TOE-RADS – Total Observation of the Extremity

Toe imaging standardized reporting.


Data position:                    Meaning:

1.       Laterality- R=right L=left

2.       Number of digit- 1=Great toe

3.       Number of phalanx- 1=most proximal

4.       Classification of finding -F=fracture, D=degenerative, O=other, F=foreign body, O=osteomyelitis

5.       Severity of disease graded 1-5

6.       TBA


If a process involves a joint the joint can be specified by placing the phalangeal numbers in brackets

Example- PIP joint (1/2)

For fractures involving the MTP joints or more proximal joints please refer to FOOTRADS.



Moderate DJD at the IP joint of the left first toe and a displaced comminuted fracture of the distal phalanx of the left 5th toe- The entire report can be simplified as follows:

L,1,(1/2)D,3 and L,5,2,F,5  (the word “and” is optional for easier reading)

See how easy and clear this abbreviated reporting style can be!


XR-Left Toes, 2 view

HISTORY: Other -please see comments

TECHNIQUE:  AP and lateral images of the toes were obtained.

For all Caromont Health Care system exams, one or more of the following radiation dose reduction techniques were used to achieve the minimum dose exposure while maintaining necessary image quality: Automatic exposure control, Patient shielding, Underpenetration with adjustment of image appearance on PACs. (see appendix 1)

All interpreting and supervising physicians were board certified by the ABR and had current standing in MOC at the time of interpretation or supervision.

The report below conforms to TOERADS reporting standards as required by CMS and its intermediaries.

FINDINGS: L,1,(1/2)D,3 and L,5,2,F,5

IMPRESSION: L,1,(1/2)D,3, L,5,2,F,5

TOERADS CATEGORY: 2B (see below)


0.       No follow up needed

1.       Follow up imaging recommended.

2.       Orthopedic follow up recommended.

3.       ED visit recommended.

4.       Hospital admission necessary.


Proposition 65 warning: This report contains substances known in the State of California to cause reproductive harm.

This report was generated using voice recognition technology. All errors are unintentional. Please notify us immediately if you think an error is present in this document.

A letter regarding the findings of this procedure was distributed to the patient as required by CMS.

This examination was reviewed with the aid of R2 computer aided detection system.

The patients gender information was obtained from EMR demographics and may not necessarily reflect the gender with which they comport at the time of this exam.

This report was generated in a facility that also processes peanuts.

Appendix 1

Dose Equivalency Chart for digital radiography.

Radiation dose equivalency for this exam is as follows

1.       Being within non safe zone at Chernobyl for 2 minutes

2.       Being within 100 miles of Nagasaki at time of explosion for 20 minutes

3.       Living in Peru for 3 months or Denver Colorado for 5 months

4.       Intercontinental plane travel at 30000 feet for 2 hours.

Other equivalencies can be found at:

Http:// photo/AF1QipOcwMUFC9xBU2CQ22lXEmdrwAU18mZzTpLlMDN4


Copyright  ACR 2018