Toes

Question 1

Projections for Toes

Answer 1

•AP/ AP Axial Projection
•PA Projection
•AP Oblique Projection (Medial Rotation)
•AP Oblique Projection (Lateral Rotation)
•PA Oblique Projection (Medial Rotation)
•Lateral Projection (Latermedial/Mediolateral)

Question 2

AP/AP Axial Projection
Part Position

Answer 2

• Supine/Seated
  Part Position:
• Knee flexed; 15o foam wedge under foot

Question 3

AP/AP Axial Projection
Central Ray

Answer 3

Perpendicular or 15° posteriorly
entering the 3rd MTP joint

Question 4

STRUCTURES SHOWN

• Phalanges & distal portion of
  metatarsals

Answer 4

AP/AP AXIAL Projection

Question 5

recommended to open the joint paces and reduce foreshortening

Answer 5

AP Axial

Question 6

PA Projection
Part Position

Answer 6

Patient Position:
- Prone (IP joints parallel to Central
Ray Angulation); dorsal aspect against IR

Question 7

PA Projection
Central Ray

Answer 7

Perpendicular to 3rd MTP joint

Question 8

Structures Shown
•IP joint spaces are well
visualized

Answer 8

PA Projection

Question 9

AP Oblique Projection (Medial Rotation)
Part Position

Answer 9

• Supine/seated
  Part Position:
• Knee flexed; lower leg & foot rotated
  medially 30-45°

Question 10

AP Oblique Projection (Medial Rotation)
Central Ray

Answer 10

Perpendicular to 3rd MTP joint

Question 11

Structures Shown
- 2nd-5th MTP joint spaces;
- 1st-2nd toes
- 1st (not always opened)

Answer 11

AP Oblique Projection (Medial Rotation)

Question 12

AP Oblique Projection (Lateral Rotation)
Part Position

Answer 12

• Supine/seated
  Part Position:
• Knee flexed; lower leg & foot rotated
  laterally 30-45°

Question 13

AP Oblique Projection (Lateral Rotation)
Central Ray

Answer 13

Perpendicular to 3rd MTP joint

Question 14

Structures Shown
•4th-5th toes

Answer 14

AP Oblique Projection (Lateral Rotation)

Question 15

PA Oblique Projection (Medial Rotation)
Part Position

Answer 15

• Lateral recumbent
  Part Position:
• Ball of the foot forms an angle of
  approximately 30° to the horizontal, or have the patient rest the foot against a foam wedge or sandbag.
• Center the IR half to the third MTJ, and adjust it so that its midline is parallel with the long axis of the foot.

Question 16

PA Oblique Projection (Medial Rotation)
Central Ray

Answer 16

Perpendicular to the MTJ

Question 17

Structures Shown

• Toes and the distal portion of
  the metatarsals
  rotated laterally
• 2nd through 5th
  MTJ
• 1st (not always
  opened)

Answer 17

PA Oblique Projection (Medial Rotation)

Question 18

Lateral Projection (Latermedial/ Mediolateral)
Part Position

Answer 18

Lateral recumbent
Prevent superimposition
Tape the unaected toes
Separate toes using gauze pad

Part Position (Great Toe, 2nd Toe)
•Patient lying on unaffected side

Part Position (3rd, 4th, 5th)
•Patient lying on affected side

Question 19

Lateral Projection (Latermedial/ Mediolateral)
Central Ray

Answer 19

• Perpendicular to (IP) joint of great toe
• Perpendicular to proximal interphalangeal (PIP) joint of aected toe (2nd - 5th)

Question 20

Structures Shown

• Lateral projection of the phalanges of the toe and IP articulations free of other toes

Answer 20

Lateral Projection (Latermedial/ Mediolateral)

Question 21

Either ___ is adequate for the third (middle) toe

Answer 21

oblique position

Question 22

• Evidence of proper collimation, side marker
• Entire toe
• No superimposition of
  adjacent toes (if cannot be avoided, proximal phalanx must be free from superimposition)
• Toes in true lateral:
  ● Concave, plantar surfaces
  of the phalanges
• Open IP joint spaces
• Bony trabecular detail and
  soft tissue

Answer 22

Lateral Projection (Latermedial/ Mediolateral)