Pitfalls

  • Fractures of the calcaneum are easily missed on ankle x-rays. Ask for calcaneal views
  • Foot injuries are common in high speed road crashes but may be overlooked if the patient has other, life-threatening, injuries
  • Injuries of the talus and other tarsal bones as well as the tarso-metatarsal joints may be difficult to detect on plain X-rays. If there is a mechanism of injury that suggests the possibility of a serious injury, or if there are clinical signs suggesting a serious injury, then have a low threshold for CT.
  • The apophysis at the base of the 5th MT may be misdiagnosed as a fracture
  • Patients with stress fractures may have normal x-rays initially.