The ankle horizontal beam lateral view is a modified lateral view part of a three view ankle series; this projection is used to assess the distal tibia and fibula, talus, navicular, cuboid, the base of the 5th metatarsal and calcaneus.
The horizontal beam lateral is a highly adaptable projection that can be used in trauma or with patients who are unable to ambulate to the desired standard lateral position.
- patient is in a supine position
- if the projection is mediolateral, the non-affected leg is placed on a stand in a flexed position to avoid superposition
- if the projection is lateromedial both legs can lay in their natural AP position
- foot in dorsiflexion if possible
- mediolateral/lateromedial horizontal beam projection
- bony prominence of the medial malleolus of the distal tibia
- bony prominence of the lateral malleolus of the distal tibia
- portrait or landscape
- 18 cm x 24 cm
- 50-60 kVp
- 3-5 mAs
- 100 cm
Image technical evaluation
The distal fibula should be superimposed by the posterior portion of the distal tibia.
The talar domes should be superimposed allowing for adequate inspection of the superior articular surface of the talus.
The joint space between the distal tibia and the talus is open and uniform.
In situations where the patient cannot be moved this projection be invaluable, it requires little to no patient positioning and can be replicated in ICU wards.
If possible, placing a sponge under the ankle in question will prevent any artefacts from bed/pillows in that are native to trauma rooms.
The projection can be done from either side depending on the makeup of the room and the patients' pathology.
The patient remains supine with an image receptor placed vertically adjacent to the lateral aspect of the upright ankle; the X-ray beam is directed horizontally, centred at the bony prominence of the medial malleolus of the distal tibia.
Superior-inferior malalignment of the superior aspect of the talus is resultant of the tibia not lying parallel to the image receptor. To adjust this, angle the tube superior-inferior to mimic the tibia laying parallel. This is not ideal but in trauma, it may be the only option.
Anterior-posterior malalignment of the talar domes is due to over or under rotation of the foot. To adjust this, angle the tube anterior-posterior to mimic correct positioning. This is not ideal but in trauma, it may be the only option.
- chest radiography
- abdominal radiography
upper limb radiography
shoulder girdle radiography
- scapula series
- shoulder AP view
- shoulder internal rotation view
- shoulder external rotation view
- shoulder axial view
- shoulder modified trauma axial
- shoulder supine lateral
- shoulder modified supine lateral
- shoulder Y lateral view
- shoulder AP glenoid view
- shoulder apical oblique view (Garth view)
- humerus (neck) AP view
- humerus axial (bicipital groove) view (Fisk view)
- shoulder outlet view (Neer view)
- Stryker notch view
- acromioclavicular joint series
- clavicle series
- sternoclavicular joint series
- arm and forearm radiography
- wrist and hand radiography
- wrist series
- scaphoid series
- hand series
- thumb series
- fingers series
- rheumatology hands series
- bone age series
- shoulder girdle radiography
lower limb radiography
- pelvic girdle radiography
- pelvis series
- hip series
- sacroiliac joint series
- thigh and leg radiography
- femur series
- knee series
- tibia/fibula series
- ankle and foot radiography
- ankle series
- foot series
- calcaneus series
- toes series
- pelvic girdle radiography
- skull radiography
sinus and facial bone radiography
- facial bones
- Caldwell view (angled skull PA view)
- nasal bones
- zygomatic arches
- paranasal sinuses
- temporal bones
- dental radiography
- cervical spine radiography
- thoracic spine radiography
- lumbar spine series
- sacrococcygeal radiography
- scoliosis radiography