Talar Tilt

- See:
   - Talar Tilt: Physical Exam

- Tilt Measurement:
    - Mortise view:
          - line drawn parallel to articular surface of distal tibia;
          - second line drawn parallel to talar surface should be parallel to each other;
    - alternative method:
          - angle between intermalleolar line & each of these two articlar surface lines is measured;
          - difference betweeen these two angles is the talar tilt;
    - by either method, normal tilt angle is 0 deg (range 1.5 to 1.5 deg);
    - AP view:
          - difference in width of superior clear space between medial & lateral sides of joint should be < 2 mm;
          - these are static measurements of the talar position;
          - in normal ankle, talus may tilt up to 5 deg w/ inversion stress;
          - measurements of talar tilt using stress x-rays are used to evaluate lateral ligament stability;

- Stress Views:
    - joint stability is defined by less than 5 deg difference between the injured and uninjured sides;
    - w/ significant ankle sprain, mean tibiotalar tilt measures 15-18 deg, but can be as large as 40 deg;;
    - more than 15 deg of tilt (compared to opposite side) often implies rupture of ATFL and CFL

Original Text by Clifford R. Wheeless, III, MD.

Last updated by Data Trace Staff on Monday, October 29, 2012 10:20 pm