Tibia/Fibula Positioning

Question 1

What IR is used for all Tib-Fib views with the ankle?

Answer 1

14x17

Question 2

What IR is used for all Tib-Fib views with the knee?

Answer 2

10x12

Question 3

What is the SID for all Tib-Fib views?

Answer 3

40”

Question 4

What are the structures seen for an AP tib-fib w/ ankle?

Answer 4

• Ankle & knee joints without rotation
• Proximal and distal articulations of the tibia & fibula moderately overlapped
• Fibular midshaft free of tibial superimposition

Question 5

How is the patient positioned for an AP tib-fib w/ ankle?

Answer 5

• Patient supine or sitting on table
• Ankle, knee, & hip on the same longitudinal plane
• Foot & ankle dorsiflexed
• Femoral condyles parallel w/ IR

Question 6

Where is the CR for an AP tib-fib w/ ankle?

Answer 6

Perpendicular to midshaft including both joints if possible

Question 7

What SID can tib-fib ankle views be increased to include the knee joint?

Answer 7

48”

Question 8

Why would you increase the SID to 48” for Tib-fib views of the ankle?

Answer 8

To include the knee joint

Question 9

What are the structures seen for an AP tib-fib w/ knee?

Answer 9

• AP of knee including proximal tib-fib
• Open femorotibial joint space
• Patella completely superimposed on the femur
• Include distal femur and proximal tib-fib

Question 10

How is the patient positioned for an AP tib-fib w/ knee?

Answer 10

• Patient is supine or sitting
• Ankle, knee, and hip are on the same longitudinal plane
• Foot and ankle dorsiflexed
• Femoral condyles parallel w/ IR

Question 11

Where is the CR for an AP tib-fib w/ knee?

Answer 11

Centered to knee 1/2” distal to apex of patella

Question 12

How many degrees is the CR angled for an AP tib-fib w/ knee?

Answer 12

5- degrees cephalic

Question 13

What are the structures seen for a mediolateral tib-fib w/ ankle?

Answer 13

• Distal fibula lying over the posterior half of the tibia
• Slight overlap of the tibia on the proximal fibular head
• Moderate separation of the tibial and fibular shafts (except at articular ends)

Question 14

How is the patient positioned for a mediolateral tib-fib w/ ankle?

Answer 14

• Patient rolled up on affected side to place lower leg in a lateral position
• Knee slightly flexed
• Foot and ankle dorsiflexed
• Femoral condyles perpendicular to IR

Question 15

Where is the CR for a mediolateral tib-fib w/ ankle?

Answer 15

perpendicular to mid-shaft including both joints if possible

Question 16

What are the structures seen for a mediolateral tib-fib w/ knee?

Answer 16

• Femoral condyles superimposed
• Patella in profile
• Fibular head and tibia slightly superimposed
• Include distal femur & proximal tib-fib

Question 17

How is the patient positioned for a mediolateral tib-fib w/ knee?

Answer 17

• Patient rolled up on affected side to place lower leg in a lateral position
• Knee flexed 20-30 degrees
• Femoral condyles perpendicular to IR

Question 18

Where is the CR for a mediolateral tib-fib w/ knee?

Answer 18

1” distal to medial epicondyle

Question 19

How many degrees is the CR angled for a mediolateral tib-fib w/ knee?

Answer 19

5-7 degrees cephalic