Les métatarsalgies posent un problème clinique fréquent. Une fois le diagnostic de rhumatisme inflammatoire éliminé, de nombreuses pathologies peuvent être en cause comme le névrome de Morton, le syndrome du 2e rayon, les bursites, les fractures de fatigue, la maladie de Freidberg. Afin de pouvoir faire un diagnostic précis et mettre en œuvre un traitement approprié, il est nécessaire d’avoir une stratégie d’imagerie basée sur un algorithme diagnostique adapté.

Nowadays, conventional or digitalized teleradiography remains the most commonly used tool for the study of the sagittal balance, sometimes with secondary digitalization. The irradiation given by this technique is important and the photographic results are often poor. Some radiographic tables allow the realization of digitalized spinal radiographs by simultaneous translation of X-ray tube and receptor. EOS system is a new, very low dose system which gives good quality images, permits a simultaneous acquisition of upright frontal and sagittal views, is able to cover in the same time the spine and the lower limbs and study the axial plane on 3D envelope reconstructions. In the future, this low dose system should take a great place in the study of the pelvispinal balance. On the lateral view, several pelvic (incidence, pelvic tilt, sacral slope) and spinal (lumbar lordosis, thoracic kyphosis, Th9 sagittal offset, C7 plumb line) parameters are drawn to define the pelvispinal balance. All are interdependent. Pelvic incidence is an individual anatomic characteristic that corresponds to the “thickness” of the pelvis and governs the spinal balance. Pelvis and spine, in a harmonious whole, can be compared to an accordion, more or less compressed or stretched.

More than 222 000 hip and knee prostheses are implanted each year in France and this number is growing. Simple radiography is generally used to examine these prostheses in situ but this method has several limitations, including superimposition, the inability to visualize some parts of the prosthesis and to study them in the axial plane, and poor visualization of intra- and peri-articular soft tissues. This article describes the advantages offered by computed tomography and ultrasonography in this setting

More than 222 000 hip and knee prostheses are implanted each year in France and this number is growing. Simple radiography is generally used to examine these prostheses in situ but this method has several limitations, including superimposition, the inability to visualize some parts of the prosthesis and to study them in the axial plane, and poor visualization of intra- and peri-articular soft tissues. This article describes the advantages offered by computed tomography and ultrasonography in this setting.

Foot and ankle problems are frequent, daily pathologies. Nowadays, imaging is able to put in evidence the most part of these affections, in a simple, non traumatic way. A good clinical examination is of highest importance to guide the imaging technique. Well done simple X-rays in a standing position is the first mandatory step. Ultrasonography has revolutionized the study of the smooth parts of the foot: tendons, sprains, pathologies of plantar aponeurosis, hind-foot problems....It is therefore the first exam to ask for. Ultrasonography is enough to resolve a very important part of the superficial soft tissues pathologies. When this technique fails, whatever the reason, RMI is the best way to study soft tissues and bone marrow (stress fractures, small intraosseous lesions, osteonecrosis...). CTscan remains the best tool to study the hard part of the skeleton. Neither CTscan nor RMI can directly put in evidence the joint's cartilage with a high degree of precision. So, an arthrography remains mandatory to have a good study of the cartilage of the ankle.

Spinal steroids injections are frequently employed in the management of degenerative conditions of the spine. During a long time, they were done at patient's bed or during medical consultation, based on physical marks. Fluoroscopically guided spinal injections began there is thirty years ago, with a double purpose: to assure a correct position of the injection and to allow the approach of anatomical structures difficult or impossible to reach in a blind way. Since some years, fluoroscopic and CT scan guided spinal steroids injections took a more and more important place in the non surgical treatment of radicular pains. The aim of this paper is to detail the technical problems of different lumbar and cervical spinal injections, their results and their possible complications, based on the review of the literature and on our experience.

Man is standing up and he moves himself in a world subject to the gravity's laws. His spine reflects these constraints. Each bivertebral unit that composes the long supple stem of the spine has an anatomic cohesion with some mobility. The mobility of the spine is the sum of the motilities of its elementary units. Despite the criticisms, all deserved, the dynamic radiographies in flexion (seating position) and in extension (standing position, lower limbs straight and buttocks wedged) give major informations with important clinical consequences. Some semiologic points of the radiographic study of the vertebra are perfectly explained by its specific architecture: a radiolucent lesion is difficult to see whereas a sclerotic one is much more easy to individualize; the sclerotic line of the vertebral endplate must be continuous and any interruption is pathologic; the corners of the vertebra must be sharp; the foramen's shape reflects the size of the spinal canal.