[Horizontal beam external total 3/4 projection of the foot during weight-bearing (author's transl)]

A method for radiological examination of the supporting areas of the anterior part of the foot employs a horizontal beam external total 3/4 projection as a complement to clinical and podoscopic investigations. This radiograph, which cannot effectively assess the condition of the talometatarsal joint, more clearly visualized on a Guntz film, can however provide more precise information on the state of the plantar pad and the level of the anterior bone pillars. These are normally disposed at an equal distance of approximately 10 mm from the ground. In cases with localised anomalies in the supporting areas, either from increased or decreased pressure, the corresponding modifications in the metatarsal heads are apparently more clearly visible in the Guntz film. The projection proposed enables study of anterior supporting areas when dorsal extension of the toes is impossible (hallux rigidus, metatarsophalyngeal arthrodesis). Finally, study of these films supplies data on the posterior bone pillars, the calcaneum, and styloid of the 5th metatarsal, which, together with the anterior supports, form the seven bone pillars of the foot. For the internal arch and the crown of the astralgus vault, the film shows the head of the astralgus, the tarsal sinus, and the posterior subastralgus joint.