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DRG1004 > Week 4 - Foot & Ankle > Flashcards

Week 4 - Foot & Ankle Flashcards

1
Q

what are the joints of the ankle

A
  • tibiofibular joint
  • fibulotalar joint
  • tibiotalar joint
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2
Q

what is Lisfranc #

A

foot injury where one or more metatarsals are displaced from tarsals

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3
Q

what is Jones #

A

5th metatarsal #

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4
Q

where does mallet toe usually affect

A

joint nearest to the toenail in 2nd, 3rd, 4th toes

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5
Q

what causes gout

A

uric acid crystalizes in joints due to excess intake or inability to process uric acid, causing painful inflammation

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6
Q

what is pes planus

A

flat foot

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7
Q

what is the target of DP foot

A

VCR angulated 10 degrees towards head (cranially) & centre at Base of 3rd metatarsal

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8
Q

what is the collimation of DP foot

A

Upper = tip of all phalanges
side = surrounding soft tissue margins
lower = distal tibia & fibula

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9
Q

what is the target of DPO foot

A

VCR directed perpendicular to IR & centre at base of 3rd metatarsal

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10
Q

what is the collimation of DPO foot

A

upper = tip of all phalanges
side = soft tissue margins of lateral & medial aspects of foot
lower = distal tibia & fibula

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11
Q

what is the target of DP toes

A

VCR directed perpendicular to IR & centre at 3rd metatarsophalangeal joint

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12
Q

what is the collimation of DP toes

A

upper = tip of distal phalanges
side = surrounding soft tissue margins
lower = distal half of metatarsals

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13
Q

what is the target of DPO toes

A

VCR directed perpendicular to IR & centre at 3rd metatarsophalangeal joint

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14
Q

what is the collimation of DPO toes

A

upper = tip of distal phalanges
side = surrounding soft tissue margins
lower = distal half of metatarsals

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15
Q

why is lateral projection of foot done

A

to evaluate pes planus & FB localization

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16
Q

what is the target of lateral foot

A

VCR directed perpendicular to IR & centre along midline of foot at base of 3rd metatarsal

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17
Q

what is the collimation of lateral foot

A

superior = ankle joint
anterior = tip of toes
posterior = soft tissue margins of calcaneus
inferior = plantar surface of foot

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18
Q

what is the ideal position of DP foot/toes

A
  • midshaft concavity & soft tissue width on both side of phalanges
  • equal spacing between 2nd to 5th metatarsals
  • open navicular-cuneiform joint spaces
  • well demonstrated MTP joints

MEOW

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19
Q

what is the ideal area of DP foot

A

all phalanges, metatarsals, tarsal bones, talar neck, surrounding soft tissues included

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20
Q

what is the ideal area of DP toes

A

all phalanges & distal third of metatarsals, surrounding soft tissues included

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21
Q

what is the ideal area of DPO foot

A

all phalanges, metatarsals, tarsal bones, calcaneus, surrounding soft tissues included

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22
Q

what is the ideal area of DPO toes

A

all phalanges & distal third of metatarsals, surrounding soft tissues included

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23
Q

what is best to view hallux valgus

A

DP foot

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24
Q

what is best to view pes planus

A

lateral foot

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25
Q

what is the target of lateral foot w/ weight bearing

A

HCR directed perpendicular to IR & centre along midline of foot at base of 3rd metatarsal

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26
Q

what is the ideal position for DPO foot/toes

A
  • twice as much soft tissue width & more phalangeal concavity on side of digit rotated away from IR
  • open IP & MTP joint spaces
  • open 2nd to 4th inter MT joint spaces
  • sinus tarsai & 5th MT tuberosity are visualized
27
Q

what is the target of DP foot w/ weight bearing

A

VCR angled 10 degrees towards ankle joint (cranially) & centre between 2 feet at base of 3rd metatarsal

28
Q

what is the ideal position for lateral foot

A
  • long axis of foot is perpendicular to long axis of lower leg
  • metatarsal heads are superimposed
  • open tibiotalar joint
  • proximal, anterior & posterior aspects of talus domes aligned
  • distal fibula superimposed by posterior half of distal tibia
29
Q

what is the ideal area for lateral foot

A

phalanges, metatarsals, tarsals, calcaneus, ~2.5 cm of distal tibia/fibula, surrounding soft tissues included

30
Q

what is maisonneuve #

A

spiral fracture of upper third of fibula w/ disruption of distal tibio-fibular syndesmosis & associated injuries

31
Q

what causes maisonneuve #

A

pronation external-rotation mechanism

32
Q

what % of all ankle # are maisonneuve

A

7%

33
Q

what is syndesmosis

A

fibrous joint held together by ligaments

34
Q

what are the different forms of Danis-Weber Classification

A

Type A = below syndesmosis
Type B = same level of syndesmosis
Type C = above syndesmosis

35
Q

what is the kVp, mAs, SID used for ankle

A

55 kVp
2.5 mAs
100 cm (SID)

36
Q

what is the kVp, mAs, SID used for calcaneum axial

A

60 kVp
3.2 mAs
100 cm (SID)

37
Q

what is the target of Mortise ankle

A

VCR perpendicular to IR & centre to mid-ankle joint (imaginary line joining both malleoli)

