Foot Imaging Techniques Overview

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Questions and Answers

What is the required posture of the patient when taking a sesamoids tangential view?

Patient lying prone or seated (correct)

Patient standing upright

Patient lying supine on the table

Patient in a lateral recumbent position

Which of the following correctly describes the positioning of the foot for a sesamoids tangential view?

Foot positioned with the 1st toe extended and ball of foot parallel to the image plate

Foot positioned resting on the edge of the image plate

Foot positioned with the 1st toe flexed and ball of foot perpendicular to the image plate (correct)

Foot positioned with toes parallel to the table edge

For the foot dorso-plantar view, what is the correct angle of the x-ray tube?

Vertical angle of 0 degrees

5 degrees towards the heel

10 degrees towards the heel (correct)

15 degrees away from the heel

What is the central ray location for a dorso-plantar foot view?

Centered on the base of the third metatarsal Signup and view all the answers

What is a requirement for collimation in a sesamoids tangential view?

Four sides of collimation must include metatarsal head and sesamoids Signup and view all the answers

What should be included in the patient preparation notes prior to taking these foot views?

Remove artifacts in the field of view, such as shoes and socks Signup and view all the answers

Which anatomical feature should be visualized in profile without superimposition for the sesamoids tangential view?

Both sesamoids Signup and view all the answers

What is the specified mAs range for a sesamoids tangential view?

2-4 mAs Signup and view all the answers

What is primarily demonstrated in the imaging of the distal femur and proximal tibia?

Cortical outline and bony trabecular pattern Signup and view all the answers

Which of the following best describes the appropriate identification of the image?

Contains a side marker and is appropriately identified or anonymised Signup and view all the answers

In which scenario would the imaging technique described typically be requested?

Post-operative assessments after total knee replacement Signup and view all the answers

What does the term 'Horizontal Beam Lateral' indicate in radiographic positioning?

A specific view focusing on the lateral profile of anatomical structures Signup and view all the answers

Which anatomical structures are primarily visualized in this imaging technique?

Distal femur, proximal tibia, and fibula Signup and view all the answers

What is the appropriate tube angle for a lateral knee view?

5-7 degrees cephalic angle Signup and view all the answers

Which anatomical structures should be included in the distal femur radiograph?

Distal femur, patella and proximal tibia/fibula Signup and view all the answers

How far should the central ray be positioned for a lateral knee view?

2.5cm distal to the medial epicondyle of femur Signup and view all the answers

What is the minimum distance that should be maintained from the x-ray tube for a lateral knee projection?

100-110cm Signup and view all the answers

What is the correct positioning for an intercondylar view of the knee?

Knee bent 60 degrees Signup and view all the answers

What is an important aspect to achieve proper collimation for knee radiographs?

Include all required anatomy including skin edges Signup and view all the answers

Which of the following best describes the alignment criteria for a lateral knee view?

Both condyles of femur superimposed with open patello-femoral join Signup and view all the answers

What might affect the density and contrast of a knee radiograph?

Choosing the wrong kVp and mAs settings Signup and view all the answers

What is the appropriate kVp range for the Lateral Lower Leg view?

50-60 kVp Signup and view all the answers

Which of the following best describes the posture for the Lateral Lower Leg view?

Patient lying on side with affected leg outstretched Signup and view all the answers

During the AP Knee view, what is the positioning of the knee?

Knee extended without rotation Signup and view all the answers

What is the correct central ray positioning for the AP Knee view?

Centered to the apex of the patella Signup and view all the answers

What is required for collimation in both the Lateral Lower Leg and AP Knee views?

Collimation must be seen to include anatomy of interest Signup and view all the answers

Which of the following is NOT a criterion for the Lateral Lower Leg view?

Centring of the tibia intercondylar eminence Signup and view all the answers

What is the required tube angle for the Lateral Lower Leg view?

Straight tube Signup and view all the answers

Which of the following best represents the density criteria for the AP Knee view?

