- 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