38 Questions
What is the source to image distance for all toes, foot, ankle, heel projections?
40 inches
What is the image receptor size for all toes, foot, ankle, heel projections?
10" x 12"
In the AP toes position, where should the central ray be directed?
1: IP joint, 2: PIP joint
What is the optional angling for AP toes positioning?
15 degrees
What is seen in an AP oblique toes projection?
Open IP and MTP joint spaces, whole toe and adjacent MTP joint space, soft tissue and bone, sesamoids on first metatarsal head
How should the lateral toes be positioned for the projection?
1-2: lateromedial, 3-5: mediolateral
What structures can be seen in a lateral toe projection?
Phalanx in profile and lateral aspect seen, open IP joint spaces, possible MTP joint overlap, soft tissue and bone
What is the positioning for an AP foot projection?
Patient supine or seated, knee bent, foot flat on Image receptor
What is the purpose of obtaining stress views in ankle imaging?
To verify the presence of ligamentous tears
How many phalanges, metatarsals, and tarsals are in the foot?
Phalanges: 14, Metatarsals: 5, Tarsals: 7
What bones make up the midfoot area of the foot?
3 cuneiforms, navicular, and cuboid
Describe the hindfoot in terms of bones.
Talus and calcaneus
What is the dorsum of the foot?
Superior surface of the foot
Define the plantar surface of the foot.
Inferior surface of the foot
What should be visible in a lateral oblique ankle X-ray?
Calcaneal sulcus, subtalar joint, fractures
When are stress views obtained in ankle imaging?
After an inversion or eversion injury
What would a ruptured ligament in the ankle/foot show on X-ray?
Widening of the joint space on the side of the injury when the foot is forcibly turned toward the opposite side
How should the patient be positioned for a mediolateral ankle X-ray?
Roll patient onto the hip of the affected side, flex the knee, plantar surface of foot perpendicular with Image receptor, dorsiflex the foot
What is the recommended cephalic angle for the axial plantodorsal heel projection?
40 degrees
How should the foot be positioned for a mediolateral heel projection?
Foot in true lateral position, dorsiflexed
What method is used for sesamoids positioning when the patient is seated?
Holly method
What is the central ray entry point for the AP foot projection?
Base of the 3rd metatarsal
Which projection shows the lateral aspect of the foot, including possible fractures or foreign bodies?
Mediolateral foot
What structures are seen in the medial oblique foot projection?
Oblique position of entire foot, 5th metatarsal base tuberosity, calcaneus
How should the ankle be positioned for the axial dorsoplantar heel projection?
Dorsiflexed with the long axis of the foot on the image receptor
What is the key structure seen in the sesamoids projection using the Lewis method?
Sesamoids free of any superimposition of the 1st metatarsal
How should the foot be positioned for the mediolateral foot projection?
Foot rolled up onto hip of affected side, plantar surface perpendicular to image receptor
What is the recommended collimation for the axial plantodorsal heel projection?
1-inch on all 3 sides of the calcaneus shadow
What term is used to describe the movement of turning the whole foot inward?
Inversion (varus)
Which tarsal bone is known as 'Os Calcis' or 'Heel'?
Calcaneus
How many phalanges are usually found in the 2nd to 5th toes of the foot?
3
What type of joint classification do all the joints of the foot have?
Synovial
Where are the sesamoid bones in the foot usually located?
On the plantar surface of the head of the 1st metatarsal
Which metatarsal bone is the shortest and thickest in the foot?
1st metatarsal
What is the alternate name for the 'ankle joint' in the foot?
Ankle mortise joint
What is the main function of the longitudinal arch of the foot?
Weight bearing
What is the common site of fracture in the foot?
Sesamoid bones
Which metatarsal bone is the longest in the foot?
2nd metatarsal
Study Notes
X-ray Projections
- Source to image distance for all toes, foot, ankle, and heel projections: not specified.
- Image receptor size for all toes, foot, ankle, and heel projections: not specified.
Toes Projections
- AP toes position: central ray directed perpendicular to the image receptor, centered at the base of the 2nd toe.
- Optional angling for AP toes positioning: 10-15° medial rotation.
- AP oblique toes projection: shows entire toe, including the phalanges and surrounding soft tissue.
- Lateral toes positioning: foot and toes are rotated 90° laterally, with the lateral aspect of the foot facing the image receptor.
- Structures seen in a lateral toe projection: phalanges, surrounding soft tissue, and possible fractures or foreign bodies.
Foot Projections
- AP foot positioning: foot is rotated 15-20° medially, with the central ray directed perpendicular to the image receptor, centered at the level of the metatarsal bases.
- Structures seen in an AP foot projection: entire foot, including the phalanges, metatarsals, and surrounding soft tissue.
Ankle Projections
- Stress views in ankle imaging: obtained to assess joint instability or ligamentous injuries.
- Purpose of obtaining stress views: to evaluate ankle joint stability and detect possible ligamentous injuries.
Anatomy of the Foot
- Number of phalanges, metatarsals, and tarsals in the foot: 14 phalanges, 5 metatarsals, and 7 tarsals.
- Bones that make up the midfoot area: cuboid, navicular, and three cuneiform bones.
- Bones that make up the hindfoot: talus and calcaneus (os calcis or heel).
- Dorsum of the foot: the top of the foot.
- Plantar surface of the foot: the bottom of the foot.
Ankle and Heel Projections
- Lateral oblique ankle X-ray: shows the lateral aspect of the ankle and surrounding soft tissue.
- Stress views obtained in ankle imaging: when assessing joint instability or ligamentous injuries.
- Ruptured ligament in the ankle/foot on X-ray: may show as a widening of the joint space or a small avulsion fracture.
- Positioning for a mediolateral ankle X-ray: ankle is rotated 90° medially, with the medial aspect of the ankle facing the image receptor.
- Recommended cephalic angle for the axial plantodorsal heel projection: 30-40°.
- Foot positioning for a mediolateral heel projection: heel is rotated 90° medially, with the medial aspect of the heel facing the image receptor.
- Method used for sesamoids positioning when the patient is seated: the patient is seated with the foot flat on the floor, and the image receptor is placed vertically.
- Central ray entry point for the AP foot projection: centered at the level of the metatarsal bases.
- Projection that shows the lateral aspect of the foot: lateral oblique foot projection.
- Structures seen in the medial oblique foot projection: medial aspect of the foot, including the medial malleolus and surrounding soft tissue.
Other
- Ankle joint classification: synovial hinge joint.
- Location of the sesamoid bones in the foot: embedded within the tendons that connect to the 1st metatarsal bone.
- Shortest and thickest metatarsal bone in the foot: 1st metatarsal bone.
- Alternate name for the 'ankle joint': talocrural joint.
- Main function of the longitudinal arch of the foot: to absorb shock and distribute body weight.
- Common site of fracture in the foot: calcaneus (os calcis or heel).
- Longest metatarsal bone in the foot: 3rd metatarsal bone.
Toes, Foot, Ankle Heel Quiz
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