Ankle series (paediatric)

The ankle series for paediatrics consists of an anteroposterior, mortise and a lateral projection. Depending on the child's age and the departmental protocol, the mortise view may or may not be performed.

Indications

• trauma with suspected fracture

• suspected dislocation

• inability to weight-bear

Projections

• anteroposterior view

• mortise view

• lateral view

Gonadal shielding

The use of gonadal and fetal shielding has been deemed as non-beneficial to patients' health in current evidences ^1-3 and may or may not be useful for paediatric extremity imaging. Placing gonadal shielding can increase the examination time and may cause the child more stress. However, shielding can also reduce the family's anxiety in relation to radiation dose. Therefore, the decision to use shielding will depend on departmental protocols and the radiographer's judgement.

Tips for paediatric ankle radiography

The major difficulty in paediatric ankle radiography relates to:

• motion artifact

To overcome this, a variety of techniques can be used ⁴:

• distract the patient with toys, games and/or conversation

• using the swaddling technique; wrap the child in a blanket to promote comfort and sleep

Immobilisation techniques

Children will find it difficult to keep their ankle still; particularly if the limb is injured. As the child will be supine, it is helpful to have the parent in the child's direct line of sight in order to keep the child calm.