Foot Medial Oblique is a radiography positioning projection of the Lower Extremity. Foot rotated medially 30-45 degrees, CR perpendicular. SID 40". The centering point is located base of the 3rd metatarsal, with foot rotated medially 30 degrees.. The central ray is perpendicular to ir with foot rotated medially 30 to 45 degrees.. Image-quality criteria include medial border of foot on the ir, entire foot visible., first through fifth metatarsals demonstrated without excessive overlap.. Standard exposure ranges from 60 to 70 kVp, 3 to 6 mAs, at an SID of 40 inches (102 cm).
Anatomy demonstrated
- All five metatarsals in slight oblique.
- First and second metatarsals without overlap.
- Tarsometatarsal joints clearly demonstrated.
- Talar head separated from the navicular bone.
- Medial cuneiform and intermediate cuneiform.
- Medial arch of the foot.
Patient preparation
- Verify patient identity using two identifiers.
- Remove footwear, socks, and any radiopaque foot jewelry.
- Position the patient supine or seated with the leg extended.
- Place the affected foot flat on the IR.
- Rotate the foot medially (inward) 30 to 45 degrees.
Position & centering point
Base of the 3rd metatarsal, with foot rotated medially 30 degrees.
Central ray
Perpendicular to IR with foot rotated medially 30 to 45 degrees.
Exposure / technique
- kVp
- 60–70
- mAs
- 3–6
- SID
- 40" (102 cm)
- Notes
- Rotate foot medially 30 to 45 degrees so medial border is on IR.
Image-quality criteria
- Medial border of foot on the IR, entire foot visible.
- First through fifth metatarsals demonstrated without excessive overlap.
- Tarsometatarsal articulations clearly shown.
- Medial tarsal bones (talar head, navicular, cuneiforms) open.
- Bone trabeculae sharp, no motion artifact.
- Collimation: 1 inch on all sides of foot, 1 inch above medial malleolus.
Common errors / ARRT traps
- 1 Insufficient medial rotation fails to open the tarsal joints.
- 2 Rotating the foot too far creates lateral oblique instead of medial.
- 3 Centering off the first metatarsal area clips anatomy.
- 4 Lifting the medial border off the IR closes the medial joints.
Clinical indications
- Evaluation of medial arch or tarsal alignment.
- Suspected midfoot fracture or dislocation.
- Assessment of pes planus (flat foot) deformity.
Aligned to the 2025 ARRT Content Specifications.