38
Q

what is the collimation of Mortise ankle

A

upper = distal third of tibia & fibula
side = surrounding soft tissues of lateral & medial malleoli
lower = base of metatarsals

39
Q

what is the target of Lateral ankle

A

VCR perpendicular to IR & centred to medial malleolus

40
Q

what is the collimation of Lateral ankle

A

upper = distal third of tibia & fibula
side = surrounding soft tissues of calcaneus
lower = base of metatarsals & plantar soft tissue margins of calcaneus

41
Q

what is the target of Lateral calcaneum

A

VCR perpendicular to IR & centre to point 2.5 cm distal to medial malleolus

42
Q

what is the collimation of Lateral calcaneum

A

upper = ankle joint
anterior = 5th metatarsal tubercle
posterior = soft tissue margins of calcaneus
inferior = plantar soft tissue margin of calcaneus

43
Q

what is the target of Axial calcaneum

A

VCR angled 40 degrees cephaladly & centre along midline of foot at level of 5th metatarsal tubercle

44
Q

what is the collimation of Axial calcaneum

A

superior = proximal third of metatarsals
laterally = soft tissue margins of calcaneus
inferior = soft tissue margin of calcaneus

45
Q

what is the ideal position of Mortise ankle

A
  • distal fibula shown w/o superimposition of talus
  • distal tibia superimposes 1/4 of distal fibula
  • open tibiotalar joint
  • open fibulotalar joint
46
Q

what is the ideal area of Mortise ankle

A

distal third of fibula & tibia, talus & soft tissues around ankle

47
Q

what is the ideal position of Lateral ankle

A
  • long axis of foot is seen at 90 degrees to long axis of tibia & fibula
  • anterior & posterior aspect of talar domes are aligned
  • distal fibula is superimposed by posterior half of distal tibia
  • open tibiotalar joint
  • proximal aspects of talar domes are aligned
48
Q

what is the ideal position of Lateral calcaneum

A
  • long axis of foot is seen at 90 degrees to long axis of tibia & fibula
  • anterior & posterior aspect of talar domes are aligned
  • distal fibula is superimposed by posterior half of distal tibia
  • open tibiotalar joint
  • proximal aspects of talar domes are aligned
49
Q

what is the ideal area of Lateral ankle

A
  • distal third of tibia & fibula
  • calcaneus
  • 2.5cm of 5th metatarsal base
  • surrounding soft tissues
50
Q

what is the ideal collimation of Lateral ankle

A

anterior pretalar & posterior pericapsular fat pads demonstrated

51
Q

what is the idea area of Lateral calcaneum

A
  • tibiotalar joint
  • talus
  • calcaneus
  • calcaneus-articulating tarsal bones
  • plantar soft tissue margins

TCPCT

52
Q

what is the ideal position of Axial Calcaneum

A
  • open talo-calcaneal joint
  • minimal shape distortion of calcaneal tuberosity
  • distal metatarsals not shown on medial or lateral aspect of foot
  • sustentaculum tali is in profile
53
Q

what is the ideal area of Axial calcaneum

A
  • entire calcaneus
  • talocalcaneal joint
  • surrounding soft tissues
54
Q

what is the room prep for foot DP

A
  • kVp = 50 - 60
  • mAs = 1.25 - 3.2
  • SID = 100 cm
55
Q

what is the room prep for foot lateral

A
  • kVp = 55 - 60
  • mAs = 2 - 4
  • SID = 100 cm
56
Q

what is the room prep for toes

A
  • kVp = 40 - 50
  • mAs = 1 - 3.2
  • SID = 100 cm
  • 18 x 24 CR cassette used
57
Q

what is the positioning of DP foot

A
  • patient sit or lie supine on the x-ray couch
  • proximal foot positioned at cathode end of tube
  • flex affected knee such that plantar aspect of foot is in contact with IR
  • all toes fully extended and in contact w/ IR
  • long axis of foot aligned to long axis of IR
58
Q

what is the positioning of DPO foot

A
  • From DP position, rotate affected foot medially till plantar aspect of foot forms 30 degree angle w/ IR
  • long axis of foot parallel to long axis of IR
59
Q

what is the positioning of lateral foot

A
  • seated or lying supine with both legs fully extended
  • rotate affected foot laterally till lateral aspect of foot in contact w/ IR
  • plantar aspect of foot adjusted to be perpendicular to IR
60
Q

what is the positioning of mortise ankle

A
  • patient seated or lie on x-ray couch w/ fully extended legs
  • dorsiflex affected ankle
  • rotate affected limb medially about 20 degrees till medial & lateral malleoli are equidistant from IR
  • long axis of tibia parallel to long axis of IR
61
Q

what is the positioning of lateral ankle & calcaneum positioning

A
  • patient seated or lying on x-ray couch
  • rotate body till lateral aspect of affected leg in contact w/ x-ray couch
  • medial & lateral malleoli adjusted till they superimpose vertically
  • long axis of tibia parallel to long axis of IR
  • foot remains dorsiflexed
62
Q

what does obliquity of foot at 30 degrees allow one to see

A
  • ideal position of foot/toes
63
Q

what does bimalleolar involve

A

lateral & medial malleolus

64
Q

what does trimalleolar involve

A

lateral, medial & posterior malleolus

DRG1004 (12 decks)

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