Ankle Case 7 Diagnosis

The diagnosis is typically made by plain film X rays. If suspicion is high, obtain an additional anteroposterior (AP) “Canale” view to fully assess the talar head and the talonavicular joint [1].  The “Canale” view is done with the foot in maximal plantar flexion, obtaining 15° of pronation, and angling the beam 75° cephalad [1].

The sensitivity of radiographs in detecting talar fractures is estimated around 74% [3]. If the patient had a high velocity mechanism and suspicion remains elevated despite negative X rays, talar fractures can be ruled in or out by CT.