Broken ankle xray6/11/2023 The use of weight-bearing radiographs to assess the stability of supination-external rotation fractures of the ankle. When is a simple fracture of the lateral malleolus not so simple? Bone Joint J. Journal of Medical Imaging and Radiation Oncology. Diagnostic imaging of ankle syndesmosis injuries: A general review. ABC of Emergency Radiology, Third Edition. Emergency Department evaluation and management of foot and ankle pain. Academic Radiology, Vol 25, No 10, October 2018. The views and needs of program directors. Radiology Education in Medical School and Residency. Afraid you might miss something commonly missed or catastrophic? “Can’t Miss” Foot and Ankle Injuries.Find an abnormality and not sure which splint to apply? Read more about this in our SplintER Series: Common ED Splint Techniques.Why: Although this view exists, CT has better sensitivity and specificity for calcaneus fracture.When: High concern for calcaneus fracture.Case courtesy of Dr Maulik S Patel, įor further information, check out this CoreEM post about manual stress views. įigure 6: Example of medial space widening on an manual stress view. A standard ankle x-ray series consists of the AP, lateral and a 15 degree internal oblique (aka Mortise View).Did you fully examine the entirety of the fibula, the base of the foot, or the midfoot? If not, consider imaging these areas if the patient has clinical or symptoms on a physical exam.2 visits: Bring patient back for repeat films.2 occasions: Always compare with old x-rays if available.2 sides: If unsure regarding a potential pathologic finding, compare to another side.2 joints: Image above and below (especially for forearm and leg).2 abnormalities: If you see one abnormality, look for another.Does this patient even need an x-ray? Consider applying the Ottawa Ankle Rules.īefore we begin: Make sure to employ the rule of 2’s.20% of ankle injuries can have long-standing morbidity.4% of all visits to the ED involve the ankle.Why the ankle matters and the radiology rule of 2’s The Ankle Identify clinical scenarios in which an additional view might improve pathology diagnosis.Interpret traumatic ankle x-rays using a standard approach.When applicable, it will provide pertinent measurements specific to management, and offer a framework for when to get an additional view, if appropriate. We can do better! Enter EM:Rad, a series aimed at providing “just in time” approaches to commonly ordered radiology studies in the emergency department. Many of us likely received an approach to a chest x-ray, but approaches to other studies may or may not have not been taught. Radiology teaching during medical school is variable, ranging from informal teaching to required clerkships.
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