Calcaneus (axial view)

Mr Andrew Murphy et al.

Calcaneus axial view is part of the two view calcaneus series, this projection is best used to asses the talocalcaneal joint and plantar aspects of the calcaneus. The axial view has a diagnostic sensitivity of 87% for calcaneus fractures 1

  • patient is supine or seated with the affected limb extended 
  • the posterior aspect of the ankle is resting on the image receptor 
  • foot is dorsiflexed until the plantar surface is running perpendicular to the image receptor 
  • dorsiflexion can be aided with tape or fabric wrapped around the distal phalanges to be pulled backward by the patient, this should only be performed if the patient can tolerate it 
  • plantodorsal projection
  • centring point
    • the central ray is angled 40° cephalad from the long axis of the foot centred at the base of the 3rd metatarsal (midfoot)
  • collimation
    • lateral to the skin margins
    • anterior to distal third of the foot
    • posterior to the skin margins of the calcaneus 
  • orientation  
    • portrait
  • detector size
    • 18 cm x 24 cm
  • exposure
    • 60-70 kVp
    • 8-15 mAs
  • SID
    • 100 cm
  • grid
    • no
  • entire calcaneus is visible from the posterior tuberosity to the talocalcaneal joint
  • sustentaculum tali is evident on the medial aspect of the image
  • subtalar joint should be visible on the superior portion of the image

Although it is preferred to have the patient's foot in full dorsiflexion, many times this will not be possible due to pain. In these scenarios it is just as effective to increase the angle to compensate for lack of dorsiflexion. 


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Article Information

rID: 44851
Section: Radiography
Synonyms or Alternate Spellings:
  • axial heel

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    Figure 1: calcaneal anatomy
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    Case 1: calcaneal fracture
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    Case 2: calcaneal fracture
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