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Oral Disease , Defense and Repair > Reporting Radiographs > Flashcards

Reporting Radiographs Flashcards

1
Q

Possible outcomes of x ray photons when interacting with tissue?

A
  • Absorbed (not reaching image receptor)
  • Scattered (reach image receptor but information not helpful)
  • Pass through and reach image receptor giving useful information
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2
Q

Explanation of different shades of grey seen in X ray photographs?

A
  • Dense structures absorb more x-rays so will appear white
    E.g. enamel, cortical bone, metal
  • Soft tissues absorb less so appear dark grey
  • Air absorbs no photons so appears black.
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3
Q

How do we view a radiographs? (film)

A

If on film:

  • Darkened room
  • A light box providing a homogeneous light source, with an optional focal spot of bright light
  • Magnifier.
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4
Q

Ho do we view radiographs (digital)?

A

Digital

  • Darkened room
  • Minimal direct and reflected light
  • Diagnostic monitor with tested standards of resolution and contrast display
  • Monitor positioned at eye level
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5
Q

What is the SMPTE?

A
  • A test pattern for monitors to ensure adequate image display for diagnosis
  • High and low contrast line pairs to test resolution
    5% and 95% contrast squares centrally
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6
Q

Radiographic reports what are they?

A

Every radiographic image should have a radiographic report- legal requirement
A report is a description of any disease detected and a recording in the notes that the image has been clinically evaluated

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7
Q

Contents of the Radiographic Report

A
  • Demonstrate that each radiograph has been evaluated
  • Record pathological findings and/or key negative findings
  • A description of pathological findings to allow someone to visualise the image, even if they cannot see it
  • Should include sufficient information so that it can be subject to later audit
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8
Q

Correct reporting procedure:

A
  • Optimum conditions
  • Identify it is the correct patient
  • Ensure the film is dated
  • Correct right/left orientation
  • Identify film faults which may render diagnosis impossible
  • Examine full radiograph with a systematic approach.
  • Describe radiographic features of pathology
  • Form a differential diagnosis
  • Compare with previous imaging
  • —- Assess for stability, progression or resolution.
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9
Q

Systematic Approach to Viewing Radiographs

A
  • Identify any artefacts which might be mistaken for pathology
  • Identify normal anatomical features and variants of normal
  • Teeth, apical tissues and periodontal tissues
  • — URQ → ULQ → LLQ → LRQ
  • Assess other structures
  • — Body/ramus of mandible on OPT
  • — Antral floor
  • — Nasal cavity
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10
Q

Radiolucency

A
  • Black on image
  • Caused by area of decreased density
  • More x-rays passing through to interact with receptor, e.g. air, less bone
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11
Q

Radiopacity/radiodensity

A
  • Whiter on image

- Fewer x-rays reaching receptor as resorbed by denser tissue e.g. bone

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12
Q

Caries- causes loss of hard tissue - what is seen on radioraph?

A
  • loss of mineral in enamel and dentine, causing a relative radiolucency
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13
Q

Periodontal disease and radiographic appearance

A

Loss of bone at the alveolar crest- radiolucency

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14
Q

Reporting a Lesion:

A
  • Location
  • Size
  • Density
  • — Radiolucent/ radiopaque/mixed density
  • Shape
  • Margins
  • Effects on surrounding structures
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15
Q

Location of Lesion - how do I describe it?

A
  • Maxilla/mandible/soft tissues
  • Relation to teeth- Which teeth,
  • Which part of tooth- Apex, Root, Crown
  • Position above or below the ID canal
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16
Q

Size of Lesion - how do I describe it?

A
  • Direct measurement and units
  • Some radiographs have inherent magnification (e.g. 1.2-1.7 x magnification in panoramics) so measurements may not be precise
  • In the jaws we can describe size relative to adjacent structures.
17
Q

Density of Lesion - how do I describe it?

A
  • Homogeneous (uniform, smooth)
    —- Radiolucent (dark)
    —- Radiopaque (light)
    Heterogeneous
    —- Mixed density
    —- Mix of radiolucent and radiopaque areas
18
Q

Size of Lesion - how do I describe it?

A

Circular
Lobulated
Sausage shaped
Expansile

19
Q

Shape of Lesion - how do I describe it?

A
  • Unilocular= singular lesion compartment
  • Multilocular= many compartments separated
  • Pseudolocular= has a more scalloped outline so septa project towards the centre of the lesion but don’t compartmentalise it
20
Q

Margins of Lesion - how do I describe it?

A 
Smooth
Lobular
Irregular
Corticated
Partially corticated
Well-defined
Ill-defined/diffuse
21
Q

Radiograph limitations

A
  • Radiograph is a 2D representation of 3D structure
  • Always consider need for another view at a different angle (Parallax technique/SLOB rule) esp when
  • – Localise a radiodensity
  • – Assess a fracture

Oral Disease , Defense and Repair (24 decks)

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