Ankle (AP view)

Ankle AP view is part of a three view series of the distal tibia, distal fibula, proximal talus and proximal metatarsals.

Patient position

• the patient may be supine or sitting upright with their leg straighten on the table
• the foot is in dorsiflexion
• the toes will be pointing directly toward the ceiling

Technical factors

• AP projection
• centering point
  • the midpoint of the lateral and medial malleoli
• collimation
  • laterally to the skin margins
  • superior to examine the distal third of the tibia and fibula
  • inferior to the proximal aspect of the metatarsals
• orientation  
  • portrait
• detector size
  • 24 cm x 30 cm
• exposure
  • 50-60 kVp
  • 3-5 mAs
• SID
  • 100 cm
• grid
  • no

Image technical evaluation

The distal fibula should be slightly superimposed the distal tibia.

The lateral and medial malleoli of the distal fibula and tibia are in profile.

The tibiotalar joint space should be open, yet the full mortise joint should not be visualized on the AP.

Practical points

This view can be thought of as the literal anteroposterior of the ankle. Most patients will naturally place their foot in this position.

Although dorsiflexion is essential in both the AP and the mortise view it should be noted that during trauma this may not be possible.