Xray Readings

How to Read an Imaging Study

Image 1 – Right foot. “This is a radiograph of the Right foot, AP view. Starting proximal to distal, there is an increase in intermetatarsal angle and within normal Hallux Abductus Angle. There is metatarsal head flattening, joint space narrowing, osteophytic production, spuring, subchondral sclerosis, and subchondral cysts. There is increase in soft tissue volume and density of the first metatarsalphalangeal joint. Overall there is appropriate parabola of the metatarsals, sesamoids in adequate position with an accessory fibular sesamoid seen. My impression is…Hallux Rigidus with severe flattening of the metatarsal head. Regnauld/Oloff classification Stage 3. I would like to see a lateral view and test it clinically to solidify my findings.” Answer: Hallux Rigidus

Image 2 – Right foot, Lateal View. “This is a radiograph of the right foot, Lateral view. With Achilles tendon insertion, and plantar fascia origin enthesophyte (spurring). There is a break in the anterior cyme line, and dorsal spurring of the 1st metatarsal head. The dorsiflexed toe shows limited range of motion. My impression is… consistent with image 1, Hallux Rigidus with metatarsal head flattening, dorsal spurring, and decreased first metatarsal joint range of motion. Regnauld/Oloff classification Stage 3. ” Answer: Hallux Rigidus

Image 3 – Left foot, Lateral View. “This is a radiograph of the left foot, Lateral view. Showing no degenerative changes in the rearfoot or midfoot. An anterior brake in the cyme line. Adequate joint alignment in the tarsometatarsal and metatarsalphalangeal joints. Overall there are no signs of fractures, or dislocation. No sings of soft tissue increase volume or density. My impression is… a normal radiographic foot with mild signs of flatfoot. I would like to check clinically or order MRI to solidify my impression.” Answer: Normal Foot

Image 4 – Left foot, AP View. “This is a radiograph of the left foot, AP View. Showing punched out periarticular erosion of the first metatarsalphalangeal joint, periarticular swelling with preserved joint space. There is positive cloud sign showing increased soft tissue volume and density. Positive Martel sign – overhanging edge of bone, no fractures or dislocation is seen. Overall there is localized increased soft tissue volume and density on the first metarsalphalangeal joint localized. The parabola is within normal limits. My impression is… Chronic tophaceous gout of the fist metatarsal phalangeal joint, left foot. I would like to test clinically to solidify my findings.” Answer: Chronic Tophaceous gout/ Gouty Arthritis


MRI Readings