Percentage of Weight Placed on Acute, Subacute, and Chronic Foot and Ankle Injuries in Weightbearing Radiographs

Background: Weightbearing radiography is an essential diagnostic tool in orthopedics, especially in the setting of foot and ankle pathology. However, there is a lack of studies examining the percentage of weight placed on a limb during weightbearing x-rays, potentially affecting the quality of the radiograph. Methods: Over a 3-month period, the percentage of weight placed through an injured extremity was recorded for 434 patients receiving weightbearing radiographs of the foot or ankle in a single clinic. Results: For the overwhelming majority of radiographs, patients placed less than half their weight on their injured extremity. Lateral radiographs had a lesser percentage of weightbearing compared with anteroposterior (P = .0096) and oblique (P = .0042) radiographs. Patients with acute injuries placed less weight on their extremity in lateral foot radiographs compared with those with acute injuries (P = .0023). A high variability of weight was placed through the extremity regardless of pathology. Conclusion: These results highlight the need for clinician awareness regarding the discrepancies in weightbearing radiography, the importance of technician and patient education on technique and importance of quality imaging, and the plethora of questions that still remain regarding what characteristics comprise a sufficient weightbearing radiograph.