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Updated: Feb 15 2023

Adult Hindfoot Radiographs

NORMAL ANATOMY
 Osteology
  • Lateral view
  • Posterior view
  • Superior view
 Attachments
  • Posterior view
  • Medial view
  • Lateral view
  • Superior view
RADIOGRAPHIC VIEWS
 Lateral View
  • Positioning
    • patient
      • lateral decubitus on ipsilateral side
      • knee flexed 45° + foot dorsiflexed
    • beam
      • aim 2.5cm below medial malleolus
  • Indications
    • Bohler's angle
    • angle of Gissane
  • Critique
    • superimposition of fibula + posterior tibia
    • superimposition of talar domes
    • open tibiotalar joint + talonavicular joint + tarsal sinus
 Axial View
  • Positioning
METHOD
PATIENT
BEAM
Plantodorsal/Harris supine vs. seated knee extended + leg slightly IR + foot dorsiflexed base of 3rd metatarsal 40° cephalad
Dorsoplantar prone ankle elevated + foot dorsiflexed proximal anterior calcaneus 40° caudad
Dorsoplantar/Harris erect foot dorsiflexed mid-calcaneus 45° cephald
  • Indications
    • anterior + posterior calcaneus
  • Critique
    • visualization of entire calcaneus
    • visualization of sustentaculum tali
 Canale View 
  • Positioning
    • patient
      • supine
      • foot with max plantarflexion + pronated 15°
    • beam
      • aim at talar neck + 15° cephalad
  • Indications
    • talar neck
  • Critique
    • visualization of talar neck
 Broden View
  • Positioning 
    • patient
      • supine
      • leg IR 10/20/30/40° + foot dorsiflexed
    • beam
      • aim at lateral malleolus + 10/20/30/40° cephalad
  • Indications
    • posterior facet of talus = 10° shows posterior aspect, 40° shows anterior aspect
    • sustentaculum tali/middle facet of talus = 20-30° view
    • subtalar joint
NORMAL FINDINGS
  • Notable normal variants
    • os trigonum
      • sesamoid bone located posterior to posterior process of talus, usually unilateral
    • Steida’s process
      • elongated posterior process of talus
    • oblique talus
      • talonavicular subluxation that reduces with forced plantarflexion
Private Note