What is the patient position for the calcaneal axial radiograph?

What is the patient position for the calcaneal axial radiograph?

• A. Supine or leg fully extended
• B. Prone with knee flexed
• C. Standing with weight-bearing
• D. Seated with foot plantar flexed

Answer: (A)

Positioning for the calcaneal axial view aims to place the calcaneus in an axial orientation while allowing a cephalad beam tilt. The patient is placed supine with the leg fully extended. This setup provides a stable, neutral alignment so the x-ray beam can be angled (about 40 degrees cephalad) to project the calcaneus axially without distortion. Being supine and with the leg straight also keeps the foot in a predictable position, facilitating visualization of the calcaneal body and subtalar joint. Other positions would complicate the projection: prone with the knee flexed would alter the hindfoot orientation and hinder achieving the proper axial alignment; standing weight-bearing would change the hindfoot under load and introduce variability in magnification and tilt; seated with the foot plantar flexed would rotate the calcaneus away from the ideal axial relation, reducing the view of the intended structures.

Positioning for the calcaneal axial view aims to place the calcaneus in an axial orientation while allowing a cephalad beam tilt. The patient is placed supine with the leg fully extended. This setup provides a stable, neutral alignment so the x-ray beam can be angled (about 40 degrees cephalad) to project the calcaneus axially without distortion. Being supine and with the leg straight also keeps the foot in a predictable position, facilitating visualization of the calcaneal body and subtalar joint.

Other positions would complicate the projection: prone with the knee flexed would alter the hindfoot orientation and hinder achieving the proper axial alignment; standing weight-bearing would change the hindfoot under load and introduce variability in magnification and tilt; seated with the foot plantar flexed would rotate the calcaneus away from the ideal axial relation, reducing the view of the intended structures.