Pediatric foot (medial oblique view)

Last revised by Andrew Murphy on 23 Mar 2023

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

  • anteroposterior projection

  • centering point

    • base of the 3rd metatarsal

  • collimation

    • lateral to the skin margins

    • anterior to the skin margins of the distal phalanges

    • posterior to the skin margins of the calcaneum

  • orientation  

    • portrait

  • detector size

    • 18 cm x 24 cm

  • exposure 1

    • 50-55 kVp

    • 1-2 mAs

  • SID

    • 100 cm

  • grid

    • no

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

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Cases and figures

  • Normal pediatric foot series
    Drag here to reorder.
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