x-ray anatomy foot

Question 1

describe the normal bony alignment of a foot on a DP and oblique

Answer 1

DP = base of 2nd metatarsal in line with the medial border of the middle cuneiform

oblique = base of 3rd metatarsal in line with medial border of lateral cuneiform

Question 2

where are the 5 places accessory ossicles can be found on the foot

Answer 2

• postero medial (innerside) to navicular
• lateral to cuboid
• next to anterior process of calcaneum
• b/w 1st and 2nd metatarsal
• distal end of metatarsal (bipartite)

Question 3

avulsion at the base of 5th metatarsal is common, this is due to which tendon

Answer 3

peroneous brevis tendon

Question 4

what is a jones fracture of the foot

Answer 4

transverse fracture at the proximal shaft of 5th metatarsal

Question 5

kids tend to have an unfused apophysis on their 5th metatarsal, not to be confused with a fracture. How can you tell

Answer 5

the apophysis runs longitudinal to the shaft of the 5th metatarsal where as an avulsion/fracture is transverse

Question 6

keep in mind that the normal 5th metatarsal apophysis in kids can appear as displaced or fragmented (THIS IS USUALLY NORMAL)

Question 7

know that an apophysis is located at the sight of a ligament/tendon attachement, it doesnt contribute to the longitudinal growth of the bone ( not epiphysis)

Question 8

some stress fractures on metatarsals cannot be seen until 10 days later, what is a sign seen 10 days later of there having been a stress fracture

Answer 8

fluffy cortical findings on radiograph indicating healing

Question 9

what are 5 other common places of avulsion fractures in the foot besides the base of 5th?

Answer 9

• lateral to cuboid
• dorsal aspect of navicular
• head of talus
• anterior process and lateral of calcaneum

Question 10

keep an eye out for the calcaneum as the SMALL anterolateral fracture/avulsion of the calcaneum can easily be missed

Question 11

what is a lisfranc fracture-dislocation of the foot, what joint does it involve / how is is radiographically displayed

Answer 11

• fracture to the base of metatarsal resulting in lateral subluxation of the tarso-metatarsal joints

Question 12

what bone is typically involved in a lisfranc fracture, describe its characteristics

Answer 12

• as the base of the 2nd metatarsal is held in mortise by the 3 cuneiform, when there is fracture at base, the base remains in position whilst the distal aspect of fracture is laterally displaced

Question 13

what is a mid tarsal (chopart) fracture-dislocation?

Answer 13

disruption of the talonavicular and calcaneocuboid joint with medial or lateral displacement.