What is X-RAY ANKLE AP AND LAT?

AP:
The ankle AP view is part of a three-view series and visualizes the distal tibia, distal fibula, proximal talus, and proximal fifth metatarsal.

LAT:
The ankle lateral view is part of a three-view ankle series; this projection is used to assess the distal tibia and fibula, talus, navicular, cuboid, the base of the 5th metatarsal, and calcaneus.

Indications

LAT:
This projection aids in evaluating fractures, dislocations, and joint effusions surrounding the ankle joint, and helps to assess the severity of a calcaneal fracture by measuring the Böhler angle and Gissane angle.

AP:
The true anteroposterior view of the ankle is often performed in the setting of ankle trauma and suspected ankle fractures in addition to the lateral and Mortise views of the ankle.

Other indications include:

• assessment of fragment position and implants in postoperative follow up
• evaluation of fracture healing
• evaluation of tibiofibular clear space and overlap in suspected syndesmotic injury
• evaluation of hindfoot deformities

In addition, this view can show bony diseases or lesions of the distal lower leg, talus and proximal fifth metatarsal.

Patient position

AP:

• the patient may be supine or sitting upright with their leg straighten on the table
• the foot is in dorsiflexion
• the toes will be pointing directly toward the ceiling

LAT:

• patient is in a lateral recumbent position on the table
• the lateral aspect of the knee and ankle joint should be in contact with the table resulting in the tibia lying parallel to the table
• the leg can be bent or straight
• foot in dorsiflexion
• place the opposite leg behind the injured limb to avoid over-rotation

Technical factors

AP:

• inferior-superior axial projection
• Centering point
  • the midpoint of the lateral and medial malleoli
• 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
• Orientation
  • portrait
• Detector Size
  • 24 cm x 30 cm
• Exposure
  • 50-60 kVp
  • 3-5 mAs
• SID
  • 100cm
• Grid
  • no

LAT:

• Mediolateral projection
• Centering point
  • the bony prominence of the medial malleolus of the distal tibia
• Collimation
  • anteriorly from the hindfoot to extent of the skin margins of the most posterior portion of the calcaneus
  • superior to examine the distal third of the tibia and fibula
  • inferior to the skin margins of the plantar aspect of the foot
• Orientation
  • portrait
• Detector Size
  • 18 cm x 24 cm
• Exposure
  • 50-60 kVp
  • 3-5 mAs
• SID
  • 100cm
• Grid
  • no