• Patient's leg fully extended on the table
• Place IR under the ankle
• Place the lower leg in the AP position
• The foot is dorsiflexed so that the plantar surface is perpendicular to the table
• The lateral and medial malleoli will not be equidistant from the IR (the lateral malleoli will be closer to the IR)
• Centre to the midpoint between the malleoli

• PACEMAN

• A true AP position is achieved evidenced by

1. The lateral joint space is not open
2. The medial mortice is open

• The tibiotalar joint is open and at the centre of collimation

• Distal third of the tibia and fibula, proximal half of the metatarsals, lateral and medial malleoli, talus, soft tissues
  

• Centre: The midpoint between the malleoli
• Shutter A: Open to include thelateral skin margins
• Shutter B: Open to include thedistal third of the tibia and fibula and the proximal half of the metatarsals
  

• Bony trabecular patterns and cortical outlines are sharply defined
• Soft tissues are visualised

• Internal rotation of the leg will show no superimposition of the talus on the fibula
• External rotation of the leg will show greater superimposition of the tibia and talus on the fibula