Which radiographic views are used for navicular syndrome/P3 fracture diagnosis?

• A. Lateral and oblique views
• B. 45-degree DP and 65-degree DP
• C. Ventral DP view
• D. Skyline views

Answer: (B)

To see navicular issues clearly, radiographs must minimize overlap of the navicular bone with surrounding structures and highlight its margins. Angled dorsopalmar projections that are 45 degrees and 65 degrees open up the navicular region from different angles, making cracks, fissures, lucencies, sclerosis, and subtle fractures of the navicular bone or P3 more conspicuous. These oblique views specifically optimize visualization of the navicular apparatus and the solar/dorsal margins, which is essential for diagnosing navicular syndrome and P3 fractures.

Other views can still provide helpful information, but they’re less sensitive for detecting these particular lesions. A lateral plus a standard DP may miss subtle pathology, a ventral DP focuses more on the palmar aspect, and skyline views target certain margins but don’t replace the diagnostic yield of the targeted obliques.