From the Guidelines
The best radiographic views for a foot X-ray include anteroposterior (AP), medial oblique, and lateral projections, with weight-bearing views preferred when possible, as recommended by the most recent guidelines 1. These views provide comprehensive visualization of the bones and joints of the foot, allowing for the detection of various pathologies. The AP view shows the metatarsals, phalanges, and tarsal bones from a top-down perspective, while the lateral view displays the longitudinal arch and alignment of the foot bones. The medial oblique view helps visualize the metatarsal bases and intermetatarsal spaces that might be obscured in other views.
Key considerations for foot X-ray views include:
- Weight-bearing views are preferred to assess alignment under load and detect dynamic abnormalities, such as joint mal-alignment or fracture displacement 1.
- Non-weight-bearing radiographs can be obtained if the patient is unable to bear weight on their feet, but may not demonstrate malalignments that are more apparent in the standing position 1.
- Additional specialized views, such as a sesamoid view or calcaneal axial view, may be necessary for specific foot conditions 1.
Proper positioning and technique are crucial for diagnostic quality images, and the choice of views should be guided by the clinical suspicion and the patient's specific condition, as outlined in the guidelines 1.
From the Research
Radiographic Views for Foot X-ray
- The standard radiographic views for a foot X-ray include anteroposterior (AP), lateral, and oblique views 2.
- A study published in the Foot & ankle international journal in 2013 found that a standing anteroposterior (AP) radiograph of the foot can be used to assess complex foot deformities using the Tripod Index (TI) 3.
- Another study published in the AJR. American journal of roentgenology in 2000 found that reducing the ankle radiographic series from three to two views would result in a small but significant decrease in the detection of fractures of the ankle and foot 4.
- The lateral and mortise views alone appear sufficient for ankle fracture diagnosis, implying a substantial decrease in radiation and cost savings to the patient 5.
Specific Views
- The anteroposterior view is useful for assessing the alignment of the foot and the presence of fractures 4, 3.
- The lateral view is useful for assessing the presence of fractures and the alignment of the foot 4, 5.
- The oblique view is useful for uniquely revealing abnormalities and increasing the confidence of the final radiographic diagnosis 2.