Roentgen ankle

Currently, in traumatology, more often you have to deal with various injuries. One of the weakest organs that are most often injured is the foot. To damage it is quite simple. To do this, do not need heavy falls, shocks, and displacements. Quite easy to push, and the foot will be damaged. Also sometimes it is only necessary to turn a little leg - and the foot will also be injured. This is especially true for women, as they often wear heels. Also often with similar injuries experienced professional athletes, for example, when performing physical exercises without a preliminary warm-up, or in the regime of increased load, fatigue. In this regard, one of the most sought-after diagnostic methods is currently the x-ray of the ankle.

[1], [2], [3], [4], [5], [6], [7], [8], [9], [10]

Indications for the procedure

An ankle can be assigned primarily to a diagnostic purpose in order to establish the type and nature of the injury to which the ankle was subjected. It is used to diagnose fractures, joint dislocation, dislocations, cracks, sprains, tears and ligament tears. It is also used for the purpose of examining the foot to determine the causes of edema development, hematomas, damage, internal defects and bleeding.

The need for this type of X-ray also occurs in connection with changes in normal mobility, shape, structure, appearance of the foot, and also with intense pain sensations in the ankle. Using X-ray can confirm such diagnoses as arthritis, arthrosis, diagnose various types of inflammatory processes, edema. The procedure also allows to identify tumors, deformities.

[11], [12], [13], [14]

Preparation

The procedure does not require long preparatory measures (in terms of compliance with a specific diet, rest, work of physical activity). Preparation can be limited solely to psychological and moral preparation for the forthcoming study.

The doctor should explain to the patient who, in what way, and for what purpose will conduct the study, and also to talk about the expected expectations from the procedure. The patient should approximately imagine the course of the procedure, understand its essence and significance. It should also have an idea of the purpose for which it is conducted, what risks arise in connection with the procedure.

During the study, the victim must take the necessary position on the couch. In this case, the laboratory assistant or the doctor conducting the research should tell or show the patient the position that he should take. Legs should be bent at the knees, and put the feet on a flat surface. If it is necessary to identify an ankle injury, the x-ray is carried out in the lateral projection. For this patient must be seated. The injured limb should be placed on a pedestal.

In order to determine the degree of transverse or longitudinal flat feet, it is necessary to provide increased load on the ankle joint. When examining the arch of the foot, the patient should stand on one foot, and the second should be tightened.

Also, in the process of preparation, a preliminary anamnesis should be collected. For example, if an X-ray procedure was performed 6 months ago, the X-ray can not be repeated, because it is associated with a high level of radiation load on the body. It is also important to inform the doctor about pregnancy, breastfeeding, as this is a contraindication for the procedure. Exceptions are cases of severe injuries. In this case, a special lead apron is required, which can provide protection against radiation.

[15], [16], [17]

Ankle joint placement

To conduct the study, the ankle joint should be properly placed. To start, a visual assessment of the lesion is performed, and then an X-ray examination is performed. The whole procedure takes no more than 10 minutes.

Most often, a forward posterior projection is used. The advantage of this projection is that it eliminates the rotation of the foot. To conduct the study in this position, the patient should take a prone position, the legs should be stretched along the surface of the table, horizontally. The sagittal plane of the foot should form an angle of 90 degrees with the surface of the table.

Also, the study can be carried out in a direct rear projection with the rotation of the foot. To do this, it is necessary to lay the leg in the same way as it fits in the rear projection (lying, legs along the table). The difference is that the foot should be deployed inward, at the same time an angle of 15-20 degrees is formed.

When examining the ankle in the lateral projection, the patient is lying in a position lying on its side. The limb that does not undergo examination should be pressed against the stomach, and the foot of the other surface must come in contact with the lateral surface. At the same time, the heel should be pressed tightly against the cassette, the foot should be turned about 15-20 degrees inwards.

The study can be conducted with or without load on the foot.

[18]

Technique of the ankle x-ray

The essence of the research is that x-rays pass through the tissues that need to be examined. They pass through soft tissues, and are retained by hard tissues. The picture shows the differences between healthy and damaged tissues, as well as between soft and hard tissues. Modern equipment is able to receive high quality images, with well-visualized complexes.

The research is carried out in different projections. Most often, a straight and a side projection is used. The patient is laid out in the necessary position, then the study is directly conducted, passing the X-rays through the tissues being examined. The ankle must be fixed in such a position, in which the most visualized is the area to be examined.

X-ray of the external malleolus

The procedure should be performed in the supine position. At the same time, an obligatory condition is the preservation of the immobility of the investigated part of the body. The patient is placed in one of three possible positions and fixes the leg in such a way as to maximize the visualization of the required site.

Contraindications to the procedure

Among the contraindications include pregnancy, lactation. Contraindication is also age till 15 years. Also it is impossible to carry out a study often, the frequency should not exceed 3-4 times a year.

X-ray of the ankle in pregnancy

X-ray examination is contraindicated during pregnancy, especially in the first trimester. Lactation is also a contraindication. Since at this time the body receives a radiation load (radiation radiation), which is dangerous for both the mother and the fetus. Radiation can cause various genetic and somatic mutations in the fetus, developmental defects, serious damage from the nervous, hormonal, immune system. Sometimes the fetus may even die. Especially dangerous is exposure in the first trimester, because during this period, the protection of the fetus is minimal, and it is as vulnerable as possible. Lactation is contraindicated due to the fact that radiation can accumulate in breast milk.

However, despite the contraindications, the procedure can be carried out in any of these cases with acute necessity. In this case, to minimize exposure, it is necessary to use a special protective apron, or protective lining. For example, pregnant women use lining on the stomach and pelvic region.

[19], [20], [21], [22], [23], [24], [25], [26], [27]

Normal performance

In a healthy person, soft tissue is visualized separately in the image, and bone tissue is seen separately. The uniformity is observed: the lines of discontinuity are not reflected, the fabric looks homogeneous and homogeneous.

Normally, there should be an angle between the foot and the shin. Normally, it should be 130 degrees. It may be lower, but the excess of these indicators indicates a pathology. The arch of the foot is normally 35 mm, or more.

Fracture of the ankle on x-ray

If there is a suspicion of a fracture, the doctor prescribes an X-ray examination. In this case, most often it is necessary to compare the healthy leg and the damaged one. The fracture in the image is clearly visible in the form of a pronounced fault line located on the bone tissue.

[28], [29], [30]

Complications after the procedure

The procedure has no serious consequences. No injuries occur, the load on the body does not increase. Exceptions are cases of frequent procedure. You can not do x-rays more than once every 6 months. This is due to the fact that each procedure is associated with a certain level of exposure. There may also be negative consequences for pregnant women. Radiation can cause mutations, gene defects.

The occurrence of complications after X-rays is unknown. Theoretically, it is believed that X-ray radiation can cause an allergic reaction in people with increased allergization. However, there is no evidence to support this theoretical position.

[31], [32], [33], [34], [35]

Care after the procedure

The procedure does not require special care. After an x-ray of the ankle has been performed, a person can return to his daily routine immediately after the procedure.

[36], [37], [38]