Radiology Angles

Front 1

Back 1

1st Met Declination Angle
Normal: 20-30 degrees
-Angle between first metatarsal axis and plane of support

Front 2

Back 2

Boehlers Angle
Normal: 28-40 degrees
- angle always taken with calcaneal fractures and indicates relative declination of the posterior facet

Front 3

Back 3

Calcaneal Inclination Angle
Normal: 18-22 degrees
-Angle decreases with pronation

Front 4

Back 4

Talar Declination Angle
Normal: 21 degrees, increases with increased pronation

Front 5

What is the talar axis, how is it drawn?

Back 5

line joining bisection of distal regular neck and proximal regular neck of talus

Front 6

Talar declination angle

Back 6

Norm: 21°

Angle formed by collum tali axis and plane of support.

Angle increase with pronation.

Front 7

Plane of support

Back 7

Formed by a line joining the plantar most aspect of the plantar calcaneal tuberosity to the most plantar aspect of the head of the fifth metatarsal

Front 8

Calcaneal inclination axis

Back 8

Formed by a line joining the most plantar aspect of the calcaneal tuberosity and the most distal plantar aspect of the calcaneus

Front 9

First metatarsal axis

Back 9

Formed by a bisection of the shaft of the first metatarsal. Care needs to be taken not to bisect the base or head of the first metatarsal

Front 10

Back 10

Calcaneocuboid Angle
Norm: 0-5 degrees
-angle increases with pronation

Front 11

Back 11

Forefoot angle
Norm: 8 degrees
12-14 FF adductus
<12 straight rectus foot

Front 12

Back 12

HAV Angle
Norm: < 15

Front 13

Back 13

IM Angle
Norm: 8-12
Rectus >14 degrees

Metatarsus adductus/forefoot adductus = 12 degrees

Front 14

Back 14

Hallux Interphalangeal Angle
Norm: 8-10

Front 15

Back 15

Lesser Tarsus Angle

Front 16

Back 16

Lesser Tarsus Axis
(1) line joining distal medial point of medial cuneiform and proximal medial portion of navicular.

(2) line joining distal lateral point of cuboid and proximal lateral point of cuboid

(3) line joining bisection of (1) and (2)

(4) Line perpendicular to bisection of line (3)

Front 17

Back 17

Tibial Sesamoid Position
-determined by the position of the tibial sesamoid relative to the 1st metatarsal axis

Front 18

Back 18

TaloCalcaneal
Norm: 17-20
Angle increases above 21 degrees when foot is pronated further from a resting position

Angle decreases below 16 degrees when foot is supinated further from a resting position

Front 19

Tibial Sesamoid Position

Back 19

Position of sesamoid relative to a bisection of the first metatarsal
1) Sesamoid is medial to axis
2) Sesamoid is touching the axis (laterally)
3) Sesamoid overlaps the axis (laterally)
4) Sesamoid is bisected by the axis
5) Sesamoid overlaps the axis (medially)
6) Sesamoid is touching the axis (medially)
7) Sesamoid is lateral

Front 20

Axial Calcaneal view

Back 20

- Central beam aimed 45 degrees at calcaneus
- Used to visualise posterior calcaneus

Front 21

Harris Beath

Back 21

- For posterior and middle facets of STJ
- Central ray aimed from 30 to 50 degrees at posterior calcaneus
- May need serial x-rays

Front 22

Anterior posterior Ankle xray view

Back 22

- Standing in angle base of gait, posterior aspect of calcaneus against x-ray film, central ray horizontal and aimed at middle of ankle

Front 23

Ankle Mortise xray view

Back 23

- Same as ankle AP, but leg internally rotated 15 degrees

Front 24

Ankle MO and LO xray views

Back 24

- MO - leg externally rotated 45 degrees
- LO - leg internally rotated 45 degrees (for view of tibofibular syndesmosis)

Front 25

RF longitudinal axis

Back 25

Formed by a line that bisects the posterior aspect of calcaneus and continues anteriorly to the anterior medial edge of the calcaneus. Often the posterior aspect of the calcaneus is not visible, so a line parallel to the anterior lateral edge of the calcaneus is usually used

Front 26

Metatarsus Longitudinal axis

Back 26

Formed by a longitudinal bisection of the shaft of the second metatarsal.

