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==Planning==
Weight-bearing radiography.
==Evaluation==
| Large osteophytes, marked joint space narrowing, severe sclerosis and definite bony deformity
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Evaluate separately for the lateral versus medial side of the joint.
===Varus or valgus===
[[File:X-ray of frontal tibiotalar surface angle (TTS).jpg|right|100px]]
Varus or valgus deformity, if suspected, can be measured with the frontal tibiotalar surface angle (TTS), formed by the mid-longitudinal tibial axis (such as through a line bisecting the tibia at 8 and 13 cm above the tibial plafond) and the talar surface.<ref name=Nosewicz2012>{{cite journal|last1=Nosewicz|first1=Tomasz L.|last2=Knupp|first2=Markus|last3=Bolliger|first3=Lilianna|last4=Hintermann|first4=Beat|title=The reliability and validity of radiographic measurements for determining the three-dimensional position of the talus in varus and valgus osteoarthritic ankles|journal=Skeletal Radiology|volume=41|issue=12|year=2012|pages=1567–1573|issn=0364-2348|doi=10.1007/s00256-012-1421-6}}</ref> An angle of less than 84 degrees is regarded as talipes varus, and an angle of more than 94 degrees is regarded as talipes valgus.<ref>[https://pure.uva.nl/ws/files/28148791/Chapter_5.pdf Chapter 5 - Radiological morphology of peritalar instability in varus and valgus tilted ankles], in: {{cite book|author=T.L. Nosewicz|title=Acute and chronic aspects of hindfoot trauma|date=2018-09-25|isbn=9789463750479|publisher=University of Amsterdam, Faculty of Medicine (AMC-UvA)}}</ref>
==Report==
*Severity grading:
:*A subjective grading of osteoarthritis is generally warranted, such as mild, moderate or severe, which may correspond to grades 1/2, 3 and 4, respectively, of the Kellgren-Lawrence scale. In Swedish practice, such subjective grading is regarded as sufficient to report for osteoarthritis, since the management of the disease depends on symptoms<ref>{{cite web|url=https://www.nice.org.uk/guidance/ipg538/resources/joint-distraction-for-ankle-osteoarthritis-1899871873045189|title=Joint distraction for ankle osteoarthritis, Interventional procedures guidance|date=2015-12-16|website=National Institute for Health and Care Excellence (NICE)}}</ref> and any varus/valgus deformity<ref name="BargPagenstert2013">{{cite journal|last1=Barg|first1=Alexej|last2=Pagenstert|first2=Geert I.|last3=Hügle|first3=Thomas|last4=Gloyer|first4=Marcel|last5=Wiewiorski|first5=Martin|last6=Henninger|first6=Heath B.|last7=Valderrabano|first7=Victor|title=Ankle Osteoarthritis|journal=Foot and Ankle Clinics|volume=18|issue=3|year=2013|pages=411–426|issn=10837515|doi=10.1016/j.fcl.2013.06.001}}</ref> rather than the exact grading of imaging findings.
:*The most severe feature(s) of the osteoarthritis, such as joint space narrowing.
*Any varus/valgus deformity, and if such, the degree thereof.
Example: Osteoarthritis which is severe medially, with almost obliterated joint space, and moderate laterally. Mild valgus deformity, with frontal tibiotalar surface angle of 94°.
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