The lateral foot view for pediatrics is one of three views in order to examine the phalanges, metatarsals and tarsal bones of the foot.
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Indications
This projection demonstrates the foot joint orthogonal to the natural anatomical position. It is useful in diagnosing fractures, soft tissue effusions, joint space abnormalities and localizing foreign bodies in pediatric patients.
Patient position
the affected leg is externally rotated until the lateral aspect of the foot is resting on the image receptor
affected foot is slightly dorsiflexed
Technical factors
lateral projection
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centering point
base of metatarsals or midfoot
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collimation
superior to the talocrural joint
anterior to the skin margins of the distal phalanges
posterior to the skin margins of the calcaneum
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orientation
portrait
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detector size
18 cm x 24 cm
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exposure 1
50-55 kVp
1-2 mAs
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SID
100 cm
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grid
no
Image technical evaluation
The domes of the talus are superimposed with the tibiotalar joint open. Superimposition of metatarsals is demonstrated with the fifth metatarsal tuberosity in profile 2.
Practical points
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 foot is moved onto the detector.
Immobilization techniques
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