What is the optimal angle for a calcaneal (calc) axial radiograph?

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From the Research

To calculate the axial radiograph angle of the calcaneus, position the patient with the limb at a desired angle to the X-ray beam, typically between 15-45 degrees, and use a goniometer to measure the precise angle before exposure, with the most relevant angle being the Böhler angle, which should be greater than 20° post-surgically for optimal outcomes, as evidenced by a study published in 2020 1. When calculating the axial radiograph angle, it is essential to consider the anatomical structure being examined and the clinical question being addressed.

  • The Böhler angle is a critical measurement in assessing calcaneal fractures, and a post-surgical angle greater than 20° is associated with better functional outcomes and lower pain scores, as shown in a study published in 2020 1.
  • The use of computed tomography (CT) scans can provide valuable information on the subtalar joint and fracture lines, allowing for more accurate characterization of calcaneal fractures, as discussed in a study published in 2011 2.
  • A measurement technique using the lateral malleolus and longitudinal bone trabeculae of the posterior calcaneal tubercle as references can provide a reliable calculation of the calcaneal varus angle, as demonstrated in a study published in 2015 3.
  • The calculation of axial angles is crucial in visualizing anatomical relationships and avoiding diagnostic errors or missed pathology, as emphasized in various studies, including one published in 2005 4.
  • It is essential to follow institutional protocols and consider the specific clinical question being addressed when determining the axial angle requirements, as different angles may be necessary for different anatomical structures and clinical scenarios, as highlighted in a study published in 1985 5.

References

Research

Surgically treated calcaneal joint fractures: what does postoperative computed tomography give us?

Revista espanola de cirugia ortopedica y traumatologia (English ed.), 2020

Research

Multidetector CT evaluation of calcaneal fractures.

Radiographics : a review publication of the Radiological Society of North America, Inc, 2011

Research

Fractures of the calcaneus: a review with emphasis on CT.

Radiographics : a review publication of the Radiological Society of North America, Inc, 2005

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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