Lateral Toe Radiography

Introduction

There are three important considerations that impact on toe radiography

1. Lateral toe radiography is nothing if not tedious.
2. The doctor's request will often ask for "foot".
3. Toes are not considered important

Given the above, the lateral toe view is often omitted. This page examines the case for always including the lateral toe projection when the injury is toe rather than foot

Case 1

This patient presented after stubbing her foot on a door frame.

The AP foot image shows no displaced fracture	The oblique foot image demonstrates no convincing fracture

This is a steep reverse oblique view. No clearly identifiable displaced fracture is demonstrated	The lateral toe image demonstrates a fracture of the proximal phalange of the fourth toe with proximal retraction of the distal fragment

Discussion

In retrospect, there is subtle evidence of a spiral fracture of the proximal phalange of the 4th toe on the oblique foot image and the reverse oblique foot image. The lateral toe image not only demonstrates the fracture, it also demonstrates the displacement of the distal fragment.

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