Foot/ ankle Flashcards
1
Q
AP view:
- pt position
- central beam
- advantage
- disadvantage
A
- pt position - supine with heel resting on the film cassette; foot in neutral position
- central beam - directed vertically to the ankle joint at the midpoint between the malleoli
- advantage - Identifies distal tib and fib (fib mall longer than tib mall)
- disadvantage - tib-fib syndesmosis is not clearly demonstrated bc of the distal overlap of the fibula and lateral aspect of the tib
2
Q
Mortise view:
- pt position
- central beam
- advantage
A
- pt position - supine, ankle IR 10 degrees
- central beam - same as AP
- advantage - eliminates overlap of medial aspect of distal fib; syndesmotic space well demonstrated
3
Q
Lateral view:
- pt position
- central beam
- advantage
A
- pt position - laying on affected side with fibula resting on cassette film and foot in neutral position
- central beam - central beam is directed vertically to the medial malleolus
- advantage - anterior aspect of distal tibia ad posterior lip; fractures in coronal plane
4
Q
internal oblique view:
- pt position
- central beam
- advantage
A
- pt position - supine and leg/ foot rotated medially 35 degrees, foot in neutral position forming 90 degree angle with distal leg
- central beam - perpendicular to the lateral malleolus
- advantage - demonstrates tibiofibular syndesmosis, tibiotalar joint, dome of talus, tibial plafond, and M/ L malleoli
5
Q
inversion stress view view:
- pt position
- uses
A
- pt position - supine and foot s fixed into device; pressure plate is positioned 2 cm above the ankle joint and applies varus stress adducting the heel; AP film
- uses - degree of taller tilt is measured by the angle formed by lines drawn along the tibial plafond and the dome of the talus, compared to other side; 5 degrees normal, 5-15 normal to abnormal, 15-25 abnormal, 25+ definite ligamentous damage
6
Q
Anterior drawer stress is obtained from lateral projection. What ligament is being assessed? what separation distance is normal and abnormal?
A
- anterior talofib ligament
- 0 to 5 mm = normal
- 5 to 10 mm = normal/ abnormal
- 10 + = abnormal
7
Q
Dorsoplantar AP view
- pt position
- central beam
- advantage
A
- pt position - supine with knee flexed and sole played firmly on film cassette
- central beam - directed vertically to the base of the first MT bone
- advantage - demonstrates MT bones and phalanges; 1st interMT angle
8
Q
What is the 1st inter metatarsal angle?
A
a way to quantify the amount of metatarsus Primus varus associated with hallux valgus
9
Q
Lateral foot view:
- pt position
- central beam
- advantage
A
- pt position - sidlying on affected side with knee slightly flexed and lateral aspect of the film cassette
- central beam - directed vertically to the midtarsus
- advantage - boehler angle; calcanea pitch; demonstrates burial projection, posterior tub, medial tub, anterior tub, anterosuperior spine calcaneous, posterior facet of subtler joint, sustenaculum tali, talonavicular, calcaneocuboid
10
Q
What is the boehler angle? why does it matter?
A
- an anatomic relation of the lotus and the calcaneus
- intersection of a line drawn from posterior superior margin of the calcanea tuberosity (burial projection) through the posterior facet of the subtler joint and a line drawn from the tip-off the posterior facet through the superior margin of the anterior process of the calcaneus
- important in evaluation of calcaneal fractures
11
Q
used to measure the height of the foot; intersection of line drawn tangentially to inferior surface of calcaneus and one drawn along the plantar surface of the foot
A
calcaneal pitch
- higher values = cavus foot deformity
12
Q
Oblique foot view:
- pt position
- central beam
- advantages
A
- pt position - supine with the knee flexed and lateral border of the foot is elevated about 40-45 degrees
- central beam - directed vertically to the base of the 3rd MT
- advantages - demonstrates phalanges, MTs, anterior subtler joint, talonavicular, naviculocuneiform, calcaneocuboid
13
Q
Harris-beath (posterior tangential) view:
- pt position
- central beam
- advantages
A
- pt position - standing with sole of the foot flat on cassette
- central beam - angles 45 degrees toward the midline of the heel
- advantages - demonstrates middle and posterior facet of subtler joint, susentaculum tali, body of calcaneus
14
Q
Tangential (sesamoid) view:
- pt position
- central beam
- advantages
A
- pt position - seated on table with foot and toes Did with gauze
- central beam - directed vertically to head of first MT bone
- advantages - assessment of sesmoid bones of 1st MT and MT heads
15
Q
What may lead to a misdiagnosis that a fx is not present when it really is?
A
ossicles in the foot
- it is important to have accessory views to rule in/out fxs
