view

• Shield

• Marker

• Measures 10

Part position for AP

• Patient Supine on table• Place shield over lap• leg fully extended• place leg in true AP position for knee and ankle• Femoral condyles parallel to IR• foot flexed to 90 degree (TOES up)• include both joints (knee & ankle) IR.

Central Ray

• 40 SID

• perpendicular to mid-leg

• Collimate to skin borders on lateral and medial sides.

• Leave collimation open from top to bottom

• ** can go up to 44 or 48 SID to include more of part**

Seen on Radiograph

• The entire tibia and fibula

• both ankle and knee joint

• the condyles of tibia and femur in profile

• the intercondylar eminence centered in the intercondylar fossa

• some imposition of distal and proximal tib/fib

Lateral Tib/Fib

• 14 X 17 diagonally

• shield

• Marker

Part position for lateral

• Patient on side with injured side down

• flex knee about 45 degree to ensure true lateral

• plane of patella should be perpendicular to IR

• opposite leg behind injured one

• both joints included on IR

•40 SID

Central Ray

• perpendicular to mid-leg

• collimation to skin borders on sides

• open fully top to bottom

• ** can go up to 44 or 48**

Seen on Radiograph

• Entire tib/fib

• both joints

• tibial tuberosity in profile

• fibula head imposed by tibia

• distal fibula imposed on posterior portion of tibia

• femoral condyles superimposed.

!!!Important Note!!!!

• If you can not fit entire leg on on film...

• You must include the joint nearest the injury on the film and take a separate picture of the other joint.