Which foot X rays are most helpful?

When referring a patient for X-rays you should ideally ask for weight bearing X-rays. These demonstrate problems such as arthritis in the foot much better than the default non-weightbearing radiographs which are commonly performed. Weight bearing radiographs also demonstrate the shape of the foot in its position of function which is helpful in understanding how the foot functions under load. 


X ray views for forefoot pain, bunions, lesser toe problems, metatarsalgia, midfoot or big toe arthritis should include:

Standing lateral and standing dorsoplantar (AP) views of the foot with an oblique view.

X ray views for ankle arthritis, heel pain and pain after ankle injury should include:

Standing lateral of the ankle and Ankle mortise view.

Xray views for painful flat feet or high-arched (cavus) feet should include:

Standing lateral and standing dorsoplantar (AP)  views of the foot with an oblique view and Ankle mortise view.

Why take weightbearing X rays?
Case study: 
​ X-rays of a patient with severe pain in the back of his foot. 

The non-weightbearing view does not demonstrate any cause for the patient's pain.

The weight bearing view taken a few days later in the same patient demonstrates established arthritis.

The patient went on to have a successful subtalar joint fusion by Mr Dawe which eradicated his pain.