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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