Normal Ankle X-Ray Report Template (3-View)
Normal 3-view ankle radiograph report template: mortise congruity, soft tissues and alignment, with notes on Weber classification and stress-view wording.
EXAMINATION: Ankle radiograph, 3 views. CLINICAL HISTORY: [indication] COMPARISON: None available. TECHNIQUE: AP, mortise and lateral views of the ankle. FINDINGS: Alignment: Anatomic. The ankle mortise is congruent. Bones: No acute fracture or dislocation. No osteochondral defect of the talar dome. Joints: Joint spaces are preserved. No significant degenerative change. Soft tissues: No significant soft tissue swelling. No joint effusion. IMPRESSION: 1. No acute fracture or malalignment.
Dictation notes
- Report medial clear space and tibiofibular overlap when the mechanism suggests a syndesmotic injury.
- A Weber classification belongs in the impression only when a fibular fracture is actually present.
Related references
Weber ankle fracture quick reference
Frequently asked questions
What views make up a standard ankle X-ray series?
A standard ankle series is three views: AP, mortise and lateral. The mortise view, an AP with the leg internally rotated about 15-20 degrees, profiles the tibiotalar joint so mortise congruity can be assessed. A normal report confirms anatomic alignment, a congruent mortise, no acute fracture or dislocation, no osteochondral defect of the talar dome, preserved joint spaces and no joint effusion or significant soft tissue swelling.
When should medial clear space be reported on an ankle X-ray?
The medial clear space and tibiofibular overlap should be reported whenever the injury mechanism suggests a syndesmotic (high ankle) injury. Medial clear space widening implies deltoid ligament disruption and an unstable injury even when no medial fracture is seen, and reduced tibiofibular overlap suggests syndesmotic disruption. On a routine normal study, stating that the mortise is congruent covers these relationships.
When does a Weber classification belong in an ankle X-ray report?
The Weber classification applies only when a fibular fracture is actually present — it categorizes the fracture by its level relative to the syndesmosis (A below, B at, C above). It should not appear in the impression of a normal study. When used, the level matters because Weber B and C patterns raise the question of syndesmotic instability and potential operative management.
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