X-ray interpretation (main)

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Background

It is important to have a method of reading xrays and communicating these findings with colleagues or consultants

Method

Demographics

  • Patient name and age
  • Orientation and location of images
    • ex. AP and lateral of the right wrist
  • Skeletal maturity

Assessment of bones

Follow the cortex and look for discontinuities

  • Fractures
    • Location
      • Epiphysis, diaphysis, metaphysis
      • Midshaft, proximal 3rd, mid-3rd, distal 3rd
      • Joint involvement
    • Orientation
      • Transverse, oblique, sagittal
    • Comminution
      • Comminuted - small fragments
      • Segmental - small section of bone boarded by fractures distally and proximally
      • Butterfly fragment - large triangular segment
    • Displacement
      • Percentage of disruption
      • ex. 50% displacement if bones are half overlapping or 200% displacement if the bones are separated by the distance of one bone-width
      • Describe displacement of distal fragment relative to proximal
    • Angulation
      • Describe angulation as the direction the apex is pointing relative to anatomical long axis of the bone
    • Shortening
    • Rotational deformity
  • Lesions
    • Lytic/blastic lesion
    • Important if assessing a pathological fracture

Assessment of Joints

  • Position and alignment
  • Fracture involving the joint
  • Obvious degeneration or FB

Assessment of Soft Tissue

  • Gas
    • Can be present in open fractures or with soft tissue infections
  • Fat pads
    • ex. Sail sign
  • Foreign body

Spinal Imaging

  • By standard convention, spine films have slightly different terminology
  • Anterolisthesis - A description of the inferior edge of a superior vertebrae in relationship to the superior edge of the inferior vertebrae
    • Anterolisthesis of C5 on C6 (C5 is more anterior than C6)
  • Retrolisthesis - A description of the inferior edge of a superior vertebrae in relationship to the superior edge of the inferior vertebrae
    • Retrolisthesis of C6 on C7 (C5 is more anterior than C6)

See Also

External Links

References