1.3 Radiographic search pattern

radiographs provide info about

bone, joint and soft tissue structures

radiographs should complement

history and a physical exam

important points of radiographs analysis

look at all views, compare with other side or old images, look for unexpected, dont stop at one abnormality, assess image quality

patient and image details

ensure looking at correct image, check pt details and date of image, look at correct side, L or R marker may identify laterality of image

place image on viewbox/screen as if

person is in anatomic position facing you

projections

describes path of xray beam as it travels from the xray tube through patient to image receptor - all bones and joints have standard/routine projections

minimum projections of

2 views taken at 90 degrees from one another

lateral views are named by

the side that is touching the image receptor, right or left

oblique views are names by

what hitting the image receptor and where the xray goes through

ABCS are a

search pattern for systematic review of images for abnormality

ABCS

anatomic appearance and alignment, bony density, cartilage spaces, soft tissues

anatomic appearance assessment

assess size, appearance, number of bones, countour of bones

aligment assessment

relationship to the bones is connected to stability, articulation, and abnormality, check continuity of cortical outline

bone density assessment

cortical bone should make up 50% of the width of the shaft of long bones

loss of bone density results in

poor contrast between soft tissues and bone

sclerosis

buildup with joint space narrowing

coarsening

dense trabecular bone, more load will make more dense, usually where fractures or cracks begin

cartilage spaces assessment

assess for joint space narrowing, spurs/erosions/sclerosis, evaluate growth plate

soft tissue assessment

muscles (swelling or wasting), fat pads and fat lines (should be parallel to bone), periosteum (swelling or lifting), joint capsules

displacement of fat pads leads to

joint effusion

periosteum lifting causes

onion skin appearance

most joint capsule are

low density