X-ray of the foot for adult and child

What is radiography, they know almost everything. This is a specific and very common form of diagnosis, which uses X-rays. However, not everyone knows in which cases this study is scheduled, for example, when it is necessary to make a foot X-ray?

Both the traumatologist and the orthopedist can prescribe a foot x-ray, depending on the problem with which the patient sought medical help. This type of diagnosis is indispensable for injuries and diseases of the foot: the study will help to clarify the diagnosis, determine the treatment tactics, monitor the progress of the patient’s recovery.

Indications for the procedure

According to statistics, the most common pathology of the foot is osteoarthritis: its “popularity” is associated with the mechanical development of cartilage (as a result of age-related changes or against the background of excess weight). But, in addition to osteoarthritis, x-rays of the foot are also prescribed for other inflammatory processes:

• rheumatoid arthritis;
• joint damage in psoriasis;
• ankylosing spondyloarthritis;
• Reiter's disease.

Frequent pathologies of the foot also include gouty joints and diabetic neuropathic osteoarthropathy.

Tumor processes in the foot occur relatively rarely: as a rule, they are benign, and are more often represented by cysts or enchondromas. Radiography is the best suited for the diagnosis of such tumors.

X-rays of the foot are also prescribed for traumatic injuries - for example, for fractures of bone structures. Thus, X-rays can determine the anatomy of damage, its orientation, linearity, the degree of grinding of the bone; X-rays are also needed to differentiate a fracture from dislocation.

General indications for foot X-ray are:

• impaired bone integrity;
• tumor processes;
• flat feet;
• arthritis (rheumatoid, psoriatic, septic, osteoarthritis);
• Reiter's disease;
• osteoarthropathy, ankylosing spondyloarthritis).

A common problem that requires radiological confirmation is flatfoot, in which the biomechanics of the foot is disturbed as a result of loss of ability to depreciate. With flat feet, the ligamentous apparatus of the foot weakens, the arch becomes flatter, and the body weight is distributed from the heel region to the middle part of the foot. Due to the pathologically changed biomechanics, the spinal column, the ankle joint and the hip joint become overload compensators. As a result, articular cartilage and intervertebral discs are modified, articular deformity is observed. Externally, this is manifested by pain in the lumbar region, in the calf muscles, in the feet. In addition, complications may develop:

• arthrosis;
• varicose veins;
• heel spurs;
• curvature of the spine.
• X-rays of the foot on flat feet can be prescribed if the patient voices the following complaints:
• pain in the foot, calf, or back, not associated with physical activity;
• external changes of the foot;
• frequent injury to the foot;
• intense exercise, overweight, hereditary predisposition to flatfoot and foot deformities.

An x-ray of the foot is especially necessary for the military registration and enlistment office, if the conscript has third-degree flatfoot - it is with this degree of pathological changes that a person is considered unfit for military service. In the second degree, flat-footedness can be voiced by the decision “fit with restrictions”.

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Preparation

By and large, for the x-ray of the foot does not require any specific preparation. Before you go to the procedure, the patient should consider what clothes and shoes to wear so that the study foot can be quickly exposed in the office.

If a pregnant patient is sent for X-rays, then she must warn the doctor about her “situation”.

The entire foot X-ray procedure can last about fifteen minutes: at the same time, the immediate period of exposure of the rays does not exceed one second.

X-rays are done in a special room - an X-ray room. A walking patient can self-test for examination. Not walking sick and children may need the help of relatives, parents. If someone from the attendant remains in the office during the procedure, he is invited to wear special protective clothing (apron) to protect himself from radiation.

Laying the foot is carried out on a table or a special stool - to achieve the desired position. If several pictures are taken in different projections, then the medical radiologist will periodically change the position of the patient's foot. In addition, a healthy foot image may be required (if a comparison is necessary).

[2], [3]

Technique of the foot x-ray

During the x-ray of the foot, the patient does not feel anything - there is neither pleasant nor unpleasant sensations. The position of the foot, which has to be taken to get the correct picture, may not seem very convenient: however, this is not a problem, because such a position will have to be held for only a couple of seconds.

If the patient cannot hold the desired position due to severe pain (for example, after an injury), then the medical radiologist should help the patient to decide on another acceptable position, which is more comfortable and no less informative.

After receiving a snapshot, the image is viewed by the doctor in the radiology room, transcribed and sent the results to the attending doctor.

The duration of the results may vary from 1-2 hours to 1-2 days.

X-rays of the toes of the foot make it possible to examine the structure and condition of the bone apparatus well, to analyze the quality of the articular function. In what cases the procedure can be assigned:

• with suspected dislocations and fractures;
• in inflammatory diseases;
• with impaired blood circulation in the foot (especially in cases where the etiology cannot be determined);
• with impaired motor function of the fingers.

