Tibia and fibula series

Last revised by Andrew Murphy on 23 Mar 2023

The tibia/fibula is comprised of an anteroposterior (AP), and lateral radiograph. The series is often used in emergency departments to evaluate the entirety of the tibia and fibula after trauma. 

Indications

The tibia/fibula radiographs are performed for a variety of indications including:

  • trauma
  • obvious deformity following major midshaft impaction 
  • suspected foreign body 
  • inability to weight bear
  • osteomyelitis 

Projections

Standard projections
  • AP
    • demonstrates the lower limb in the natural anatomical position
  • lateral
    • projection 90° to the AP  view
    • must include both the knee and ankle joint
Modified trauma projections
  • horizontal beam lateral 
    • a modified projection 90° to the AP  view
    • demonstrates lower limb in a lateral profile 
    • must include both the knee and ankle joint
Additional projections

Dedicated joint views should be performed if there is suspicion of an occult knee or ankle injury.

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