Transcript Ankle
Ankle Views • Ap • Lateral • Internal and external Obliques Things to know • • • • • • Page 224 in book Cassette: 10 x 12 crosswise divided in half Measures 8 Shield Marker Hold still Part Position for AP • Place patient supine on table • Do not flex foot allow it to be in a natural position • Point toes up to ensure a true AP of lower leg and ankle. Central Ray • 40 SID • Perpendicular to a point mid-way between malleoli • Collimate to lateral skin borders and included distal tib/fib and proximal half of metatarsals. Seen on Radiograph • • • • The Distal tib/fib The lateral and medial malleoli The talus Proximal half of metatarsals Lateral • The other half of the 10x 12 cassette • Shield • Marker Part Position • Rotate patient on side of affect foot • Place unaffected leg behind affected leg • Dorsiflex foot for a true 90 degree angle Central ray • 40 Sid • Perpendicular to the medial malleolus Seen on Radiograph • • • • • Distal third of tib/fib superimposed The talus The calcaneus The navicular and cuboid Tibotalar joint open Obliques 10 x12 cassette divided in half Shield Marker Part Position for oblique • Start like on an AP • Patient supine and heel against cassette toes up • Center ankle to center of Cassette • Rotate leg medially (internal) 45 degrees • Rotate leg laterally (external) 45 degrees Central ray • 40 SID • Perpendicular to midway between malleoli Seen on internal oblique • • • • • • Distal third of tib/fib the malleoli the talus and proximal half of metatarsals tibiofibular joint open the lateral malleoli and talus joint open the medial malleoli and talus partially imposed. Seen on external oblique • The Calcaneal sulcus • The superior portion of the calcaneus • The distal tib/fib superimposed anterior The lower leg Tib/fib the Views • AP • Lateral Things to know • • • • • Cassette size: 14 X 17 turned diagonally one cassette per view Shield Marker Measures 10 Part position for AP • • • • • • • Patient Supine on table Place shield over lap leg fully extended place leg in true AP position for knee and ankle Femoral condyles parallel to IR foot flexed to 90 degree (TOES up) include both joints (knee & ankle) IR. Central Ray • 40 SID • perpendicular to mid-leg • Collimate to skin borders on lateral and medial sides. • Leave collimation open from top to bottom • ** can go up to 44 or 48 SID to include more of part** Seen on Radiograph • • • • The entire tibia and fibula both ankle and knee joint the condyles of tibia and femur in profile the intercondylar eminence centered in the intercondylar fossa • some imposition of distal and proximal tib/fib Lateral Tib/Fib • 14 X 17 diagonally • shield • Marker Part position for lateral • Patient on side with injured side down • flex knee about 45 degree to ensure true lateral • plane of patella should be perpendicular to IR • opposite leg behind injured one • both joints included on IR •40 SID Central Ray • • • • perpendicular to mid-leg collimation to skin borders on sides open fully top to bottom ** can go up to 44 or 48** Seen on Radiograph • • • • • Entire tib/fib both joints tibial tuberosity in profile fibula head imposed by tibia distal fibula imposed on posterior portion of tibia • femoral condyles superimposed. !!!Important Note!!!! • If you can not fit entire leg on on film... • You must include the joint nearest the injury on the film and take a separate picture of the other joint.