Presentation
Left ankle pain and swelling, still able to weight-bear.
Patient Data
Joint space narrowing is seen in the ankle and subtalar joints, in keeping with known chronic erosive arthropathy. No cortical destruction or erosion.
Diffuse soft tissue swelling is seen around the ankle and foot.
Healing fractures of the 5th metatarsal base and proximal phalanx big toe are noted.
Case Discussion
Weight-bearing views are specialised, functional projections allowing the patient's bone alignment to be assessed appropriately.
Due to the various ways that a lateral weight-bearing image can be set up in an x-ray room, patients tend to be positioned with their feet one in front of the other. However, the lower limb of interest is often the weaker, painful side, and they may favour balancing on their stronger, unaffected leg. This causes weight distribution to be uneven. It is hence important to encourage your patient to place normal, even weight distribution on both feet.
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