Pediatric foot (medial oblique view)
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The medial oblique foot view for pediatrics is one of three views performed to examine the phalanges, metatarsals and tarsal bones of the foot.
This projection is useful in diagnosing fractures; particularly 5th metatarsal fractures, soft tissue effusions, joint space abnormalities and localizing foreign bodies in pediatric patients.
the patient is supine with the affected knee flexed
plantar aspect of the affected foot resting on the image receptor
the foot is medially rotated until the plantar surface is at a 45° angle to the image receptor
base of the 3rd metatarsal
lateral to the skin margins
anterior to the skin margins of the distal phalanges
posterior to the skin margins of the calcaneum
18 cm x 24 cm
Image technical evaluation
The patient's foot is adequately obliqued when the 5th metatarsal is demonstrated as free from superimposition with no superimposition of the 3rd to 5th metatarsals. The bases of the 1st and 2nd metatarsals will demonstrate superimposition 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 foot 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