Which statement best describes the appearance of the sesamoids on tangential radiographs?

• A. The sesamoid bones should be free of superimposition of the first metatarsal
• B. The sesamoids should be partially overlapped by the first metatarsal
• C. The first metatarsal should be radiopaque
• D. The sesamoids appear elongated due to magnification

Answer: (C)

When imaging the sesamoids with a tangential view, bone structures appear as dense, radiopaque areas on the film. The first metatarsal, being a dense bone, should show up clearly and serve as a reference against which the sesamoids are viewed. This radiopacity of the metatarsal on this projection helps you confirm the projection and assess the sesamoids’ position relative to it. The goal of the tangential view is to visualize the sesamoids with minimal confusion from overlying structures, not to emphasize any change in magnification or require the sesamoids to be overlapped.