Interpreting X-rays Flashcards
Systematic order to follow when interpreting an x-ray?
- Name of patient
- Date
- 2 views: lateral and AP
- 2 joints above and below the fracture
- Name the bone
- Name the part of the bone thats fractured
- type of fracture
- describe the deformity
What are the 2 x-ray views?
- AP - Anterior-Posterior: x-ray passes from the anterior to the posterior of the patient
- lateral - may be obtained as a mediolateral view or lateromedial view depending
Note: views are taken at right angles
Why do we take 2 views?
To not miss the fracture - might be seen in one view and not the other
Why do we take 2 views of joints above and below the fracture?
prevent missing dislocation of joints
How to name the part of the bone thats fractured?
- Intra-articular fracture/ epiphysis
- Metaphysis fracture
- Diaphysis fracture
Name and describe the types of fractures?
- SIMPLE fracture - one fracture line
> spiral
> oblique
> transverse - WEDGE fracture - butterfly segment
- COMPLEX fracture - comminuted
When does a spiral fracture usually happen?
when you twist the leg
- especially in children
What is the difference between transverse and oblique fractures?
oblique fractures = >30 degrees
transverse fractures = <30 degrees
What is a segmental fracture?
when the bone is broken in at least 2 places leaving a segment of your bone totally separated by the breaks
What is a wedge fracture?
results from two oblique fracture lines meeting to create a large triangular or wedge-shaped fragment located between the proximal and distal fracture fragments
Note: known as butterfly segment fracture
What is a comminuted fracture?
bone is broken into more than 2 pieces
What is a greenstick fracture?
occurs when a bone bends and cracks instead of breaking completely into separate pieces
Describe the difference in bone healing between segmental and wedge fractures?
segmental fracture cant heal without middle piece where as in wedge fracture you can remove the wedge and healing will still take place
What criteria do you use to describe deformity?
DAMS
1. Displacement
2. Angulation
3. Malrotation
4. Shortening
What is displacement?
bone ends have moved relative to one another
How do you describe displacement?
- Use distal fragment to describe displacement
- Describe displacement in both planes - where
- Estimate % of contact - how much
i.e. 25, 50, 75, 100%
e.g. lateral displacement with 50% bone apposition
What is angulation?
bone fragments are angulated relative to each other
How do you describe angulation?
- with respect to tilt of distal fragment
- Estimate angle between fragments
e.g. Distal fragment angulated laterally at 25 degrees
How do you calculate angulation?
- draw an axis through what would be the normal unfractured bone
- drawn an axis through the distal fractured bone
- measure the angle between them
What is malrotation?
bone fragments have rotated relative to one another
How do you describe malrotation?
Very important to have two joints in the X-ray
e.g. femur
At hip it looks AP
Knee it looks lateral
> Therefore rotated by 90 degrees
Note: joint positions will tell the rotation
What is shortening?
proximal migration of the distal fracture component results in shortening of the overall bone length
Note: an oblique fracture is more readily shortened than transverse fracture
What is diastasis?
separation of bone
What is distraction?
a fracture resulting in increased overall bone length due to widening of space between bone components