As a rule, x-rays of the toes are carried out in two projections.

An x-ray of the foot joints is often performed on the entire ankle joint. The procedure is performed in different projections, depending on the diagnostic requirements and complaints of the patient, with the use of the load, or without it. The most informative in this situation have: side image of the foot, oblique image of the foot, a snapshot of the heel bone.

X-rays of the foot joints reveal:

• traumatic injuries;
• inflammatory diseases;
• degenerative processes;
• congenital osteo-articular pathologies;
• osteophytes;
• metabolic and secondary disorders.

X-rays of both feet, left, right foot can be performed with flat-footedness, as well as in cases where the doctor needs to compare both distal limbs. Depending on the patient's complaints and the intended diagnosis, the doctor may require visualization of the feet in different positions:

• X-ray of the foot in the lateral projection - this study is performed in a lying or standing position, and X-ray radiation is directed from the left perspective (if the left limb is examined) or from the right perspective (when studying the right limb).
• X-rays of the foot in two projections may include performing oblique and rear-plantar visualization. Oblique image is obtained when the patient puts the foot on a special cassette with a slope (standard angle of 45 °, but if necessary it can be changed). Rear-plantar visualization is performed when the patient puts the foot on a flat table, with a slight deflection of the tibia posteriorly. X-rays should be directed from above.
• X-rays of the foot in a direct projection are often performed to diagnose flatfoot, congenital or acquired deformities. Sometimes, the front and anterior-posterior projection is used to compare both feet, and they must touch each other.

X-ray with a load is usually prescribed if the patient complains of "incomprehensible" pain in the extremities, for no apparent reason. Such a procedure is also required in case of flat-footedness, in violation of the shape of the foot. This type of research is especially common in pediatric practice: it is used for the early diagnosis of flatfoot.

X-ray load is performed in two projections. During the procedure, the person must stand on one leg, while the other bends at the knee joint, transferring body weight to the limb being examined. Two projections include a straight and a side shot: the cassette is positioned alternately under the foot and on the side of the ankle joint. In most cases, examine both feet.

To assess the functional ability of the foot, the doctor may recommend taking pictures with or without a load: the position of the foot with such a diagnosis should be the same.

X-ray foot child

Children are given a foot X-ray not less often than adult patients: injuries of the osteo-ligamentous mechanism in childhood are mainly due to injuries, but the study is also used for congenital deformities, inflammatory processes, etc.

It is often possible to get rid of many pathologies, including congenital ones, if we conduct timely examination and treatment. For example, such serious problems as flat feet and clubfoot can be corrected in time.

For example, a child’s clubfoot is said when the child’s foot has an opening in the inner direction: there is a typical plantar flexion. Emphasis falls on the outer surface of the foot, which is manifested by a change in gait.

Flatfoot: such a diagnosis is made to the child only after the formation of the transverse and longitudinal arch of the foot is completed - that is, from about the age of ten. At an earlier age, the pathology can be corrected, so there is no need to make such a diagnosis.

X-ray stop during pregnancy

Often, a pregnant woman is faced with the need to do an x-ray of the foot and wonders if this will cause harm to the unborn baby. Indeed, during pregnancy, such procedures are not welcome, and during the first trimester are completely contraindicated. However, you should not worry: without sufficient evidence, no one will make a woman an X-ray. And if such strong indications are still available, the doctor will take all measures to protect the future mother and her child from the harmful effects of radiation.

The foot is relatively far from the abdomen, so the effect of X-rays can be reduced to almost zero. To do this, a woman will be asked to wear a special apron with a lead protective layer during the procedure. Upon arrival home, the patient should take a shower and drink a cup of milk. Usually these measures are enough to level the negative impact of diagnosis on the body. Additionally, you can visit your gynecologist and consult with him: it may be recommended to repeat the ultrasound to assess the condition of the child.

Contraindications to the procedure

Radiation produced during X-rays of the foot, is recognized to be completely safe for human health, subject to infrequent procedures. However, we must not forget about the states when it is better to replace X-ray examination with other types of diagnostics.

First, if possible, should not be X-rayed to pregnant patients: it is carried out only according to vital emergency indications. Even if such a study is carried out, the woman must first wear a special lead protective apron.

It is undesirable to do x-rays of the foot, if such a procedure has already been performed recently or several times. Frequent exposure is highly undesirable for the body. Therefore, one should not insist on the procedure if there are no corresponding indications for it.

There are no other contraindications for the study.

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Normal performance

Qualitatively carried out X-ray of the foot allows you to consider this part of the limb in sufficient detail. Immediately after the procedure, the resulting image is carefully studied by the radiologist: its goal is not to make a diagnosis, but a description of what was seen with the fixation of all the detected pathologies. Next, a picture with the description is sent to the attending doctor. It is he who makes the final diagnosis on the basis of the results obtained, after which he is determined with the treatment tactics.

