Radiological Interpretation

Question 1

What are the three primary uses of imaging in foot and ankle assessments?

Answer 1

Diagnosis
Objective assessment
Monitoring of disease processes

Question 2

What are the standard views for foot X-rays?

Answer 2

Dorsal/Plantar (DP) – Also known as Anterior-Posterior (AP)
Medial Oblique (MO)
Lateral Oblique (LO)
Lateral
Axial (Tangential)

Question 3

What are the standard views for ankle X-rays?

Answer 3

Anterior/Posterior (AP)
Mortise View
Lateral View

Question 4

What does the mnemonic ABCD’S stand for in radiological interpretation?

Answer 4

A – Alignment
B – Bone Density
C – Cartilage Spacing
D – Distribution
S – Soft Tissues

Question 5

What are the key factors to assess in alignment on an X-ray?

Answer 5

Weight-bearing view is preferred
Multiple views aid diagnosis
Examine bones individually for malalignment
Assess biomechanical deformities (e.g., pes cavus, flatfoot)
Consider trauma, systemic diseases, congenital abnormalities

Question 6

How is bone density assessed in radiology?

Answer 6

Compare density to surrounding soft tissue and other bones

Look at cortical thickness (e.g., 2/3 of metatarsals)

Increased density – Seen in stress fractures, trauma, and systemic diseases (e.g., Paget’s disease)

Decreased density – Seen in osteoporosis, osteopenia, disuse, and systemic conditions

Question 7

Cartilage Spacing - Key Considerations

What are the key radiographic signs of joint space abnormalities?

Answer 7

Regular narrowing – Seen in Rheumatoid Arthritis (RA)

Irregular narrowing – Seen in Osteoarthritis (OA)

Joint space widening – Seen in early synovitis, Freiberg’s infraction, and acromegaly

Question 8

Which conditions commonly affect which joints?

Answer 8

Osteoarthritis (OA) – 1st MTPJ, tarsal joints, ankle joint

Rheumatoid Arthritis (RA) – PIPJs, MPJs, STJ (not ankle)

Gout – Randomly distributed

Psoriatic Arthritis – Distal joints, MPJs, calcaneus

Charcot Arthropathy – Tarsus

Ankylosing Spondylitis – Calcaneus

Question 9

What soft tissue abnormalities can be seen on X-rays

Answer 9

Diffuse swelling – Juvenile Idiopathic Arthritis (JIA)

Gas formation – Suggests infection (e.g., gas gangrene)

Soft tissue calcification – Seen in trauma, gout, endocrine disorders, and systemic diseases