Cortical outline and bony trabecular pattern demonstrated Signup and view all the answers

What is the primary anatomical focus when performing the intercondylar fossa open view?

Distal femur and proximal tibia/fibula Signup and view all the answers

What is the optimal tube angle when capturing a skyline view of the patella?

Parallel to the patella body Signup and view all the answers

Which of the following criteria is essential for achieving a good skyline view of the patella?

Superimposition of superior and inferior patellar borders Signup and view all the answers

What is the required postural position for a patient during a PA Rosenberg view?

Standing with knees bent at 45 degrees Signup and view all the answers

What mAs range is typically utilized for the patella skyline view?

7-10 mAs Signup and view all the answers

Which aspect is NOT a requirement in the collimation criteria for the patella skyline view?

Include adjacent joint areas Signup and view all the answers

In terms of patient preparation for the skyline view, what is emphasized?

Removing artifacts from the field of view Signup and view all the answers

What is the optimal distance for taking a patella skyline view?

100-110 cm Signup and view all the answers

Study Notes

Sesamoids Tangential View

Position: Patient lying prone or seated with foot positioned with 1st toe flexed and ball of foot perpendicular to image plate. Alternatively, patient can remain seated with foot flexed and tape tensioning toes back.
Tube Angle: Straight
Central Ray: Centered on second metatarsal
Distance: 100-110cm
Collimation: Include metatarsal head and sesamoids
kVp: 50-55 kVp
mAs: 2-4 mAs
Grid: No
Patient Prep: Remove artifacts in field of view (shoes, socks)

Sesamoids Tangential View Criteria

Collimation: Include all required anatomy including skin edges
Alignment: Joint spaces between sesamoids and 1st metatarsal are open
Anatomy: Both sesamoids seen in profile without superimposition
Density: Cortical outline and bony trabecular pattern adequately demonstrated
Contrast: Soft tissue and bony interfaces visualized

Foot Dorso-Plantar View

Position: Patient seated on table with foot positioned flat on image plate
Tube Angle: 10 degrees towards heel
Central Ray: Centered on base of third metatarsal
Distance: 100-110cm
Collimation: Include anatomy of interest
kVp: 50-55 kVp
mAs: 3-4 mAs
Grid: No
Patient Prep: Remove artifacts in field of view (shoes, socks)

Foot Dorso-Plantar View Criteria

Collimation: Include all required anatomy including skin edges
Alignment: No rotation of foot, long axis of image plate aligned with long axis of foot
Anatomy: Toes to tarsals included, slight overlap of 2nd-5th metatarsal bases
Density: Cortical outline and bony trabecular pattern adequately demonstrated
Contrast: Soft tissue and bony interfaces visualized

Lateral Lower Leg View

Position: Patient lying on side with affected leg outstretched, foot fully flexed, knee slightly bent, true lateral, diagonal image plate to include both joints
Tube Angle: Straight
Central Ray: Centered mid shaft tib/fib
Distance: 100-110cm
Collimation: Include anatomy of interest
kVp: 50-60 kVp
mAs: 3-5 mAs
Grid: No
Patient Prep: Remove artifacts in field of view (shoes, clothing)

Lateral Lower Leg Criteria

Collimation: Include all required anatomy including skin edges
Alignment: True lateral knee and ankle, slight superimposition of proximal and distal tib/fib
Anatomy: Knee joint to ankle joint included on one or more images
Density: Cortical outline and bony trabecular pattern adequately demonstrated
Contrast: Soft tissue and bony interfaces visualized

AP Knee View

Position: Patient seated on table with leg extended, knee extended without rotation
Tube Angle: Straight tube (may use small cephalic angle if patient has big thighs)
Central Ray: Centered to apex of patella
Distance: 100-110cm
Collimation: Include anatomy of interest
kVp: 60-70 kVp
mAs: 7-10 mAs
Grid: No
Patient Prep: Remove artifacts in field of view (clothing)

