Image interpretation ofthe upper limb and introduction to PIE

Question 1

patient and image details

Answer 1

Are you looking at the right patient?
Is it the most recent imaging?
Have all projections been performed?
Do you have access?
Important legends?

Question 2

bone and joint alignment

Answer 2

is the joint congregant?
Are the articulating bones aligned?
Signs of sublux/dislocation?
Growth plate aligned in paediatrics?Expected location of bones
Direction of displacement

Question 3

joint spacing

Answer 3

Is the cartilage as expected?
Any loose bodies/FB?
Any signs of erosion/jointdestruction?
Any osteophytes around the jointspace?

Question 4

cortical outline

Answer 4

Follow the outline of all bones
Any breaks/disruption to cortex?
Any buckle in paediatrics?
A step in the cortex is indictive of fracture
Look for secondary breaks

Question 5

bone texture

Answer 5

Is bone matrix as expected?
Any loss in trabecular pattern?
Any signs of reduced density?
Age related change?
Any sign of disruption to normal pattern?

Question 6

soft tissue

Answer 6

Any soft tissue signs?
Presence of lipohaemathrosis?
Any signs of effusion?
Fat pad signs?
Evidence of gross swelling?

Question 7

artefact

Answer 7

Any internal or external artefact?
Any anatomy obscured
Is it relevant to pathology?
Is a repeat needed?

Question 8

section d

Answer 8

General description
Specific description
Joints
Direction of displacement
Soft tissue
Artefact