Imaging Case of the Week 178 Answer

There is an obvious comminuted intra-articular fracture of the calcaneus on the x-ray.

The Bohler’s angle is significantly reduced.

Bohler's angle

Bohler’s angle is an anatomic landmark on a lateral ankle x-ray. Normal value is between 20-40 degrees. An angle of less than 20 degrees indicates a compression fracture of the calcaneus.

The Bohler’s angle is formed by drawing 2 lines:

  • A line from the highest point of the calcaneal tuberosity to the highest point of the posterior facet of the calcaneus.
  • Another line from the highest point of the posterior facet to the top of the anterior process.

The intersection of the above two lines is Bohler’s angle.

Normal Bohler's angle

Caveat- a normal Bohler’s angle does not exclude a calcaneal fracture.

Reference – Fundamentals of Diagnostic Radiology by Brant and Helms.

 

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