Pediatric ankle (lateral view)
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The lateral projection demonstrates the ankle joint orthogonal to the AP ankle view. It is useful in diagnosing fractures, joint space abnormalities and localizing foreign bodies in pediatric patients.
the patient is in a lateral recumbent position with the lateral aspect of the ankle in contact with the detector
affected foot in dorsiflexion
the midpoint of the lateral and medial malleoli
laterally to the skin margins
superior to examine the distal third of the tibia and fibula
inferior to the proximal aspect of the metatarsals
18 x 24 cm
Image technical evaluation
The talar domes should be seen superimposed to allow for assessment of joint space articulation and the superior surface of the talus. The distal fibula should be superimposed on the posterior aspect of the distal tibia 2. A physical metal marker is ideal for pediatric imaging.
Preparing the room beforehand (setting up the detector, exposure and preparing lead gowns) is important as pediatric patients may not remain still when their affected ankle is moved onto the detector.
It is important for the radiograph to be free from motion artifact and rotation to avoid repeated x-rays.
it may be necessary for the parent or radiographer to hold the patient in position
ideally the parent should be in the child's direct line of sight
techniques will vary based on the department
distraction techniques can be utilized to avoid scattered radiation to parents and staff 3