It is very important to carefully consider the image. For example, an x-ray stop morphometry is performed to diagnose longitudinal flat-footedness: the doctor is required to make an additional measurement of the angle of the foot. Normal angle should not exceed 130 °, with the height of the arch - not less than 3.5 cm. When determining transverse flatfoot, a direct image of the foot is required. It is considered normal if only the heads of the I and V metatarsal bones are adjacent to the support.

If the clinic or diagnostic center has a modern x-ray machine, then, as a rule, it shows all the nuances of the foot structure in more detail. This will allow the doctor to make an accurate diagnosis and prescribe the correct treatment.

Healthy foot x-ray, normal

The foot is a moving mechanism represented by bones, joints, and soft tissues. Due to this structure, a person has the ability to stand, walk, run or jump.

The skeleton of the foot is quite complex: it is completely “thought out” by nature to perform the function assigned to it.

During radiographic diagnostics, the device transmits radiation through the area necessary limbs, and the resulting "picture" is transferred to a computer monitor or a special x-ray film. The picture displays all the bone elements and soft tissues that make up the structure of the foot: this is the ankle joint, the metatarsal system, and the finger phalanges.

As many know, the X-ray "picture" is presented in white and black. At the same time, denser elements prevent the radiological flow from passing through - for example, bones, therefore they are white in the image. Soft structures (for example, muscle tissue) let the rays pass through themselves and appear in dark color. Thus, the denser the structure, the brighter it is.

As a rule, the radiologist performs the procedure in three projections: this is the anteroposterior, lateral and oblique image.

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X-ray signs during examination of the foot

In the course of the description of certain pathological changes, the doctor uses various terms that characterize the current x-ray picture. However, the standard schemes of such descriptions do not exist: each radiologist has his own algorithms, which he focuses on when making a conclusion. There are only a number of signs by which the doctor determines traumatic, destructive and other processes in the bone and joint apparatus of the foot.

For example, minor injuries, such as bone fractures, may remain imperceptible on the X-ray. It is possible to clarify the diagnosis only after performing a computed tomography.

Fracture of the foot on the x-ray has a specific appearance, and the typical signs are:

• line of enlightenment;
• fragmentary offset;
• location of bone fragments at an angle.

In order to determine the treatment tactics, the doctor must assess the nature of the damage relative to the surface of the joint. An extra-articular fracture heals sooner and is rarely accompanied by the development of complications. An intra-articular fracture affects the bones included in the structure of the joint. Such a violation often leads to a limitation of the motor capacity of the foot; a callus may form. Such a corn has the appearance of an intense center of darkening.

Varus deformity of the foot on the x-ray may be present in several variants. For flat-valgus deformity, a typically pronounced change in the bone structure of the middle and posterior sections, as well as the base of the metatarsal bones, is typical. If the pathology is congenital, then the most pronounced disorders are localized in the middle section. Deformed sphenoid, cuboid and scaphoid bones are found on the background of moderate osteoporosis, a large-looped image of bone trabeculae with areas of rarefaction. Some trabeculae are thickened, with orientation along the load axis on the middle part of the foot. In the calcaneus there is no typical spongy structure. The IV and V bases of the metatarsal bones are especially deformed.

For the equino-polovarsa deformation, an enlarged longitudinal arch, heel supination, absence of the transverse arch, hammer-like fingers, equinus are characteristic. The intensity of the bone pattern may evenly decrease, and the bone trabeculae thinned. There is a partial preservation of lines of force in the talus and heel. The head of the talus and the calcaneus form a large-looped image of trabeculae. There may be deformity of the navicular and sphenoid bones, with the navicular bone shifted to the back side. Osteoporosis is most pronounced in the heel bone (calcaneal tuber).

Osteoarthritis stop on the x-ray is manifested in different ways, depending on many factors. In particular, early and chronic arthrosis are characterized by a number of special features.

At the initial stage of development, arthrosis has the following features:

• unexpressed narrowing of the joint space;
• point calcifications;
• moderate signs of osteosclerosis.

When running osteoarthritis, the picture is somewhat different and expands:

• joint space narrows significantly;
• osteosclerosis is more pronounced;
• bone tissue is compacted;
• subluxation is noticeable, the volume of the surface of the joint decreases, flattening is observed;
• osteophytes are present

Arthritis of the foot on the x-ray is characterized by expansion of the joint space, which is explained by the presence of inflammatory effusion in the joint cavity. In addition, there are other signs:

• compaction of soft tissue near the inflammatory focus;
• deposition of calcifications.

Gout of the foot on the x-ray also has the appearance of arthritis, however, specific signs are also characteristic of gout, for example, the presence of uric acid accumulation zones. The presence of urates is fixed in the periarthricular tissues, in the joint space: an enlightened structure of the surfaces of the joints is found. In gouty arthritis, MRI diagnosis is more informative.

