Foot X-ray

A foot x-ray shows the bones of the midfoot and toes and how they line up, usually after an injury or for a painful deformity. One thing it is poor at is the early stress fracture, which often does not appear until weeks later — a normal film does not always end the question.

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What it is

The foot carries the whole body on twenty-six bones arranged into arches, and an x-ray is the standard way to see what those bones are doing. It shows breaks and dislocations after an injury, the shape of a bunion or a flattened arch, and foreign objects trodden into the sole. Its well-known blind spot is the stress fracture — the hairline crack that builds up from repeated loading rather than a single blow. Early on, that crack is too fine to register on a film; it becomes visible weeks later, once healing bone starts to form around it. That is why a runner with a sore forefoot and a normal x-ray is sometimes sent for a repeat film, an MRI, or a bone scan instead.

Why it is done

  • To find a fracture or a dislocation in the midfoot or toes after a drop, a twist, or a crush injury
  • To look at the shape and alignment of the foot in bunions, flat feet, high arches, and other deformities, often with the patient standing
  • To locate glass, metal, or other foreign material embedded in the foot
  • To look for changes from arthritis or, in people with diabetes, for bone destruction from infection or joint collapse
  • To check a known stress fracture some weeks in, when the healing bone finally makes the fracture line visible

What to expect

The foot rests flat on the imaging plate for the first view, then is angled or turned on its side for the others; some studies are done standing, so that body weight shows how the arches behave under load. Each exposure is instantaneous, and the appointment is usually five to ten minutes. Nothing is required beforehand. If the films are negative and the pain continues, the next step is often a different imaging test rather than a repeat of the same one. A radiologist reads and reports the images formally.

Questions worth asking

  • If this x-ray comes back normal and the pain continues, what is the next test and what does it cost? An MRI or a bone scan for a suspected stress fracture is many times the price of the film.
  • Were the views taken standing? Weight-bearing views are the ones that answer alignment questions, and it is worth knowing which study was actually performed.
  • If the foot and the ankle are both filmed, are those billed as two studies?
  • Does the price differ between a podiatry office, an urgent care, and the hospital radiology department for the same images?
  • Is the radiologist's interpretation included in the quoted price, or billed separately as a professional fee?

What Foot X-ray costs by state

Foot X-ray prices at hospitals

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Sources

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