Ankle - Stress ProjectionsThis is a featured page

Radiographic Positioning


Adult
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Name of projection Ankle - Stress Projections (Forced Inversion + Forced Eversion)
Area Covered Ankle - distal third of the tibia and fibula, proximal half of the metatarsals, lateral and medial malleoli, talus
Pathology shownAnkle joint for evaluation of joint separation and ligament tear or rupture under inversion and eversion stresses.
Radiographic AnatomyAnkle Radiographic Anatomy
IR Size & Orientation 24cm x 30cm
Landscape, divided in two usually fits two ankle projections, use lead masking for unused area
Film / Screen Combination Detail
(CR and DR as recommended by manufacturer)
Bucky / Grid No
FilterNo
Exposure 60 kVp
3.2 mAs
FFD / SID 100cm
Central Ray CR directed to the midpoint between the malleoli, in line with the medial malleolus (to show the tibiotalar joint space open)
Perpendicular to the IR
Collimation To lateral skin margins and to include the distal third of the tibia and fibula and proximal half of the metatarsals
Markers Distal and lateral
Marker orientation AP
Shielding Gonadal (check your department's policy guidelines)
RespirationNot applicable
Positioning
  • 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
  • Ankle is then manually stressed with both inversion and eversion stresses
  • Lead protection (apron + gloves) is required for the individual applying the stress to the ankle
Critique

Positioning
  • A true AP position is achieved with no rotation
  • The appearance of the joint space may vary greatly depending on the severity of ligament damage
Area Covered
  • Distal third of the tibia and fibula, proximal half of the metatarsals, lateral and medial malleoli, talus, soft tissues
Collimation
  • 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
Exposure
  • Bony trabecular patterns and cortical outlines are sharply defined
  • Soft tissues are visualised
  • No motion artifacts
Special Notes



AndyC
AndyC 		Latest page update: made by AndyC , Jun 17 2011, 5:09 PM EDT (about this update About This Update AndyC Edited by AndyC

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