Introduction #
An Ankle X-ray is a brief, non-invasive scan that uses low-dose ionizing radiation to capture images of the bony structures around the ankle. Because the ankle is commonly injured, X-rays are often the initial investigation to confirm or rule out fractures, dislocations, and some degenerative changes. For soft-tissue injuries (ligaments, tendons, cartilage), more advanced imaging such as MRI may be required.
When is an Ankle X-ray recommended? #
Your clinician may order an ankle X-ray if you have:
• A recent injury with pain, swelling or inability to bear weight
• Obvious deformity after trauma (possible dislocation)
• Persistent or unexplained ankle pain or swelling
• Suspected arthritis or long-standing joint problems
• Signs that suggest bone infection or a mass
• Follow-up after ankle surgery to check healing or hardware placement
What parts of the ankle are seen on the X-ray? #
An ankle X-ray typically shows:
– The lower ends of the tibia and fibula (shin bones)
– The talus (the primary ankle bone) and nearby tarsal bones (including parts of the calcaneus)
– Joint spaces and bone surfaces where wear or narrowing may indicate arthritis
Note: muscles, ligaments and nerves are not well visualized on plain X-rays.
How should I prepare? #
No special prep is usually necessary. Typical instructions:
– Remove shoes, socks and any jewellery or metal around the ankle.
– Wear loose clothing that’s easy to roll up.
– Tell staff if you are pregnant or think you might be.
Pregnancy and children — is it safe? #
– Pregnancy: Because the ankle is remote from the abdomen, fetal exposure is minimal. Still, X-rays are avoided in pregnancy when possible; if essential, protective abdominal shielding is used and the physician will weigh risks versus benefits.
– Children: Ankle X-rays are commonly and safely used in children; technicians take care to keep dose as low as possible.
Typical views taken #
To evaluate the ankle fully, radiographers commonly take multiple views, for example:
– AP (anteroposterior) — front to back
– Lateral — side view for alignment and displacement
– Mortise — an angled view that opens the joint space and shows the ankle mortise clearly
– Special/weight-bearing views may be requested to assess joint space under load
What happens during the test? #
You’ll be seated or standing and asked to place your foot on the X-ray plate in specific positions. The technician will position the machine and take the exposures; you must remain still for a few seconds for each view. The exam is quick and does not require needles or injections.
Is the procedure painful or invasive? #
No. The X-ray itself is painless and non-invasive. Any minor discomfort usually comes from holding a position or weight-bearing after injury.
How long does it take and when are results ready? #
The scan itself usually takes 5–10 minutes, depending on the number of views. Results are often available within hours to a day after a radiologist reviews the images and issues a report.
Can I have an Ankle X-ray after surgery? #
Yes — post-operative X-rays are routinely used to:
– Confirm correct placement of screws, plates or other hardware
– Monitor bone healing and alignment
– Detect complications such as delayed union or infection
Surgeons often order multiple follow-up X-rays to track recovery.
What can an Ankle X-ray detect? #
It can show:
– Fractures or cracks in the bones
– Dislocations or subluxations
– Arthritis-related joint narrowing or bone spurs
– Bone infections or suspicious lesions
– Hardware placement and healing progress after surgery
What are the limits of an Ankle X-ray? #
Ankle X-rays do not reliably demonstrate ligament tears, tendon injuries, cartilage defects, or subtle bone bruises. If these are suspected despite normal X-rays, your clinician may recommend MRI, CT or ultrasound.
How often can I have ankle X-rays? #
There’s no fixed maximum, but X-rays are performed only when medically justified. Although the radiation dose per exam is low, clinicians still try to avoid unnecessary repeat imaging.
When should I seek urgent care? #
Seek immediate medical attention if you experience:
– Severe deformity of the ankle
– Inability to move or bear weight on the foot after trauma
– Numbness, severe pain, or loss of circulation (cold, pale toes)
– High fever with localized ankle pain (possible infection)
Final note #
An Ankle X-ray is a fast, effective first step to identify many bone and alignment problems. If your symptoms suggest soft-tissue injury or a more complex issue, your doctor will arrange the appropriate advanced imaging.