Ankle

1
Ankle
2
Views

• Ap
• Lateral
• Internal and external Obliques

3
Things to know

• Page 224 in book
• Cassette 10 x 12 crosswise divided in half
• Measures 8
• Shield
• Marker
• Hold still

4
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.

5
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6
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.

7
Seen on Radiograph

• The Distal tib/fib
• The lateral and medial malleoli
• The talus
• Proximal half of metatarsals

8
Lateral

• The other half of the 10x 12 cassette
• Shield
• Marker

9
Part Position

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

10
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11
Central ray

• 40 Sid
• Perpendicular to the medial malleolus

12
Seen on Radiograph

• Distal third of tib/fib superimposed
• The talus
• The calcaneus
• The navicular and cuboid
• Tibotalar joint open

13
Obliques

• 10 x12 cassette divided in half
• Shield
• Marker

14
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

15
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16
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17
Central ray

• 40 SID
• Perpendicular to mid-way between malleoli

18
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.

19
Seen on external oblique

• The Calcaneal sulcus
• The superior portion of the calcaneus
• The distal tib/fib superimposed anterior

20
The lower legTib/fib
21
the Views

• AP
• Lateral

22
Things to know

• Cassette size 14 X 17 turned diagonally
• one cassette per view
• Shield
• Marker
• Measures 10

23
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.

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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

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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

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Lateral Tib/Fib

• 14 X 17 diagonally
• shield
• Marker

28
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

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• 40 SID

30
Central Ray

• perpendicular to mid-leg
• collimation to skin borders on sides
• open fully top to bottom
• can go up to 44 or 48

31
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.

32
!!!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.