Konventionelle Bildgebung Fuß und Sprunggelenk – akut und chronisch

Zusammenfassung

Grundlage für Diagnose und Behandlung akuter und chronischer Beschwerden an Fuß und Sprunggelenk sind, neben einer ausführlichen klinischen Untersuchung, konventionelle Röntgenbilder. Basis der Diagnostik sind standardisierte Röntgenaufnahmen, wobei empfohlen wird, bei der Wahl der Projektion zwischen akuten und chronischen Beschwerden zu differenzieren. Bei akuten Symptomen an Fuß und Sprunggelenk empfehlen wir standardmäßig eine „5er-Serie“ mit Röntgen des Fußes dorsoplantar, schräg und lateral sowie des Sprunggelenks anterior–posterior und lateral ohne Belastung. Bei chronischen Beschwerden hingegen empfiehlt sich eine „4er-Serie“ unter Belastung mit Röntgen des Fußes dorsoplantar und lateral sowie des Sprunggelenks anterior–posterior sowie einer Saltzman-Aufnahme. Wichtig ist es, bei chronischen Symptomen die Aufnahmen im Stehen und unter Belastung durchzuführen, während bei Patienten nach frischem Trauma oder unmittelbar nach einem operativen Eingriff Röntgenaufnahmen ohne Belastung durchgeführt werden sollten. Nach primär konventioneller Bildgebung kann bei Bedarf die Diagnostik im Anschluss zielgerichtet erweitert werden.

Abstract

The basis for diagnosis and treatment of acute and chronic complaints of the foot and ankle are conventional X-ray images, in addition to a detailed clinical examination. Standardized radiographs should always represent the beginning of the diagnostic process. It is recommended to differentiate between acute and chronic complaints when selecting the X-ray projection. For acute symptoms of the foot and ankle, we suggest a standard “five-series” with X-rays of the foot dorsoplantar, oblique, and lateral, and of the ankle anterior–posterior and lateral without loading. In the case of chronic symptoms, we recommend a “four-series” under stress with X-rays of the foot dorso-plantar and lateral as well as of the ankle joint anterior–posterior and a Saltzman image. It is important to perform the radiographs with the patient standing and under weight bearing in cases of chronic symptoms, whereas radiographs should be performed without weight bearing in patients after fresh trauma, or immediately after a surgical procedure. After primary conventional X-ray imaging, diagnostics can subsequently be expanded in a targeted manner if necessary.

Schlüsselwörter

konventionelle Röntgenaufnahmen von Fuß und Sprunggelenk - Saltzman-Aufnahme - radiologische Beurteilung der Rückfußausrichtung

Key words

radiographs of the foot and ankle - Saltzman view - radiographic assessment of hindfoot alignment

Publikationsverlauf

Artikel online veröffentlicht:
15. Juli 2021

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