Lecture 1: Intro to Radiology 2 (Basic of Radiographic Films)

Terminology:

• What is the correct term when referring to the films?

  • NOT called what?

• Position:

  • Position is described in what 2 ways?

• Conventional Radiographs

  • NOT X Ray

• Position: (2)

  • General body position

  • To describe the part closest to the image

    • Ex: L Ant Oblique Position

Terminology:

• Projection:

  • What is it?

    • Ex:

• Path of the X-Ray as it moves from tube through the patient

  • Ex: Post Ant Oblique Projection

Angle of Projection:

• The angle that the X-Ray enters the body will influence what?

Radiodensity of the Object

Curved Planes:

• How to shoot Curved Planes compared to the image receptor?

• How many planes is needed to view?

• Shoot:

  • Perpendicular

  • Parallel

• Need 2

One View is

NO VIEW

• How many projections are needed see Right Angles?

  • In order to see an objects… (3)

• T/F: Need to see three dimensions in your head when looking at a radiographic film

• Need 2

  • Length

  • Width

  • Depth

• True

Projection:

• What is the BEST view for looking at the spine?

• AP

  • X Ray: Ant

  • Film: Post

Film Viewing:

• Film is placed on the ___ with the patient is in ____ position.

  • True with what 2 views?

• Box

• Anatomical Position

  • True AP and PA

Film Viewing:

• Hands and Feet:

  • Placed on the view box with toes and fingers pointing ___

• Lateral Projections:

  • Placed on the view box as if seeing the image from the perspective of what?

• Upward

• X-Ray Beam

What view is this?

L Lateral View

• Film on L

• Patient facing R

• Looking at it as if YOU are the machine and the receptor is behind them

What view is this?

R AP View

• Pt in Anatomical Position

• Pt facing you

What view is this?

R Hand

Radiologic Evaluation:

• What are the ABCS of Radiologic Analysis?

• Search pattern helps account for what?

• ABCS:

  • A: Alignment

  • B: Bone Density

  • C: Cartilage Spaces

  • S: Soft Tissue

• Search Pattern

  • Structures needing visualization

A = Alignment:

• What to look for? (Pt 1 - 4)

• Correct # of bones

• Size of Bones

• Bone abnormalities

• Developmental Deformities

A = Alignment:

• What to look for? (Pt 2 - 4)

• Contour of Bones

  • Do edges look smooth?

• External and Internal Abnormalities

• Cortical Bone Outline

  • Breaks in Continuity

  • Sites of Muscle Attachment (Bone Spurs)

  • Past Surgical Sites

• Bone Spurs

A = Alignment:

• What to look for? (Pt 3 - 4)

• Alignment of bones relative to adjacent bones

• Fx

  • How this may disrupt jt articulations

• Dislocation

  • Do joint articulations look normal

• Subluxation

  • Partial dislocations

  • Signs of recent dislocations

B = Bone Density:

• What to look for? (Pt 1 - 2)

• Normal shades of gray

• Compare to surrounding soft tissue and other bone

B = Bone Density:

• What to look for? (Pt 2 - 2)

• Look within bone itself

  • Contrast of cortical bone to medullary bone

  • Assess trabeculae of bone

• Density Changes

  • Sclerotic Bone

    • May be normal or abnormal

Textural Abnormalities:

• Assess the ___ for abnormalities

Trabeculae

Local Density Changes:

• Sclerosis?

  • Normal or Abnormal?

• Excessive Sclerosis?

  • Normal or Abnormal?

• What is Reactive Sclerosis?

• Sclerosis (Increased Bone Density)

  • Normal or Abnormal

• Excessive Sclerosis:

  • May be Normal

    • Bone Healing

  • May be Abnormal

    • OC (hands and fingers)

• Reactive Sclerosis:

  • Bodies way of surrounding an infection or tumor

Local Density Changes:

• Describe this Hip:

• Normal Sclerosis:

  • Increased Bone Density

  • Response to WB

  • Wolf’s Law

Knee OA Pic

Excessive Sclerosis

C = Cartilage Spaces:

• What does Cartilage Spaces explain?

• What are the 2 main things that Subchondral Bone may show?

  • Why may show increased sclerosis?

• Explains:

  • Joint Space width

• Sunchondral Bone (Below the articular cartilage)

  • Erosions

  • Increased Sclerosis

    • Due to loss of articular cartilage new bone formation

C = Cartilage Spaces:

• What are the 3 main things that Epiphyseal Plates may show?

• Disruption

• Sclerotic Bone

• Size of plate related to age of child

What does this show?

• Gout

  • Increased Radiolucency

    • Subchondral bone erosions

    • Minimal Sclerosis

S = Soft Tissue:

• What are the main things that can be seen when assessing Soft Tissue? (Pt 1 - 3)

• Muscle

  • Gross Muscle Wasting

  • Swelling of Muscle and Soft Tissue

• Fat Pads

  • Swelling or Displacement of a Fat Pad

• Jt Capsule

  • If abnormal from swelling may see capsule

S = Soft Tissue:

• What are the main things that can be seen when assessing Soft Tissue? (Pt 2 - 2)

• Calficiations

  • Radiodense areas that should NOT be there

• Foreign Bodies

  • Metal

  • Pacemakers