Podiatry X-Rays

Our clinic has a special interest in podiatry radiographic studies. We pay extra attention to answering the clinical questions asked by Central Coast Podiatrists, including performing specialised functional standing leg length studies, which demonstrate not only the actual difference in length between each leg, including measuring each femur and tibia, but also the effect that standing has on leg length. As any podiatrist, physiotherapist or chiropractor will tell you, apparent leg length can vary greatly due to changes in the feet and ankles, knees, hips and pelvis, when a person stands up. Most leg length referrals by other clinics are performed lying down. We are able to take our leg length images standing. And the best thing is, because the leg length studies use Medicare item numbers available to podiatrists, using plain radiography, the studies are entirely bulk billed upon referral from a podiatrist. This improves convenience for both the referring podiatrist and the patient, as there is no need to send the patient back to a General Practitioner simply to sign on the dotted line. Leg length studies are available by appointment, Monday to Friday. Call us on 02 4323 9200 for more information. Standard foot and ankle x-rays are available 7 days a week, with no appointment necessary.

Case Study 1: 52 Year Old Female

A 52 year old female patient presented to a podiatrist, referred by a chiropractor who was treating her for marked low back pain. The chiropractor noted on a lumbopelvic x-ray that there appeared to be pelvic tilt and suspected an anatomically short leg. The patient was also complaining of severe right lateral knee pain and plantar fascial pain and pain around the navicular. The podiatrist referred for weight bearing functional leg length x-rays as well as a standard set of right foot x-rays (see below). The leg length films demonstrated a combination of anatomical and functional shortening of the right leg, and also demonstrated the cause of the lateral knee pain. They also demonstrated the marked biomechanical stresses on the right leg. The foot x-rays demonstrated the osteoarthritic change in the navicular-cunieform joint and the calcaneal spur. The patient was treated with orthotic therapy and a 6mm heel lift, which, in spite of a further MRI which demonstrated almost complete obliteration of her lateral meniscus, resulted in a marked improvement in her foot pain, knee pain and back pain.

Functional Leg Length X-Rays
Lateral Weight Bearing Foot
DP & Oblique X-Rays

Case Study 2: 70 Year Old Male

A 70 year old male patient with tibia and fibula fractures, many years before. Although an open reduction had been considered, a closed reduction was performed. The patient presented in shoes with a 22 mm heel build up. The patient’s x-rays were captured standing, in the shoes with the 22 mm build up under the right heel. See the images, below. These demonstrate a 24.9 mm discrepancy between the lengths of the legs, with the right being shorter. On the individual bones, the femur lengths are within the 1 mm margin of error. The tibial lengths, however, exhibit a marked discrepancy, and there is deformity of the right tibia and fibula from the prior trauma. The distal third of the fibula has fused with the tibia, and mild osteoarthritis is also noted in the right ankle.