Feet and ankles

• What is the first projection for foot radiography?

  Dorsoplantar (DP) Projection
• What is the patient position for the Dorsoplantar (DP) Projection?

  Seated or lying with knee flexed
• Where is the Central Ray (CR) directed in the DP Projection?

  Base of the third metatarsal
• What should be included in the collimation for the DP Projection?

  Toes, metatarsals, tarsals, soft tissue
• How much should the foot be rotated for the Medial Oblique Projection?

  30-40 degrees medially
• What is the purpose of the Medial Oblique Projection?

  Visualizes bases of metatarsals and lateral cuneiforms
• What is the patient position for the Lateral Projection of the foot?

  Lies on their side with lateral foot down
• What is the CR direction for the Lateral Projection of the foot?

  Perpendicular to the image receptor
• Where is the CR centered in the Lateral Projection of the foot?

  At the medial cuneiform
• What should be included in the collimation for the Lateral Projection of the foot?

  Distal phalanges to calcaneus, soft tissue
• What is the first projection for ankle radiography?

  Anteroposterior (AP) Projection
• What is the patient position for the Anteroposterior (AP) Projection of the ankle?

  Seated or supine with leg extended
• Where is the CR directed in the AP Projection of the ankle?

  Midpoint between the malleoli
• What should be included in the collimation for the AP Projection of the ankle?

  Distal tibia, fibula, talus, soft tissue
• How much should the foot and ankle be rotated for the Mortise View?

  15-20 degrees internally
• What is the purpose of the Mortise View?

  Shows entire ankle joint without overlap
• Where is the CR centered in the Mortise View?

  Midpoint between the malleoli
• What should be included in the collimation for the Mortise View?

  Distal tibia, fibula, talus, soft tissue
• What is the patient position for the Lateral Projection of the ankle?

  Lies on the affected side
• Where is the CR directed in the Lateral Projection of the ankle?

  At the medial malleolus
• What are the rationales for the chosen foot positions?

  • DP: Full overview of metatarsals and tarsals
  • Medial Oblique: Visualizes bases of metatarsals
  • Lateral: Highlights longitudinal arch and soft tissue
• What are the rationales for the chosen ankle positions?

  • AP: Clear image of distal tibia, fibula, talus
  • Mortise View: Entire ankle joint visible
  • Lateral: Shows posterior aspect and alignment
• What should be included in the collimation for the Lateral Projection of the ankle?

  Distal tibia, fibula, talus, calcaneus, soft tissue
• What are the criteria for correct positioning in foot radiographs?

  1. DP: Equal spacing between metatarsal shafts
  2. Medial Oblique: Bases of 3rd-5th metatarsals free of overlap
  3. Lateral: Tibiotalar joint space visible
• What are the criteria for correct positioning in ankle radiographs?

  1. AP: Medial and superior aspects visible
  2. Mortise View: Entire joint space visible
  3. Lateral: Tibiotalar joint visualized
• What are common positioning errors in foot and ankle radiography?

  1. Rotation: Unequal spacing or improper visualization
  2. Inadequate Dorsiflexion: Superimposition of talus over tibia
  3. Cut-Off Anatomy: Excluded anatomy from images
  4. Blurring/Artifacts: Patient movement or objects present
• What is the correction for rotation errors in positioning?

  Realign the foot or ankle properly
• What is the correction for inadequate dorsiflexion?

  Instruct patient to pull toes upward
• What is the correction for cut-off anatomy errors?

  Adjust collimation and receptor placement
• What is the correction for blurring/artifacts?

  Ensure patient stability and remove objects