Overview
Ankle stress radiographs apply controlled force to evaluate syndesmotic and lateral ligament stability. They are performed under fluoroscopic guidance or with manual stress during radiography. Stress views help determine need for surgical stabilization.
Technique
Apply inversion eversion or external rotation stress while obtaining AP mortise or specialized stress projections. Use protective measures and informed consent due to discomfort risk. Document the applied stress and technique used.
Clinical Indications
Stress views are indicated for suspected ligamentous injury when standard views are inconclusive. They assess widening of the mortise and talar tilt. MRI may be used to directly visualize ligament tears when needed.
Image Assessment
Measure joint space widening and talar tilt compared with the contralateral side. Evaluate for associated fractures and instability patterns. Report findings to guide orthopedic decision making.