Foot and Ankle Radiology

Total Contact Hours: 
26
Credits: 
6
Course Director(s):

Ebony Love, D.P.M., Asst. Professor

Definition 

This course will introduce the podiatric medical student to the scope of diagnostic radiology applicable to podiatric medicine, including the following:

RADIOGRAPHY: radiologic sciences (physics, chemistry, and biology); radiation protection and safety; principles of radiography; radiography of the foot and ankle; and, special diagnostic imaging studies.

RADIOGRAPHIC INTERPRETATION: principles of radiographic interpretation; normal and variant radiographic anatomy and development of the foot and ankle; systematic evaluation of bone and joint disorders; and, bone and joint abnormalities.

At the completion of the radiology course the student will be able to:

  • Describe the principles of radiation physics, chemistry, and biology.
  • Practice radiation protection and safety.
  • Describe lower extremity radiography equipment and accessories.
  • Discuss the formation of the radiographic image.
  • Assess film quality.
  • Perform radiologic positioning techniques of the foot and ankle.
  • Apply the principles of film interpretation to any given radiograph.
  • Identify normal and variant radiographic anatomy of the foot and ankle.
  • Identify normal and variant development of the foot and ankle.
  • Systematically assess bone and joint abnormalities in a radiograph.
  • Describe and identify the radiologic features of pertinent pathology:
    • Positional abnormalities
    • Congenital anomalies
    • Skeletal dysplasias
    • Fractures and related disorders
    • Arthritis
    • Infection
    • Tumors and tumor-like processes
    • Metabolic, endocrine, circulatory, and nutritional disorders
    • Soft tissue abnormalities
  • Discuss special imaging techniques applicable to foot and ankle imaging.

Purpose

Radiology is an important diagnostic tool useful for the evaluation of foot and ankle pathology. However, because of the potential risks associated with ionizing radiation, one must have knowledge of the radiological sciences in order to provide protection and safety to all involved. The Doctor of Podiatric Medicine is responsible for the practice of proper radiography in the office setting, whether by him or herself or by an appropriate assistant/technologist. The doctor must also be familiar with all special imaging studies applicable to imaging of the foot and ankle so that they are ordered as warranted.

The podiatric physician encounters numerous pathologic conditions radiographically that are either intrinsic to the foot or represent manifestations of extrinsic disease. Therefore, the student must not only learn specific radiologic pathology of the foot and ankle, but must acquire an understanding of general diagnostic radiology and pathologic correlation. Furthermore, the student must learn how to analyze a radiograph systematically and acquire a basic knowledge of bone radiology in order to interpret radiographs and establish differential diagnoses.

PREREQUISITES FOR THE COURSE

  • Undergraduate physics, chemistry, and biology or equivalent
  • Lower extremity anatomy
     

CONTENT TO BE LEARNED

RADIOGRAPHY:

  • Radiologic physics
  • The x-ray beam
  • The radiographic image
  • Radiation protection
  • Podiatric radiography
  • Special imaging procedures

RADIOGRAPHIC INTERPRETATION:

  • Principles of radiographic interpretation
  • Radiology of the foot and ankle
    • Basic considerations of bones and joints
    • Normal radiographic anatomy
    • Normal roentgen variants
    • Normal development
    • Variations of development
    • Analytical radiography
  • Systematic approach to bone and joint abnormalities
  • Bone and joint disorders
    • Fractures and related conditions
    • Joint disease
    • Infection
    • Metabolic, endocrine, circulatory, and nutritional disorders
    • Congenital/developmental anomalies and dysplasias
    • Bone tumors and tumor-like processes

LABORATORY OR CLINICAL EXPERIENCES
Extensive use of clinical material (i.e., radiographs) will be presented in class. Representative radiographs and images of the current topic will be displayed in the classroom and available on the web throughout the course. Students are expected to visit the radiology department in the Foot and Ankle Institute during free time to examine the radiography equipment, observe radiography techniques, and practice positioning techniques with a partner. The latter will be tested by practical examination. The required textbook is a secondary source of example radiographs; use it often. Radiology teaching files will be available in the library on reserve and on Temple's Blackboard site. Examinations will include radiographic images.

REQUIREMENTS FOR THE COURSE
Attendance: You are adult learners and will be treated as such. Test and quiz material will be emphasized during each class. Announcements will be posted online; check FREQUENTLY!

Quizzes: Quizzes will be administered online for each unit of instruction. The subject matter will be based upon the assigned readings, handouts, written objectives, and material covered for that particular unit. (See the course schedule for unit topics.) Quizzes will be available online for approximately 4 days following the completion of the unit in class. The quizzes can be taken anytime and anywhere during that time period. However, cheating (use of books/notes or assistance from another person) is not permitted. You are on the honor system. Students are not permitted to copy or print questions from the quizzes. These items are copyright protected. They will, however, remain online for you to review. Quizzes will consist of six questions; each question is worth 20 points, for a possible total of 120 points per quiz. The sixth question serves as extra credit, and no quiz grades will be dropped. My reasoning is this: if you are doing well with the material, you can afford to miss a quiz here and there and still obtain a 100% average; however, if you are doing poorly, you need to study a little harder. The final, recorded cumulative average of all quizzes will not be greater than 100%.

Examinations: Each examination will concentrate on the material corresponding to its section. (In other words, they are not comprehensive. However, material from each section builds upon foundations covered in prior sections.) All examinations are computer-based and will be held at an assigned date and time.
Students are not permitted to copy, photograph, or print questions from the examinations. These items are copyright protected.

Assignments: Homework assignments will be given and may be collected and graded as a quiz.

Grading System:
Quizzes: 25%. NOTE: No quiz grades will be dropped.
Examinations (3): 25% each

*Note that quizzes, examinations, assignments, and thus the above point system may be adjusted throughout the semester as necessary.

REQUIRED TEXTBOOK
Christman, RA: Foot and Ankle Radiology, Churchill Livingstone, St. Louis, 2003. ($139)

STRONGLY RECOMMENDED
The following textbooks are strongly recommended and will serve as reference sources for the remainder of your podiatric medical training and practice. Optional assigned readings for instructional units will additionally include these textbooks, which are on reserve in the library:

Bushong, Stewart C.: Radiologic Science for Technologists: Physics, Biology, and Protection, 7th ed., C.V. Mosby Co., St. Louis, 2001. ($72)

Resnick, D.: Bone and Joint Imaging, 2nd ed., W.B. Saunders Co., Phila., 1996. ($249)
Dr. Resnick is an internationally respected expert in skeletal radiology. This textbook is a condensed version of his definitive 5-volume set (Diagnosis of Bone and Joint Disorders, 4th Edition, 2002) that retails for $799.

BIBLIOGRAPHY
Outlined above in the "Required Textbook" section and provided in course handouts.

MISCELLANEOUS
Any student who has a need for accommodation based on the impact of a disability should contact me privately to discuss the specific situation a soon as possible.