Human Anatomy, Part 1 - K. A. Dyubenko, A. K. Kolomiytsev, Yu. B. Chaykovsky 2002

Special Part
Bones of the Foot
X-ray Anatomy of the Bones of the Lower Limb

Femur. Roentgenographic examination of the proximal femur is performed in the anteroposterior projection. In addition to the proximal femur, radiographs demonstrate a part of the pelvic bone and the hip joint (Fig. 71). The femoral HEAD, as well as the superior and medial margins of the acetabulum, are clearly visible. The posterior margin of the acetabulum projects onto the femoral head, which should not be misinterpreted as a fracture line. The femoral neck is well visualized when the lower limb is rotated medially, whereas the lesser trochanter is best seen upon external rotation. The femoral shaft is studied using anteroposterior and lateral radiographs, which clearly display the compact substance and the medullary cavity. The distal epiphysis of the femur is examined on anteroposterior radiographs, clearly showing the condyles and the intercondylar fossa (Fig. 72). Lateral radiographs are used to determine the position and Structure OF THE Patella.

BONES OF THE leg. Radiographs in the anteroposterior projection are used to examine the bones of the leg (Fig. 73). In the area of the proximal epiphyses, one can observe their internal structure and contours, as well as the intercondylar eminence of the Tibia. When the lower limb is rotated medially, the head of the Fibula is well outlined. In the diaphyseal region, the compact substance and the medullary canal are distinguishable. In the distal epiphyseal region, the size and shape of the lateral and medial malleoli are determined. In newborns, the upper and lower epiphyses are cartilaginous and thus not visualized on radiographs, whereas in children aged 7 to 18 years, ossification centers and epiphyseal growth plates appear as a narrow band with sharp but irregular margins (see Fig. 73).

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Fig. 71. Overview radiograph of the femur — proximal part (according to Ya. I. Kryzhanovsky):

1 - femur, 2 - trochanter major, 3 - trochanter minor, 4 - collum femoris; 5 - caput femoris; 6 - acetabulum; 7 - os ilium; 8 - ramus inferior os pubis; 9 - ramus superior os pubis; 10 - foramen obturatum

Fig. 72. Overview radiograph of the distal epiphysis of the femur and the proximal epiphysis of the tibia and fibula (according to Ya. I. Kryzhanovsky): 1 - femur, 2 - condylus lateralis; 3 - condylus medialis; 4 - condylus lateralis; 5 - condylus medialis; 6 - eminentia intercondylaris; 7 - fibula; 8 - tibia

Fig. 73. Overview radiograph of the tibia and fibula (child aged 4 years) (according to O. V. Dolnytskyi):

1,6 - diaphysis; 2,5 - metaphysis; 3,4 - epiphysis; 1, 6 - diaphysis; growth zones are indicated by horizontal lines

Fig. 74. Overview radiograph of the bones of the right FOOT of an adult in lateral projection (according to Ya. I. Kryzhanovsky):

1 - tibia; 2 - fibula; 5 - os calcaneus; 4 - os talus; 5 - os naviculare; 6 - os cuboideum; 7,8,9 - ossa cuneiforme; 10 - ossa metatarsi

Bones of the foot. Dorsoplantar and lateral radiographs are used to examine the bones of the foot. On lateral radiographs, the calcaneus, talus, navicular, and partially the cuboid bones are well outlined (Fig. 74). Dorsoplantar radiographs allow for the visualization of all foot bones except the calcaneus and talus.