American Orthopaedic Foot & Ankle Society

View all recommendations from this society

Released September 17, 2014; Revised January 15, 2021

Avoid non-weightbearing X-ray evaluation of the foot and ankle when patients are able to stand.

The functional position of the foot and ankle is one of weightbearing. Foot and ankle deformity may be decreased or absent on non-weightbearing x-rays as compared to weightbearing x-rays. Therefore, foot and ankle disorders including flatfeet, ligamentous injuries of the midfoot, ankle arthritis, bunions, and hammertoes that are well-demonstrated on weightbearing x-rays may be underestimated or not appreciated at all on non-weightbearing x-rays. Therefore, when possible, weightbearing x-rays of the foot and ankle are preferred in order to give the most accurate assessment of the functional bony anatomy of the foot and ankle.

These items are provided solely for informational purposes and are not intended as a substitute for consultation with a medical professional. Patients with any specific questions about the items on this list or their individual situation should consult their health care provider.

How The List Was Created

In order to formulate this list, the American Orthopaedic Foot & Ankle Society Evidence-Based Medicine Committee reviewed the society position statements on foot and ankle care and solicited expert opinion from specialty leaders to prepare an initial list of topics for the Choosing Wisely website. The Evidence-Based Medicine Committee members reviewed the scientific literature on each statement and presented draft statements with supporting evidence to the committee for discussion. The finalized list was then reviewed and approved by the AOFAS Board of Directors.

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