Radiographic Techniques: Foot and Ankle

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Questions and Answers

What is the recommended position for a patient during the PA projection of the patella?

Prone with support under the thigh and leg if there is pain (correct)

Sitting on an examination table with legs hanging

Supine with knees flexed

Standing upright with legs straight

What appears on the PA projection of the patella when it is properly positioned?

Distorted bony detail of the proximal femur

Patella completely superimposed by the femur (correct)

Patella completely superimposed by the fibula

Exaggerated curvature of the femur

What kind of detail is provided by the PA projection of the patella?

Blurry details of surrounding soft tissue

Total absence of bony structures

Sharper recorded detail of the patella (correct)

Poor detail due to patient positioning

Which area should be centered on the image receptor for the PA projection of the patella?

Mid-popliteal area Signup and view all the answers

What indicates a successful PA projection of the patella regarding the tibiofibular overlap?

Slight tibiofibular overlap Signup and view all the answers

What is the position of the calcaneus in relation to the ankle during the procedure?

It is not under the ankle. Signup and view all the answers

What must be ensured about the long axis of the foot for dorsiflexion?

It needs to be perpendicular to the tabletop. Signup and view all the answers

Which metatarsals are highlighted in the procedure discussed?

First and fifth metatarsals. Signup and view all the answers

What is used to support the image receptor in position?

A sandbag. Signup and view all the answers

What can happen if excessive density is present over the posterior portion of the calcaneus?

The image may not be projected correctly. Signup and view all the answers

When might two images be required during the procedure?

For regions of thickness. Signup and view all the answers

Where should the image receptor be placed during the process?

Against the plantar surface of the foot. Signup and view all the answers

What might occur if the calcaneus is improperly positioned?

There may be a need for additional imaging. Signup and view all the answers

What is the primary purpose of the lateral projection weight-bearing method for the longitudinal arch?

To demonstrate the structural status of the longitudinal arch Signup and view all the answers

What is the recommended patient position for the lateral projection weight-bearing method?

Upright, standing on both feet Signup and view all the answers

Which of the following is NOT noted in the description of the lateral projection weight-bearing method?

Uses a seated position for imaging Signup and view all the answers

What should be done if a stool is not available for the lateral projection weight-bearing method?

Elevate the foot using blocks Signup and view all the answers

Which of the following indicates correct placement of the image receptor (IR) for the procedure?

Vertical on the IR groove of the stool Signup and view all the answers

What anatomical features does the lateral projection weight-bearing view primarily highlight?

Superimposed tarsals and metatarsals Signup and view all the answers

What type of projection is explicitly discussed for demonstrating the structure of the foot?

Lateromedial projection Signup and view all the answers

Which of the following factors is essential for a successful lateral projection weight-bearing image?

Sufficient density in the image Signup and view all the answers

What is the central ray direction for the second exposure during the examination of the hind foot?

25 degrees anterior angulation Signup and view all the answers

Which of these deviations is not a characteristic of congenital clubfoot?

Elevation of the lateral border of the foot Signup and view all the answers

In the context of the forefoot exposure, how should the patient’s foot be positioned?

One step forward Signup and view all the answers

Which of the following angles is used for the composite AP axially focused on the posterior surface of the ankle?

25 degrees posterior angulation Signup and view all the answers

What does 'Talipes Equinovarus' specifically refer to?

Congenital clubfoot Signup and view all the answers

Which part of the foot is primarily elevated in congenital clubfoot?

Medial border Signup and view all the answers

During an examination of the hindfoot, what is an important aspect of maintaining foot alignment?

Carefully positioning the affected foot Signup and view all the answers

When performing an anterior angulation exposure, what is the central ray supposed to target?

Plantar surface of the foot Signup and view all the answers

Which position should the femoral condyles be in relative to the IR for proper imaging?

Parallel Signup and view all the answers

What should be adjusted to ensure the patient’s pelvis is not rotated?

The patient body Signup and view all the answers

What is crucial about the foot positioning during the imaging process?

It should be vertical. Signup and view all the answers

In the lateral projection, where is the central ray directed?

To the center of the leg Signup and view all the answers

What anatomical parts are represented in the AP projections of the leg?

Proximal and distal articulations of the tibia and fibula Signup and view all the answers

What type of image shows the trabecular detail and soft tissue of the entire leg?

AP projection Signup and view all the answers

What should the patient position be during the lateral projection?

Supine Signup and view all the answers

What is the appropriate IR size for the projections mentioned?

35 x 43 cm Signup and view all the answers

Study Notes

Lateral Projection Weight Bearing (Standing) for Longitudinal Arch

Positioning: Patient stands upright with weight evenly distributed on both feet.
IR Placement: IR is placed vertically on the IR groove of a low riser or between blocks, perpendicular to the patient.
Central Ray: Perpendicular to a point just above the base of the 3rd metatarsal.
Image Features: Shows a lateromedial projection of the bones of the foot with weight bearing, including the entire foot and distal leg.
Purpose: Demonstrates the structural status of the longitudinal arch.

Composite AP Axial, Posterior Angulation of 15 degrees

Patient Positioning: Patient is standing with one foot slightly forward.
IR Placement: IR is positioned on the floor.
Central Ray: Anterior angulation of 15 degrees, directed towards the posterior surface of the ankle.
Image Features: Shows an anterior angulation of the ankle, including the ankle and knee joints.

Composite AP Axial, Anterior Angulation of 25 degrees

Patient Positioning: Patient is standing with one foot slightly forward.
IR Placement: IR is positioned on the floor.
Central Ray: Anterior angulation of 25 degrees, directed towards the posterior surface of the ankle.
Image Features: Shows an anterior angulation of the ankle, including the ankle and knee joints.

Congenital Clubfoot

Definition: Deformity of the foot characterized by plantar flexion and inversion of the calcaneus, medial displacement of the forefoot, and elevation of the medial border of the foot.
Positioning: Patient is in supine position with the IR placed against the plantar surface of the foot, supported with a sandbag.
Central Ray: Perpendicular to the long axis of the foot, entering the dorsal surface of the ankle joint.
Image Features: Shows the calcaneus not under the ankle, the first or fifth metatarsals not projected to the sides of the foot, and the anterior portion of the calcaneus without excessive density over the posterior portion.

Lateral Projection (Mediolateral)

Patient Positioning: Patient is in supine position.
IR Placement: IR is positioned against the lateral side of the leg, center at the level of the knee.
Central Ray: Perpendicular to the center of the leg.
Image Features: Shows the ankle and knee joints, with slight tibiofibular overlap.

PA Projection of Patella

Patient Positioning: Patient is in prone with a support under the thigh if needed, to relieve pressure on the knee.
IR Placement: IR centered on the patella.
Central Ray: Perpendicular to the mid-popliteal area.
Image Features: Shows a PA projection of the patella, with the patella completely superimposed by the femur.

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Description

Test your knowledge on lateral projection weight bearing for the longitudinal arch and the composite AP axial view with posterior angulation. This quiz covers positioning, central ray direction, and image features pertaining to foot and ankle radiographs. Perfect for students in radiography or medical imaging courses.