Toes Lateral is a radiography positioning projection of the Lower Extremity. Foot in true lateral on IR, CR perpendicular. SID 40". The centering point is located ip joint of the great toe, or the pip joint of the affected toe, in true lateral.. The central ray is perpendicular to the foot in true lateral, centered to the ip joint of the affected toe.. Image-quality criteria include toes in true lateral with no rotation or overlap of phalanges., great toe separated from the second toe for clear visualization.. Standard exposure ranges from 55 to 65 kVp, 2 to 4 mAs, at an SID of 40 inches (102 cm).
Anatomy demonstrated
- The affected toe in true lateral, with adjacent toes held clear.
- Great toe separated from remaining four toes.
- Interphalangeal and metatarsophalangeal joints open.
- Metatarsal heads and shaft.
- Base of the metatarsals.
Patient preparation
- Verify patient identity using two identifiers.
- Remove footwear, socks, and any radiopaque foot jewelry.
- Position the patient supine or seated with the leg extended.
- Rotate the foot to true lateral, medial or lateral border on IR.
- Support or pad the foot to prevent toe superimposition.
Position & centering point
IP joint of the great toe, or the PIP joint of the affected toe, in true lateral.
Central ray
Perpendicular to the foot in true lateral, centered to the IP joint of the affected toe.
Exposure / technique
- kVp
- 55–65
- mAs
- 2–4
- SID
- 40" (102 cm)
- Notes
- Support the foot to prevent superimposition of toe shadows.
Image-quality criteria
- Toes in true lateral with no rotation or overlap of phalanges.
- Great toe separated from the second toe for clear visualization.
- Interphalangeal and metatarsophalangeal joints open.
- Metatarsal heads clearly demonstrated without overlap.
- Bone trabeculae sharp, no motion blur.
- Collimation: 1 inch on all sides of the foot.
Common errors / ARRT traps
- 1 Failure to achieve true lateral causes phalanx overlap and joint closure.
- 2 Insufficient foot elevation results in toe shadow superimposition.
- 3 Rotating the foot inward or outward distorts joint anatomy.
- 4 Centering off the mid-foot foot clips toes from the image.
Clinical indications
- Trauma evaluation for suspected toe fracture.
- Assessment of toe alignment or deformity.
- Post-operative follow-up of surgical repair.
Aligned to the current ARRT Radiography Content Specifications.