Normal ankle xray manual#

Note the os trigonum (red circle) which is an accessory ossicle of the foot and a normal variant. Lateral view of the ankle tracing the outline of the tibia (green), fibula (red), talus (dark red), calcaneum (blue) and base of 5th metatarsal (orange). A fracture in an abnormal bone is termed a pathological fracture.īeware of normal developmental variants such as accessory ossicles which may be mistaken for fractures. a thinner cortex and an increased bone lucency indicate osteopenia or osteoporosis). Look at the internal architecture of the bone (e.g. Note any other abnormalities such as osteophytes or calluses. On the lateral view, assess the medial, lateral and posterior malleoli, the calcaneum and the base of the fifth metatarsal.Ī loss in bone or joint alignment may be a result of a fracture, joint subluxation (partial dislocation) or dislocation. On the mortise view, trace the mortise and the talar dome surface.

In both views, trace the cortical outline of all the bones visible on the radiograph. Penetration is adequate if you can clearly distinguish between bones and soft tissues. Ideally, you should be able to see at least the distal third of the tibia and fibula and the talus on the mortise view and in addition to those, you should be able to see the calcaneum and the base of the 5 th metatarsal on the lateral view. Use a methodical approach such as ABCs to look at a radiograph. You might also be interested in our OSCE Flashcard Collection which contains over 2000 flashcards that cover clinical examination, procedures, communication skills and data interpretation. ComparisonĬomparison to previous radiographs, if available, can be especially useful when interpreting radiographs.Īsymptomatic contralateral sides are not routinely radiographed, however,§ if a recent or old image of the contralateral side is available, these may also be compared as the skeletal system is generally symmetrical and could therefore act as a reference point. a knee and a foot radiograph) to rule out additional fractures.

Normal ankle xray manual#

In some cases, a weight-bearing or a stress radiograph (gravity stress or manual stress) may also be required.Ĭonsider additional views such as a full-length tibia/fibula radiograph and imaging of the joint above and below (i.e. Mortise view: this is a modified anteroposterior (AP) view of the ankle in 10-20° internal rotation so that the medial and lateral malleoli are in the same horizontal plane and joint visualisation is optimised.In the United Kingdom, two views of the ankle joint are routinely performed: Patient details (name, date of birth, unique identification number).It is important to confirm the following details: Principles of ankle X-ray interpretation Demographicsīegin by checking that you are looking at the correct radiograph of the correct patient. Mortise radiograph of the left ankle showing the bones and ligaments (added in yellow) of the ankle joint. For more information, see the Geeky Medics guides to the bones of the lower limb and the bones of the foot. The ankle joint allows dorsiflexion and plantarflexion and is one of the weight-bearing joints. A mortise and tenon joint in carpentry 1įurther reinforcement of the ankle joint is provided by a strong fibrous complex between the distal tibia and fibula called the syndesmosis, and the medial (or deltoid) and lateral ligaments which arise from the medial and lateral malleolus respectively. This comes from the similarity to the mortise and tenon joint used in carpentry to create stable connections (Figure 1). Proximally, the joint comprises the medial malleolus (the distal end of the tibia), the tibial plafond and the lateral malleolus (the distal end of the fibula) which collectively form a rectangular socket called the mortise into which fits the talar dome distally. The ankle is a hinge joint formed by three bones: the tibia, the fibula and the talus.