The diabetic foot on an X-ray image is characterized by significant structural changes, pathological fractures, fragmentation and destruction of bone tissue (predominantly of the tarsus and metatarsal bones), divergence of the joints, and secondary bone growths.

Dislocation of the foot - this is another common injury, for the diagnosis of which in some cases have to resort to x-rays. At dislocation, a change in the articular relations of the bone joints is observed. Distinctions and subluxations are distinguished - complete and incomplete displacement of joints. X-rays of the foot quite clearly determine the nature and extent of pathological changes in the joint. You can consider the condition of periarticular tissues and bone damage. With traumatic dislocations, tearing of the articular margins and bone regions occurs, and all this should be visualized with the help of X-rays. The study is carried out in two projections. The most frequently diagnosed dislocations of the lisfrankovogo, shopoptovogo joint, or isolated dislocations of individual bones.

Complications after the procedure

Foot X-ray is considered a safe form of diagnosis. Despite the apparent health risks due to X-ray exposure, the number of rays used for the image is not dangerous.

Radiologists use the minimum required amount of radiation, which is possible to obtain the optimal diagnostic result.

Modern X-ray machines are significantly superior to their predecessors in the quality of the resulting image and the dose of the directed radiation. That is, the latest devices are much more secure. The “picture” is displayed directly on the doctor’s monitor, where he conducts an assessment without applying additional patient exposure. It follows from this that, for the sake of our own safety, it is advisable to carry out an X-ray of the foot in a good medical institution, in which there is a new high-quality diagnostic equipment.

Doctors have not voiced the concept of the maximum acceptable dose of X-ray exposure for diagnostic purposes. Therefore, most often the procedure is prescribed exactly as many times as the doctor needs to make a diagnosis or to track the dynamics.

Of course, one cannot be sure that the X-ray of the foot will be safe if diagnostics are carried out very often. But in many cases, x-rays become the only possible way to avoid major problems and complications that may be the result of a disease.

Do not ignore the protection against radiological rays. To date, there are three ways of such protection: this time, distance and shielding. Thus, the duration of radiation exposure determines the amount of radiation dose received. The same can be said about the distance: the further the patient is, the less dose he receives. The special screen installed between the patient and the X-ray machine also has a protective ability. For this reason, it is desirable to use special “clothes” during diagnostics, for example, lead aprons, hats, collars, etc.

Men and women who are planning to conceive a child are advised to cover the abdominal and genital areas from the rays.

When diagnosing children, it is generally desirable to cover the entire body, bypassing the area of the foot that is being studied.

Moreover, one should not conduct more than one type of X-ray examination in one day (for example, one cannot take a single X-ray of the foot and an X-ray, or CT, or mammography, etc.).

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Care after the procedure

After a single X-ray procedure of the foot, it is not necessary to carry out any measures for the care and removal of radiation from the body, since it is inexpedient. If a person has been subjected to X-ray irradiation several times in a row, then one may think about some post-procedural aspects.

Upon arrival home, be sure to take a shower.

A number of medications that help the body cope with a small dose of radiation are known:

• Polypefan - can be used in adult and child practice;
• Potassium orotate - prevents the accumulation of radioactive cesium;
• dimethyl sulfide - has antioxidant properties;
• calcium supplements - accelerate the excretion of radioactive strontium.

In addition to taking medications, you need to focus on proper nutrition, to speed up the purification of the body from radiation.

Immediately after the X-ray procedure, you should drink a cup of milk - this product does an excellent job with small doses of radiation. An alternative to milk can be dry wine, grape juice.

Doctors advise after the study to drink plenty of fluids, use fruit and vegetable juices, eat raw quail eggs, oatmeal, dried fruits.

Drinking vodka in order to neutralize radiation is strongly discouraged. It is proved that strong alcohol not only does not remove radioactive components, but also accelerates their distribution in the tissues of the body.

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Foot X-Ray Reviews

X-ray study method is considered the most commonly prescribed and affordable diagnostic method, which is used in various pathologies of the musculoskeletal system. X-rays can be attributed to relatively safe, easily portable methods. In addition, it is also very informative: it helps to assess the condition of the bones, see the degree of injury or the nature of the pathological disorder.

Indispensable x-ray of the foot and to monitor the dynamics of tissue healing after injuries and operations.

By and large, the X-ray procedure often allows you to answer the question about the origin of pain in the legs and even in the back, find out the cause of persistent swelling of the legs and changes in the shape of the foot.

Foot X-ray is a procedure about which only positive reviews can be read. The method allows to detect many hidden pathologies; it is available and always easily accepted by patients. Therefore, in traumatology and orthopedics, X-rays can be safely ranked among the top priority procedures.