The anteroposterior ankle view for pediatrics is one of three views in order to examine the distal tibia, distal fibula, proximal talus and proximal fifth metatarsal.
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Indications
This projection demonstrates the ankle joint in its natural anatomical position. It is useful in diagnosing fractures, joint space abnormalities and localizing foreign bodies in pediatric patients.
Patient position
the patient is supine with their affected foot in dorsiflexion
Technical factors
anteroposterior projection
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centering point
the midpoint of the lateral and medial malleoli
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collimation
laterally to the skin margins
superior to examine the distal third of the tibia and fibula
inferior to the proximal aspect of the metatarsals
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orientation
portrait
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detector size
18 x 24 cm
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exposure 1
50-55 kVp
1-2 mAs
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SID
100 cm
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grid
no
Image technical evaluation
No rotation of the ankle which is demonstrated by a closed lateral mortise and open medial mortise. The distal fibula should slightly superimpose the distal tibia 2. A physical metal marker is ideal for pediatric imaging.
Practical points
Preparing the room beforehand (setting up the detector, exposure and preparing lead gowns) is important as pediatric patients may not remain still when their affected ankle is moved onto the detector.
Immobilization techniques
It is important for the radiograph to be free from motion artifact and rotation to avoid repeated x-rays.
it may be necessary for the parent or radiographer to hold the patient in position
ideally the parent should be in the child's direct line of sight
techniques will vary based on the department
distraction techniques can be utilized to avoid scattered radiation to parents and staff 3
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