Front 27

FF Angle

Back 27

- Angle between long axis of rearfoot and metatarsus axis

Front 28

Met Adductus Angle

Back 28

- Angle between metatarsus axis lessor tarsus axis
- Normally 16-18 degrees adducted

Front 29

Lesser Tarsus Angle

Back 29

Angle between lessor tarsus axis and rearfoot axis

Front 30

IM angle

Back 30

- Angle between bisections of first and second metatarsals
- Normally 8 - 12 degrees

Front 31

Hallux Angle

Back 31

- Angle between bisections of first metatarsal and proximal phalanx

Front 32

Normal DP xray

Back 32

1) MTJ is continuous cyma line
2) Head of talus bound close to anterior calcaneus
3) Proximity of sustentaculum tali to navicular
4) Long axis of rearfoot - relationship to forefoot
5) Direction of head of talus
6) 75% of head of talus articulates with navicular
7) Lateral border of calcaneus parallel with long axis of foot

Front 33

Normal Lateral Xray

Back 33

1) Midtarsal joint cyma line continuos
2) Sinus tarsi visible
3) Body of talus parallel with plane of support
4) Normal calcaneal inclination
5) Height of foot
6) Space at posterior aspect of STJ
7) Plantar tuberosities densities superimposed
8) Dense area for sustentaculum tali
9) Cuboid articular facet evenly aligned with calcaneal
10) Peroneal groove delineated by added density

Front 34

Flat/Pronated Foot xray

Back 34

1) Break in cyma line
2) Sinus tarsi diminished
3) Talus moved distally and plantarly
4) Lower of calcaneus inclination
5) Lower height of foot
6) Eversion of calcaneus
7) Lateral tuberosity raised
8) Less density of sustentaculum tali
9) Cuboid lower and everted
10)No groove visible in plantar cuboid

Front 35

cavus/Supinated foot xray

Back 35

1) High pitch to calcaneus
2) High declination to 5th metatarsal
3) Normal cyma line of MTJ
4) Sinus tarsi accentuated
5) Acute angle between STJ and long axis of calcaneus

Front 36

FF Angle

Back 36

Ideal average measurement:(8 degrees)-Angle formed by metatarsal axis (line joining bisection of distal and proximal regular shaft of 2nd metatarsal) and the longitudinal axis of the rearfoot (line joining distal middle portion of calcaneus and center posterior aspect of calcaneus.

Front 37

Calcaneocuboid Angle

Back 37

Ideal average measurement:(0-5 degrees)

(1) line along lateral distal margin of calcaneus

(2) line along lateral distal margin of cuboid

Angle increases with foot pronation

Front 38

HAV Angle

Back 38

Ideal average measurement: <15°

Angle formed bisection of 1st metatarsal and proximal phalanx

Front 39

IM Angle

Back 39

Ideal average measurement: 8-12°

Line joining bisection of distal and proximal regular shafts of metatarsals one and two.

The lesser intermetatarsal angles are not usually measured.

Rectus >14 degrees

Metatarsus adductus/forefoot adductus = 12 degrees

Front 40

PASA

Back 40

Ideal average measurement: 0-8°

(1) Line joining edges of the proximal articular facet of the proximal phalanx

(2) Bisection of proximal phalanx

• Subtract 90° from angle

Front 41

DASA

Back 41

Ideal average measurement: 0-6°

(1) line joining edges of distal articular facet of 1st metatarsal.

(2) Bisection of 1st metatarsal

• Subtract 90° from angle.

NB: The PASA and DASA should add up to equal the HAV angle

Front 42

Met Break Angle

Back 42

Ideal average measurement: 142°

(1) Line joining distal centre 1st and 2nd metatarsals

(2) Line joining distal center 2nd and 5th metatarsals



Metatarsal Formula: 2>1=3>4>5

Front 43

Boehlers Angle

Back 43

- (28-40 degrees)

(1) line joining anterior process and posterior calcaneal facets

(2) line joining most posterior process and posterior facets

- angle always taken with calcaneal fractures and indicates relative declination of the posterior facet

Front 44

1st Met Declination Angle

Back 44

(20-30 degrees)

(1) line joining bisection of distal and proximal regular shaft of 1st metatarsal.

(2) Plane of support.