Ankle series (pediatric)

Last revised by Andrew Murphy on 23 Mar 2023

The ankle series for pediatrics consists of an anteroposterior, mortise and a lateral projection. Depending on the child's age and the departmental protocol, the mortise view may or may not be performed.

  • trauma with a suspected fracture

  • suspected dislocation

  • inability to weight-bear

The use of gonadal and fetal shielding has been deemed as non-beneficial to patients' health in current evidence 1-3 and may or may not be useful for pediatric extremity imaging. Placing gonadal shielding can increase the examination time and may cause the child more stress.

The major difficulty in pediatric ankle radiography relates to:

To overcome this, a variety of techniques can be used 4:

  • distract the patient with toys, games and/or conversation

  • using the swaddling technique; wrap the child in a blanket to promote comfort and sleep

Children will find it difficult to keep their ankle still; particularly if the limb is injured. As the child will be supine, it is helpful to have the parent in the child's direct line of sight in order to keep the child calm. 

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