Foot series (pediatric)

Last revised by Andrew Murphy on 23 Mar 2023

The foot series for pediatrics consists of a dorsoplantar (DP), medial oblique and a lateral projection. Depending on the child's age and the departmental protocol, the medial oblique view may or may not be performed.

  • trauma with suspected fracture

  • suspected dislocation

  • foreign body detection

  • inability to weight-bear

Patients should remove shoes and socks on the affected foot. 

The use of gonadal and fetal shielding has been deemed as non-beneficial to patients' health in current evidences 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. However, shielding can also reduce the family's anxiety in relation to radiation dose. Therefore, the decision to use shielding will depend on departmental protocols and the radiographer's judgment.

The major difficulty in pediatric foot 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 foot 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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Cases and figures

  • Case 1: AP
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  • Case 1: oblique
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  • Case 2: normal foot x-ray (2-year-old)
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  • Case 3: lateral
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