Indications for imaging
Trauma, particularly a fall from a height onto feet. ?calcaneal
spur,
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Anatomy Demonstrated
Calcaneum and talo calcaneal joint axially
Ankle Axial Rt Anatomy
Meschan, I. 1955 An Atlas of Normal Radiographic Anatomy
Saunders, London
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Basic Patient Position
The patient sits on the table legs extended, long axis of
the limb in line with the long axis of the table, the foot is
dorsi flexed to bring the plantar aspect 90 to the film, a
bandage round the foot held by the patient may help to maintain
this dorsiflexion of the foot. the long axis of the foot is
positioned vertically.
Ankle Axial Lt Patient Position
Meschan, I. 1955 An Atlas of Normal Radiographic Anatomy
Saunders, London
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Radiation protection
Direct lead rubber gonad protection using a "half
apron".
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Central Ray
The vertical central ray is angles 40 cranially and centered tot
he base of the third metatarsal.
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Exposure Factors
| Kv |
mAS |
FFD (cm) |
Grid |
Focus |
AEC |
Cassette |
| 70 |
6 |
100 |
No |
Fine |
No |
18 x 24 cm |
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Evaluation of the Image
ID and markers must be present and correct in the appropriate
area of the film
Evidence of collimation on four sides equally around the
centering point.
Limits of the examination, superiorly the talocalcaneal joint,
inferiorly the skin surface laterally the skin surfaces. The
long axis of the calcaneum should be vertical and the
talocalcaneal joint space should be visible. (Note it is not so
on the example radiograph!)
Optimal exposure should penetrate all the bone structures and
contrast should be low enough to visualise fully the bone and
soft tissue structures.
If calcaneal spurs are suspected both sides should be examined.
Ankle Axial Rt, Radiograph
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Related Projections
Ankle AP and lateral
Tarsal bone projections
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| Additional modalities
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