Foot (weight-bearing lateral view)
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Foot (weightbearing lateral view)
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The weightbearing lateral foot radiograph is is important in the assessment of foot alignment and the diagnosis of abnormalities that cause malalignment and foot pain. Nonweightbearing views (e.g. lateral foot radiograph) are would be inadequate for the assessment of alignment becauseas the bones of the feet are not in their functional state1
TechniqueIndications
TheThis view is key to the assessment of foot alignment and the diagnosis of abnormalities causing malalignment and foot pain, i.e. Lisfranc injury. This view may also be crucial in determining the integrity of any functional joint prior to a partial foot amputation or corrective surgery for pes planus.
Patient position
- patient stands on a stable, raised radiolucent platform (e.g. using wooden blocks) that matches the x-ray tube's lowest height
-
lateral aspect of foot is
planted on a solid surfacekept in contact with thelower leg perpendiculardetector - patient applies weight on affected foot
-
unaffected foot is lifted; if possible, the contralateral toes can be positioned posterior to the
floor (weightbearing surface). The cassetteaffected foot's calcaneus as counterbalance
Technical factors
- mediolateral projection
-
centring point
-
base of metatarsals or
detector plate is held parallelmidfoot
-
base of metatarsals or
-
collimation
- anteriorly to skin margin of the distal phalanges
- posteriorly to skin margin of the calcaneus
-
superior to the
axistalocrural joint
-
orientation
- landscape
-
detector size
- 18 cm x 24 cm
-
exposure
- 55-60 kVp
- 3-4 mAs
-
SID
- 100 cm
-
grid
- no
Image technical evaluation
- 5th metatarsal tuberosity is seen in profile
-
superior aspect of the
foot and the central beamtalar domes are superimposed -
tibiotalar joint is
directed through theopen
Practical points
With patient safety being first priority, ensure some support is provided for patients to hold onto as their affected injured foot perpendicularmay not be used to the axis of the foot (and the detector)applied pressure.
Nonambulatory patients
In nonambulatory patients, such as young children, simulated weightbearing can be achieved with a plastic board 1.
-<p>The <strong>weightbearing lateral foot radiograph</strong> is important in the assessment of foot alignment and the diagnosis of abnormalities that cause malalignment and foot pain. Nonweightbearing views (e.g. <a href="/articles/oblique-foot-radiograph">oblique foot radiograph</a>) are inadequate for the assessment of alignment because the bones of the feet are not in their functional state <sup><a href="/articles/foot-weightbearing-dorsiplantar-view">1</a></sup>.</p><h4>Technique</h4><p>The foot is planted on a solid surface with the lower leg perpendicular to the floor (weightbearing surface). The cassette or detector plate is held parallel to the axis of the foot and the central beam is directed through the foot perpendicular to the axis of the foot (and the detector).</p><h5>Nonambulatory patients</h5><p>In nonambulatory patients, such as young children, simulated weightbearing can be achieved with a plastic board <sup><a href="/articles/foot-weightbearing-dorsiplantar-view">1</a></sup>.</p>- +<p>The <strong>weightbearing lateral foot </strong>radiograph is important in the assessment of foot alignment and the diagnosis of abnormalities that cause malalignment and foot pain. Nonweightbearing views (e.g. <a href="/articles/foot-lateral-view-1">lateral foot</a>) would be inadequate for the assessment of alignment as the bones of the feet are not in their functional state.</p><h4>Indications</h4><p>This view is key to the assessment of <a href="/articles/weightbearing-foot-series-an-approach">foot alignment</a> and the diagnosis of abnormalities causing malalignment and foot pain, i.e. <a href="/articles/lisfranc-injury">Lisfranc injury</a>. This view may also be crucial in determining the integrity of any functional joint prior to a partial foot amputation or corrective surgery for <a href="/articles/pes-planus">pes planus</a>.</p><h4>Patient position</h4><ul>
- +<li>patient stands on a stable, raised radiolucent platform (e.g. using wooden blocks) that matches the x-ray tube's lowest height</li>
- +<li>lateral aspect of foot is kept in contact with the detector</li>
- +<li>patient applies weight on affected foot</li>
- +<li>unaffected foot is lifted; if possible, the contralateral toes can be positioned posterior to the affected foot's calcaneus as counterbalance</li>
- +</ul><h4>Technical factors </h4><ul>
- +<li><strong>mediolateral projection</strong></li>
- +<li>
- +<strong>centring point</strong><ul><li>base of metatarsals or midfoot </li></ul>
- +</li>
- +<li>
- +<strong>collimation</strong><ul>
- +<li>anteriorly to skin margin of the distal phalanges</li>
- +<li>posteriorly to skin margin of the <a href="/articles/calcaneus">calcaneus</a>
- +</li>
- +<li>superior to the <a href="/articles/ankle-joint-2">talocrural joint</a>
- +</li>
- +</ul>
- +</li>
- +<li>
- +<strong>orientation </strong><em> </em><ul><li>landscape</li></ul>
- +</li>
- +<li>
- +<strong>detector size</strong><ul><li>18 cm x 24 cm</li></ul>
- +</li>
- +<li>
- +<strong>exposure</strong><ul>
- +<li>55-60 kVp</li>
- +<li>3-4 mAs</li>
- +</ul>
- +</li>
- +<li>
- +<strong>SID</strong><ul><li>100 cm</li></ul>
- +</li>
- +<li>
- +<strong>grid</strong><ul><li>no</li></ul>
- +</li>
- +</ul><h4>Image technical evaluation</h4><ul>
- +<li>5th metatarsal tuberosity is seen in profile </li>
- +<li>superior aspect of the <a href="/articles/talus">talar</a> domes are superimposed </li>
- +<li>
- +<a href="/articles/ankle-joint-2">tibiotalar</a> joint is open</li>
- +</ul><h4>Practical points</h4><p>With patient safety being first priority, ensure some support is provided for patients to hold onto as their affected injured foot may not be used to the applied pressure.</p>
References changed:
- 1. John Lampignano, Leslie E. Kendrick. Bontrager's Textbook of Radiographic Positioning and Related Anatomy. (2017) ISBN: 9780323399661 - <a href="http://books.google.com/books?vid=ISBN9780323399661">Google Books</a>
Images Changes:
Image 1 X-ray ( create )
Image 2 X-ray (Lateral orthostatic) ( create )
Image 3 X-ray (Lateral) ( create )
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