Ankle X-ray positioning
How to position for each of the 4 ankle X-ray views: where the patient goes, where to centre, which receptor and distance to use, and what a good image looks like.
By the ScanFlo Editorial Team · Updated
In this section · X-ray positioning
- X-ray positioning guides
- Skull positioning
- Face & sinuses positioning
- Soft tissue neck positioning
- C-spine positioning
- Chest positioning
- Shoulder positioning
- Humerus positioning
- Elbow positioning
- Forearm positioning
- Wrist positioning
- Hand positioning
- T-spine positioning
- Abdomen positioning
- L-spine positioning
- Sacrum & SI joints positioning
- Pelvis positioning
- Hip positioning
- Femur positioning
- Knee positioning
- Tibia & fibula positioning
- Ankle positioning
- Foot positioning
X-ray positioning/Ankle
The routine ankle views are Ankle internal oblique (mortise) and Ankle lateral. Ankle AP and Ankle external oblique come in when you need to answer a particular question, or when the patient can't manage a routine view. Each guide walks you through the set-up step by step, with a short video, exposure settings for different patient sizes and what a good image should show.
A radiographer is still checking these guides.
Routine views
Extra views
All views in this region
- Ankle internal oblique (mortise)
- Ankle lateral
- Ankle AP
- Ankle external oblique
Quick reference
Where to centre, how far and which receptor, for every ankle view at a glance. Open a guide for the full set-up.
| Projection | Centre on | SID | Receptor | Breathing |
|---|---|---|---|---|
| Ankle internal oblique (mortise) | midway between the malleoli | 100 cm | 18×24 portrait | No breathing instruction needed |
| Ankle lateral | the medial malleolus | 100 cm | 18×24 portrait | No breathing instruction needed |
| Ankle AP | midway between the malleoli | 100 cm | 18×24 portrait | No breathing instruction needed |
| Ankle external oblique | midway between the malleoli | 100 cm | 18×24 portrait | No breathing instruction needed |
Mistakes that lead to repeats
- Mortise closed laterally on the ankle internal oblique (mortise): turn the foot in 15°.
- Double talar dome on the ankle lateral: adjust to a true lateral.
- Foot rotated on the ankle AP: keep the toes aimed at the ceiling so the ankle is not rotated.
- Too little rotation on the ankle external oblique: use a 30° pad.
Common questions
- Which ankle views are routine?
- Usually Ankle internal oblique (mortise) and Ankle lateral.
- What distance (SID) do ankle X-rays use?
- 100 cm for every ankle view here.
- Do ankle X-rays need a grid?
- No. These parts are thin enough that a grid isn't needed.
Try it in ScanFlo: the ScanFlo XR X-ray Room, coming soon, lets you set up every ankle projection in a 3D room and score your positioning. See ScanFlo XR →