Toes (lateral view)

The lateral toe projection is part of the three view series examining the phalanges of any specified toe(s), and distal half of the associated metatarsals.

Indications

This view evaluates all phalanges of a specified toe(s) for any fractures or dislocation, allowing the establishment of dorsal or plantar displacement. It is also useful in determining joint abnormalities such as gout and osteoarthritis.

Patient position

• the patient may be supine or upright depending on comfort
• depending on the toe of interest and to reduce magnification, the affected leg may be medially (1^st to 3^rd toes) or laterally (4^th and 5^th toes) rotated

Technical factors 

• mediolateral/lateromedial projection
• centering point
  • interphalangeal joint of 1^st digit and proximal interphalangeal joint of 2^nd to 5^th digit
• collimation
  • to skin margin of the toe(s) of interest
  • inferiorly to include distal half of the metatarsals
• orientation  
  • portrait
• detector size
  • 18 cm x 24 cm
• exposure
  • 50-55 kVp
  • 2-4 mAs
• SID
  • 100 cm
• grid
  • no

Image technical evaluation

• the condyles of the proximal phalanx should be superimposed
• increased concavity on plantar surface of proximal phalanx is demonstrated

Practical points

To prevent superimposition with the other toes, use radiolucent tape or rolled up gauze to separate the unaffected toes away.

If there is inadequate rotation, there will be equal concavity on the plantar and dorsal surfaces of the proximal phalanx and the condyles will not be superimposed.