Ankle series
Updates to Synonym Attributes
Updates to Article Attributes
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The ankle series is comprised of an anteroposterior (AP), mortise and lateral radiograph. The series is often used in emergency departments to evaluate the distal tibia, distal fibula and the talus; forming the ankle joint.
Indications
- ankle trauma
- bony tenderness at the posterior edge or the tip of the lateral malleolus
- bony tenderness at the posterior edge or the tip medial malleolus
- inability to weight bear
- non-traumatic ankle pain
Projections
Standard projections
-
AP
- Demonstrates the ankle in it's natural anatomical position
-
mortise view
- AP with the foot internally rotated approximately 10° (often this correlates with fifth toe and heel vertical alignment)
- Internal rotation projects the fibula off the medial tibial plafond resulting uniformity of the joint space allowing for assessment of the distal tibiofibular syndesmosis
- The base of the 5th metacarpal is always included
-
lateral
- Projection 90° to the mortise view
- Demonstrates the calcaneum and talus in full profile
- must include the base of the 5th metatarsal
Additional projections
If an isolated distal tibial medial malleolus fracture is noted or a significant widening of the mortise joint a knee series should be performed to rule out a combination spiral fracture of the proximal fibula.
Internal or external stress can be performed to assess for dynamic widening of the syndesmosis indicating ligamentous injury.
-</ul><h5>Additional projections</h5><p>If an isolated distal tibial medial malleolus fracture is noted or a significant widening of the mortise joint a <a href="/articles/knee-series">knee series</a> should be performed to rule out a <a href="/articles/maisonneuve-fracture">combination spiral fracture</a> of the proximal fibula.</p><p> </p><p>Internal or external stress can be performed to assess for dynamic widening of the syndesmosis indicating ligamentous injury.</p>- +</ul><h5>Additional projections</h5><p>If an isolated distal tibial medial malleolus fracture is noted or a significant widening of the mortise joint a <a href="/articles/knee-series">knee series</a> should be performed to rule out a <a href="/articles/maisonneuve-fracture">combination spiral fracture</a> of the proximal fibula.</p><p>Internal or external stress can be performed to assess for dynamic widening of the syndesmosis indicating ligamentous injury.</p>
References changed:
- 1. Whitley AS, Jefferson G, Holmes K et-al. Clark's Positioning in Radiography 13E. CRC Press. ISBN:1444122355. <a href="http://books.google.com/books?vid=ISBN1444122355">Read it at Google Books</a> - <a href="http://www.amazon.com/gp/product/1444122355">Find it at Amazon</a><span class="auto"></span>
- 2. Fletcher R. Evidence-Based Medicine. 2003;8 (6): . <a href="http://dx.doi.org/10.1136/ebm.8.6.185">doi:10.1136/ebm.8.6.185</a><span class="auto"></span>
- Whitley AS, Jefferson G, Holmes K et-al. Clark's Positioning in Radiography 13E. CRC Press. ISBN:1444122355. <a href="http://books.google.com/books?vid=ISBN1444122355">Read it at Google Books</a> - <a href="http://www.amazon.com/gp/product/1444122355">Find it at Amazon</a><span class="auto"></span>
- Fletcher R. Evidence-Based Medicine. 2003;8 (6): . <a href="http://dx.doi.org/10.1136/ebm.8.6.185">doi:10.1136/ebm.8.6.185</a><span class="auto"></span>