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Citation, DOI & article dataCitation: Murphy, A. Foot (weight-bearing medial oblique view). Reference article, Radiopaedia.org. (accessed on 29 Oct 2022) https://doi.org/10.53347/rID-96417 The weight-bearing medial oblique view of the foot is a specialised projection that places the foot under normal weight-bearing conditions. The projection is utilised to assess the foot under stress and better demonstrate structural and functional deformities. On this page:This projection is utilised to assess the structural integrity of the foot. If the patient is able, weight-bearing views should be performed in acute and follow-up settings 1. This view is key to the assessment of foot alignment and the diagnosis of abnormalities causing malalignment and foot pain, i.e. Lisfranc injury. Bilateral projections may be requested for comparison purposes. Ultimately the radiographer will determine if the projection is safe to perform.
As these views are often requested to rule out Lisfranc injuries, remember to encourage your patient to place normal, even weight distribution on their feet, instead of forcing their weight on them. Ensure ample warning is provided to the patient of the x-ray tube's close proximity to their torso. To prevent patients from burning themselves, remind them not to use the often overheated tube as weight support. ReferencesRelated articles: Imaging in practicePromoted articles (advertising)Introduction[edit | edit source]The foot has three arches: two longitudinal (medial and lateral) arches and one anterior transverse arch. These arches are formed by the tarsal and metatarsal bones and are supported by the ligaments and tendons in the foot. [1] The arches shape is designed in a similar manner to spring; bears the weight of the body and absorbs the shock that is produced with locomotion. The foot's flexibility conferred by the arches is what facilitates everyday
loco-motor functions such as walking and sprinting. The energy-sparing spring theory of the foot’s arch has become central to interpretations of the foot’s mechanical function and evolution. The metabolic energy saved by the arch is largely explained by the passive-elastic work it supplies that would otherwise be done by active muscle. Anatomy Medial, Lateral and Longitudinal arch[edit | edit source]Medial Arch[edit | edit source]
The chief characteristic of this arch is its elasticity, due to its height and to the number of small joints between its component parts. Its weakest part, i. e., the part most liable to yield from overpressure, is the joint between the talus and navicular, but this portion is braced by the plantar calcaneonavicular ligament, which is elastic and is thus able to quickly restore the arch to its pristine condition when the disturbing force is removed. The ligament is strengthened medially by blending with the deltoid ligament of the ankle joint and is supported inferiorly by the tendon of the Tibialis posterior, which is spread out in a fan-shaped insertion and prevents undue tension of the ligament or such an amount of stretching as would permanently elongate it. The arch is further supported by the plantar aponeurosis, by the small muscles in the sole of the foot, by the tendons of the Tibialis anterior and posterior and Peronæus longus, and by the ligaments of all the articulations involved. [2] Lateral Arch[edit | edit source]
While these medial and lateral arches may be readily demonstrated as the component antero-posterior arches of the
foot, yet the fundamental longitudinal arch is contributed to by both, and consists of the calcaneus, cuboid, third cuneiform, and third metatarsal: all the other bones of the foot may be removed without destroying this arch.[2] Transverse Arch[edit | edit source]
Clinical Relevance[edit | edit source]Patients commonly present with foot and ankle problems, and many find it challenging to assess these patients. This is probably related to the complexity and multiplicity of joints in this part of the body. There are 26 bones, 33 Joints, more than 100 ligaments, tendons and muscles in each foot. On average, we walk 10000 steps per day, 1000000 steps per year and 115000 miles in our lifetime. The foot stands 3-4 times body weight during running[3] As an example a person with a low longitudinal arch, or flat feet often stands and walks with their feet in a pronated position, where the foot everts. This makes the person susceptible to heel pain, arch pain, and plantar fasciitis. With high arches you have less surface area for absorbing impact and you place excessive pressure on your rearfoot and forefoot areas. This can make you susceptible to foot conditions such as heel pain, metatarsalgia, or plantar fasciitis. Assessment of Arches[edit | edit source]For a detailed assessment of the arches of the foot see below:
Common Foot Postures and Associated Conditions[edit | edit source]
References[edit | edit source]
What projection of the foot will best demonstrate the status of the longitudinal arch?lower limb positioning. Which projection of the foot will show the cuboid in profile?Foot PA Oblique (Medial Rotation)
Cuboid is shown in profile. Position of patient Lateral recumbent position on affected side. Fully extend leg. Turn patient toward prone position until plantar surface of foot forms an angle of 45 degrees to plane of IR.
What two areas of the foot are best demonstrated on the medial oblique projection of the foot?The metatarsal and tarsal bones are the most reliable rotation indicator. If the foot is over rotated the base of the 5th metatarsal will be superimposed by the tubercle of the 4th metatarsal.
Which of the following projection will best demonstrate the tarsal navicular with minimal superimposition?Bontrager Ch 6 Self Test Questions. |