how to read x-ray
DESCRIPTION
medicineTRANSCRIPT
How to read an X-ray
Ahmed H ABDELAZEEMDipl. SICOT, M.D.
Lecturer of Orthopaedics and TraumatologyCairo University
Objectives
■What is an x-ray
■How can you write an x-ray request
■How to read x-rays systematically
■How to describe fracture patterns
What is an X-ray…?
● X-radiation; discovered by Wilhelm Röntgen who coined the name (x-ray as he didn’t know its nature)
● It is a form of electromagnetic radiation● X-radiation = Röntgen radiation
What is X-rays…?
● X-ray film = Photosenstive film or its electronic equivalent
No x-rays Lots of x-raysSome x-rays
X-radiation and X-rays film
different shades of grey with
different tissues
Tissue volume penetrated
X-radiation and X-rays film
Tissue volume penetratedType of tissue/material
Fluids Bone MetalAir Soft tissues
Bonecancellous
cortical
Metal object
Air
Soft tissues
Tissue penetration and projection
Bone cement
X-ray Request
● Correct spelling of X-ray(s) in the English language includes x-ray(s) and/or X ray(s)
● Rule of ‘TWO’1. Two views: At 90 degrees, usually anterior-
posterior and lateral2. Two joints: The joints above and below.3. Two occasions: Some fractures are not easily
visible immediately after trauma4. Two limbs: If required for comparison
Two views
Two occasions
Two joints
Two limbs
Systematic reading
PROPER PLACEMENT OF THE X-RAY
Aided by■Name of patient■Side of injury■Date of x-ray
Ahmed 20.1.2012
What view…???
● AP● Lateral
Lateral AP View Medial
Ant LAT View post
Identify part of boneEpiphysisMetaphysisDiaphysis
Identify bone or anatomical region (if multiple bones
eg. Hand or foot)
Identify type of fractureSimple (TWO parts)
Transverse (<30 degrees)
Oblique (> 30 degrees)
Spiral
Wedge (usually three parts)
Complex (comminuted)
Bones Quality
Normal Osteopenia Osteopetrosis
Bone age
Skeletally mature Skeletally immature
EXAMPLE
This is;
1. Plain X-ray2. AP view 3. Of the left humerus bone4. Showing a spiral fracture 5. at its diaphysis6. with a normal bone density7. in a skeletally mature case….
Describe the deformity
1. Displacement (translation)2. Angulation3. Malrotation4. Shortening
Always describe the movement of the distal fragment relative to
the proximal one
1. Displacement (translation)
2. Angulation
3. Rotation 4. Shortening
1. Displacement (translation)
2. Angulation
3. Rotation 4. Shortening
1. Displacement (translation)
2. Angulation
3. Rotation 4. Shortening
Displacement (translation)
AP view
Lateral view
Medial and lateral
Anterior and Posterior
Angulation
AP view
Lateral view
Medial and lateral
Anterior and Posterior
Describing angulation(confusing….!!!)
According to the tip of
the angle
Fracture is angulated
laterally
According to distal fragment
Distal fragment is angulated
Medially
Easier
Angulation knee
Varus “O”Towards the midline
Valgus “X”Always from the midline
Thank you