Interpreting X rays Flashcards
When interpreting radiographic imagining, what is meant by the OLD ACID approach?
Open or closed
Location
Degree (complete vs incomplete)
Articulation involvement
Intrinsic bone quality
Displacement, angulation, rotation
What 2 standard views are used in radiographic imaging of hip joint?
Anteroposterior (AP)
Lateral
Before interpreting an X-ray, what do you need to confirm?
Confirm that this is the x ray of the correct patient
What 3 pieces of info do you need to confirm out loud in order to make sure that this X-ray is of the correct patient?
Patient personal details such as name, DOB, hospital number
Date and time at which radiograph was taken
What anatomical site was imaged and in what view eg. AP view of pelvis
If the pelvis is perfectly aligned in a X-ray, what 2 structures should be in the midline?
Pubis symphysis
Coccyx
What structures can you outline to identify bony fragments or fractures?
Cortical outlines of bone surfaces, if outline doesn’t run smoothly then it is often due to a fracture breaking the cortical outline or a fragment projecting outwards
What 2 features of an x-ray provide good adequacy?
Image shows above and below the area of concern
Beam penetration is neither under or over exposed
What are the 4 types of femoral fractures in the hip joint, and explain the location of each fracture?
Subcapital: immediately under femoral head, on femoral neck
Transcervical: middle of femoral neck
Intertrochanteric: across intertrcohanteric line between greater and lesser trochanter
Subtrochanteric: under femoral neck and lesser trochanter
Describe this x-ray?
Subcapital fracture of left neck of femur
Describe this x-ray?
Transcervical fracture of right neck of femur
It is Transcervical as the fracture is on the neck but still above intertrochanteric line, so is not intertrochanteric fracture
Describe this x-ray and what each of the arrows point to?
Blue arrow shows comminuted intertrochanteric fracture of right femur
White arrow shows fragments of greater trochanter
Red arrow shows fragments of lesser trochanter
Describe this x-ray?
Subcapital simple fracture of left femur
Describe this x-ray, and what 4 conditions could be the cause of this finding?
Lytic/lucent lesions in right femoral head and left femoral shaft
Osteomyelitis
Bone cyst
Metastasis of myeloma
Osteoblastoma
Describe this x-ray?
Sclerotic lines on posterior surface of calcaneus suggests stress fracture
What do sclerotic lines on an x-ray suggest?
Stress fracture or new bone growth due to fracture
Describe this x-ray?
Transverse stress fracture of right distal fibula due to sclerotic line
Describe 3 findings on this x-ray and what conditions these suggest?
Sclerotic borders of phalanges as proximal interphalangeal joints, suggests new bone growth
Narrowed joint space
Osteophytes at proximal interphalangeal joints
These affect all signs of OA
Describe this x-ray?
Narrowed joint space between distal femur and proximal tibia in medial compartment of left knee and lateral compartment of right knee
Sclerotic borders of proximal tibia suggests compression of bone
Osteophytes of right femur and tibia
Suggests knee OA
What is a comminuted fracture?
Fracture that causes the bone to split into 3 or more fragments
Because bone is broken in at least 2 places
What is a complete fracture?
Bone completely broken into separate pieces
What is an incomplete/partial fracture?
Crack in the bone that doesn’t break bone into separate pieces
What is a stable/non-displaced fracture?
Broken ends of the bone line up, no dislocation or subluxation
Maintains proper alignment
What is a greenstick fracture, and is it more common in adults or children?
Incomplete fracture where bone is partially broken and bent
More common in children
What is a closed fracture?
Fracture doesn’t pierce overlying skin so isn’t exposed to air
