A CT scanning system provides the ability to scan a patient's lower extremities while the patent is upright, i.e. either standing on the foot, or at least putting some load on the foot, or with the ankle at a given angle. The CT scanning system provides a generally horizontal upper support surface on which the patient's foot is supported. A gantry supporting an x-ray source and x-ray detector are rotated about a z-axis through the support surface. With the CT scanning system, the patient's lower extremities can be scanned while under load.