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RAD115-Foot/Ankle
| Question | Answer |
|---|---|
| When looking at image critique, what should you be considering? | rotation, collimation, exposure (grainy/oversaturated), is it centered? |
| When doing a lateral projection of the ankle, what should the lateral malleolus be superimposed on? | The medial malleolus, and distal tibia – you should see soft tissue and trabecular markings of the bone |
| If you’re concerned about pathology of sesamoid bones, what projection should you use? | Holly/Lewis (method) and tangential projection (where you skim part of the anatomy) |
| Compensating filter | may use one for a foot to make exposure more consistent because your foot is a slope, makes more uniform exposure, does not affect dose |
| How should foot be positioned for AP projection of ankle? | 90 degrees to IR, toes pointing up (dorsiflexion) |
| When would you use inversion vs eversion of ankle? | weight bearing, stress views |
| When doing an AP axial projection of calcaneus, what should you ensure is happening with positioning? | Foot dorsiflexed |
| Concern about longitudinal arch of foot -- what shot are you doing? | AP, lateral, and use weightbearing to assess |
| Does a longitudinal arch have anything to do with a sesamoid bone? | No |
| You’re doing a mortise joint view (ankle) and lateral malleolus is slightly imposed over talus, and lateral joint space is not open, what does this indicate? | It means there’s not enough rotation |
| An AP medial projection of the foot (oblique), if it’s positioned correctly, which metatarsals should be free of superimposition? | Third, fourth, fifth (lateral side should be opened up) |
| If trying to fit both joints on AP projection of tib-fib, what can you do? | Angle or rotate the IR the diagonally |
| Cuboid lies where? | lateral portion of foot |
| Where should you put central ray for lateral ankle? | the knobs (malleolus) |
| How do you position for AP Axial for calcaneous? | Dorsiflex, to see calcaneous via getting the toes out of the way, plantar surface of foot should be 90 degrees perpendicular to plane of IR (foot should be straight) |
| What three bones make up ankle joint? | tibia, fibula, talus |
| On tibial plateau, two bony projections at top are called | interconduloid eminence |
| Where do you put CR for AP projection of foot? | Base of third metatarsal |
| Do you ever do an AP foot with no angulation? | NO, otherwise you’re not accurately seeing joint spaces |
| Which projection of ankle will best demonstrate the lateral portion of the ankle joint? | Mortise, because there won’t be superimposition |
| penetration of toe | 60-65 kVp or lower |
| medial malleolus -- what bone is it found on? | tibia |
| lateral malleolus -- what bone is it found on? | fibula |
| malleoli of ankle – if they’re truly parallel with IR so that the JOINT is parallel, what shot is it? | mortise -- because the bones don't lie straight in AP |
| Would you say that bones of the foot bear weight? Does the tibia bear weight? Does the fibula bear weight? | foot bones - yes tibia - yes fibula - no, it's purpose is to provide support |
| If someone has inversion/eversion injury, what type of views might be ordered? | Stress view |
| What projection do you do for calcaneous? | AP Axial Planto-dorsal projection – enters bottom of foot, exits top of the foot |
| To demonstrate the TMT joint spaces of the foot, what should you do? | AP Axial shot, tube needs 10 degree cephalad angle |
| How do you perform oblique projection of the foot? | Rotate the foot medially, 30 degree rotation |
| Cuboid | lateral aspect of foot |
| To clearly demonstrate tarsal bone in lateral aspect, you should use | AP oblique |
| If equal amounts of space between second, third, and fourth metatarsal are even, bases are superimposed, this is what projection? | AP oblique |
| What does the Lewis/Holly method do? | gets clear images of small sesamoid bones which are often obscured |
| What joints need to be demonstrated on lateral projection of tib-fib? | Ankle and knee |
| How to determine if you’re in true lateral for tib-fib? | The tibia and fibula are superimposed, but also, the femoral epicondyles are superimposed. Patella should be in profile/perpendicular to IR. Lateral position, medial-lateral projection |
| How many degrees for AP axial calcaneus? | 40 degrees |
| AP oblique of foot, medial rotation – what does it show? | Lateral aspect of foot, looking at fifth metatarsal |
| how many tarsals in foot? | 26 |
| What routes would be performed for study of second toe? | AP, oblique medial rotation, and lateral |
| calcaneous, also known as | “os calsis” |
| Two arches of foot | longitudinal and transverse |
| mortise joint | joint between tibia, fibula, and talus of the foot |
| Foot series | AP Axial, AP oblique, lateral |
| Ankle series | AP, AP mortise, lateral |
| Tib-Fib | AP, lateral |
| In AP oblique, what metatarsals should be free of superimposition? | 3rd to 5th, also first and second apart from the bases |
| Where is the CR centered on all 3 foot shots? | Base of the third metatarsal |
| how many degrees is the foot rotated for AP oblique? | 30-40 degrees |
| how would you evaluate sesamoids? | tangential projection |
| How many degrees is the angulation of an AP foot? | 10 degrees |
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