Foot - Medial Oblique

Radiographic Positioning

Adult

Other related pages of interest Applied Radiography Radiographic Anatomy Radiographic Protocols

Name of projection	Foot - Oblique (Medial Rotation)
Area Covered	Entire foot from distal phalanges to the calcaneus, and the talus
Pathology Shown	Fractures, dislocation, foreign body, joint space abnormalities
Radiographic Anatomy	Foot Radiographic Anatomy
IR Size & Orientation	24 x 30cm Portrait, divided in two can usually fit 2 views, use lead masking for unused area
Film / Screen combination	Detail (CR and DR as recommended by manufacturer)
Bucky / Grid	No
Filter	Yes - when using film a thin filter covering phalanges and distal metatarsals
Exposure	57 kVp 3.2 mAs
FFD / SID	100cm
Central Ray	Directed at base of the 3rd metatarsal Perpendicular to the IR
Collimation	Outer skin margins of the foot on four sides
Markers	Distal and Lateral marker orientation AP
Shielding	Gonadal (check your department's policy guidelines)
Respiration	Not applicable
Positioning	Patient supineon the X-ray table or barouche Flex the knee of the affected leg Place IR under foot parallel to its long axis Internally (medially) rotate the leg until the plantar surface is at a 45° angle to the IR (refer to Special Notes below) Use a sponge for stabilising the foot in this position
Critique PACEMAN	Positioning The correct obliquity is evidenced by the 1st and 2nd metatarsals should only be superimposed at the bases 3rd through 5th metatarsals should not be superimposed base of the 5th metatarsal (tuberosity) should be well shown the tarsal sinus is well shown joint spaces around the cuboid are open the cuboid is seen in profile Area Covered The entire foot should be demonstrated to show all phalanges, metatarsals, calcaneum and proximal talus Collimation Centre: The base of the third metatarsal Shutter A: Open to include the outer skin margins of the lateral and medial sides of the foot Shutter B: Open to include the soft tissue of the toes and the proximal calcaneus Exposure Bony trabecular patterns and cortical outlines are sharply defined Soft tissues are visualised Correct use of a filter will give uniform density of phalanges and metatarsals
Special Notes	Effect of over rotation the base of the 5th metatarsal is superimposed over the tubercle of the 4th metatarsal the joint space between the 4th and 5th metatarsals is closed Effect of under rotation the base of the 4th metatarsal is superimposed over the base of the 5th metatarsal the joint space between the 4th and 5th metatarsals is closed Angle of obliquity This angle will vary according to the arch of the foot. 45° for a normal arch 30° for a low arch 60° for a high arch