AP Knee Criteria

Collimation: Include all required anatomy including skin edges
Aignment: No rotation of femoral condyles, symmetry of tibial plateau and centring of tibia intercondylar eminence, some overlap of fibia head on tibia is normal
Anatomy: Distal femur and proximal tib/fib included, patella superimposed over femur
Density: Cortical outline and bony trabecular pattern adequately demonstrated
Contrast: Soft tissue and bony interfaces visualized

Lateral Knee View

Position: Patient lying on side with knee flexed 30 degrees, unaffected leg positioned in front to assist with adequate rotation and stabilization, knee flexed to engage patella tendon, true lateral, patella in profile
Tube Angle: 5-7 degrees cephalic angle
Central Ray: Center on medial aspect of knee joint, 2.5cm distal to medial epicondyle of femur
Distance: 100-110cm
Collimation: Include anatomy of interest
kVp: 60-70 kVp
mAs: 7-10 mAs
Grid: No
Patient Prep: Remove artifacts in field of view (clothing)

Lateral Knee Criteria

Collimation: Include all required anatomy including skin edges
Alignment: Both condyles of femur superimposed, patello-femoral joint space open, tibial plateau profiled
Anatomy: Distal femur, patella and proximal tibia/fibula included
Density: Cortical outline and bony trabecular pattern adequately demonstrated
Contrast: Soft tissue and bony interfaces visualized

Intercondylar View

Position: PA, patient kneeling on stool or AP, patient seated on table with knee bent, AP Seated is more common, knee bent 60 degrees
Tube Angle: Tube angled to be parallel to tibial plateau
Central Ray: Cephalic angle to match tibial angle
Distance: 100-110cm
Collimation: Include anatomy of interest
kVp: 60-70 kVp
mAs: 7-10 mAs
Grid: No
Patient Prep: Remove artifacts in field of view (clothing)

Intercondylar Criteria

Collimation: Include all required anatomy including skin edges
Alignment: Femoral condyles symmetrical, intercondylar fossa open
Anatomy: Distal femur and proximal tib/fib included
Density: Cortical outline and bony trabecular pattern adequately demonstrated
Contrast: Soft tissue and bony interfaces visualized

Patella Skyline View

Position: Patient seated on table with knee bent at 30 degrees, skyline is typically an infero-superior axial projection of patella, ideally sitting to ensure quads are unsupported to allow true patella position to be visualized
Tube Angle: Angle tube to be parallel with patella body
Central Ray: Centered apex of patella, in plane with patello-femoral space
Distance: 100-110cm
Collimation: Include anatomy of interest
kVp: 60-70 kVp
mAs: 7-10 mAs
Grid: No
Patient Prep: Remove artifacts in field of view (splints, clothing)

Patella Skyline Criteria

Collimation: Include all required anatomy including skin edges
Alignment: Superimposition of inferior and superior borders of patella
Anatomy: Patella profiled axially, patello-femoral joint space open
Density: Cortical outline and bony trabecular pattern adequately demonstrated
Contrast: Soft tissue and bony interfaces visualized

PA Rosenberg View

Position: Patient standing facing upright bucky with knees bent 45 degrees so patellae are in contact with the bucky, tibia and femurs are similar angle from the bucky, don't stand patient too far from the bucky or tibial angle will be too great, often performed bilaterally
Note: This functional view demonstrates instability on flexion of knees, also useful to visualise a knee prosthesis to check for loosening
Anatomy: Distal femur, proximal tibia and fibula in lateral profile
Density: Cortical outline and bony trabecular pattern adequately demonstrated
Contrast: Soft tissue and bony interfaces visualized
Markers: Label as “Horizontal Beam Lateral”
Note: Typically requested in trauma and post operative settings (e.g. after Total Knee Replacement surgery in Recovery room)

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Description

This quiz covers the positioning and criteria for imaging the foot, including the sesamoids tangential view and the dorso-plantar view. It focuses on the essential technical factors required to achieve optimal imaging results. Perfect for students and professionals in radiology and medical imaging.