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Foot x-ray: Purpose, procedure and risks

What is a foot x-ray?

A foot x-ray is essentially a machine that can project an image of your foot onto a screen that generates a printed film image that a doctor or radiologist can read to assess your conditions that may be affecting your feet.

X-rays are assessed by radiologists, who have spent years training in the use of medical imaging to capture and diagnose injuries and health problems. X-rays are commonly used to determine broken bones, as well as different kinds of fractures, like a transverse fracture and a stable fracture.

When it comes to feet, x-rays are actually only used to determine problems with the bones. X-rays can’t actually see ligaments or tendons. So, if a doctor suspects a problem with your ligament or tendon they may refer you for an Ultrasound, CT or MRI. An ultrasound for example can detect specific things like identifying a problem with a lisfranc ligament or more general issues with weight-bearing.

While x rays can also detect issues that aren’t related to mobility in other areas of the body, foot x-rays are normally related to bones, ligaments, or tendons.

If a patient visits a doctor with foot pain, the doctor will often recommend the patient to have an x ray to determine the root of the problem.

What conditions can a foot x-ray and an ultrasound of the foot detect?

As mentioned, foot x-rays are commonly associated with mobility issues, so a lot of conditions that an x-ray will detect are bone or ligament related. Some conditions that may affect the feet are as follows:

Transverse fracture

A transverse fracture is a fracture that is across the bone that is perpendicular to the axis of the bone. This is a common foot fracture and is often otherwise known as a Jones fracture. Because this is a complete fracture it is easy for a radiologist to detect and identify on an x ray.

Lateral cuneiform break or fracture

The lateral cuneiform is the bone above the arch in the middle of your foot, this bone begins approximately in line with your middle toe. Because this bone is surrounded by many other bones, an isolated break or fracture is unlikely in this area but is possible from direct trauma. This kind of injury is detected on a normal x ray.

Stress fractures

Stress fractures are tiny fractures that are commonly caused by overuse or repetitive movements. The most common place in the foot to get a stress fracture is the second and third metatarsals. Metatarsals are five individual bones that are connected to the base of the toes. The second and third metatarsals are connected to the second and third biggest toes. This can easily be identified on a normal x ray.

Broken toes

Broken toes are by far the most common break when it comes to your feet and they can be easily detected with a simple x ray of the foot. Usually, broken toes are treated by strapping them to the neighbouring toe to make sure they don’t move. However, if it’s a particularly bad break of the big toe a patient may require a cast or even surgery to make sure it heals correctly.

Lisfranc ligament

The lisfranc ligament is one of the most important ligaments in the foot and it can be serious if you injure this ligament. It is located in the middle of the foot and maintains proper alignment between the metatarsal bones and the tarsal bones. Because normal x rays can’t detect problems with ligaments, you will need an MRI of the foot to detect an injured lisfranc ligament.

Torn ligaments

There are over 30 ligaments in the foot and they work to connect the bones to other bones to form joints. If you tear a ligament of the foot you will likely know about it as it’s very painful. Torn ligaments can restrict weight-bearing and will often show signs of bruising and inflammation. To detect a torn ligament and to be able to treat it properly, a patient will require an MRI of the foot.

Why should I get foot x-ray?

As you can see above, there are a lot of serious – even fatal – conditions that can be detected by something as simple as a chest x ray. Many serious health problems can be treated and/or cured if they are detected early enough through a chest x ray.

How do I prepare for a foot x-ray?

Any injury of the foot can affect mobility and the ability to weight bear. If someone with a foot injury continues to put weight on an injured ligament it can cause lifelong mobility problems and further complications. If someone continues weight bearing on a broken or fractured bone, the bone can shatter more, causing extensive damage to the foot. For that reason, it’s important to detect a foot injury as early as possible so it can be treated effectively and be able to heal.

What happens when I go for a foot x-ray?

For a foot x ray you will sit on a table and the technician will put a lead apron on you to cover the rest of your body from the beams and will position your foot correctly.

The radiographer will enter a connecting room where she or he can take the x-ray images.

The radiographer may come back multiple times to position your foot different so they can capture all angles of the bones. They will want to get a lateral view of the foot bones.

Remember, that it’s very important that you hold very still while the technician is taking the x-ray. Even the slightest movement can blur the image.

Once the radiographer is happy with the x-rays, you’ll be able to leave the room and will be finished. Chest x-rays generally only take five to ten minutes.


How long does it take to get results from a foot x-ray?

In an emergency x-ray results are provided almost immediately. However, foot x-rays are rarely for life-threatening conditions so you can usually expect results one to two days after your x-ray. Your doctor will usually show you the x rays and explain the problem with your foot and the best treatment for it.

Can I eat or drink before an x-ray of the foot?

Yes, an x-ray of the foot doesn’t require any special preparation, like fasting.

Will I always have to have a cast if I break a bone in my foot?

No, this will depend on where the break or fracture is. Toes rarely require a cast, however, some severe breaks of the big toe do. Some minor breaks or fractures may only need a removable brace, boot or shoe with a stiff sole. However, some breaks or fractures of the foot will require the patient to wear a cast.

If I have a broken bone in my foot won’t it hurt to have an x-ray?

You shouldn’t feel pain when taking an x-ray, even if the bone is broken. Radiographers are extremely well trained in how to handle injuries and will position your foot so that there is no pressure or weight bearing on the injury. However, some extensive injuries may be painful to move at all, so in this case you may feel some pain when moving your foot to the x-ray area. However, no further damage will be done to your foot. Your radiographer will handle your injury the gentlest way possible and make sure that you are comfortable.