Week 6 - Evaluation Of Plain Radiograoghy Flashcards
Systematic approach
Patient and image data
Bone and joint alignment
Joint spacing
Cortical outline
Bone texture
Soft tissue
Quality of the radiograph
Needs to be of good quality providing as much information as possible
Dependent of the operator skill to obtain the optimal view prescribed, sufficient density, contrast, optimal detail and minimal distortion (oblique become the most distorted
Distortions - poor vs good
Poor positioning and exposure - soft tissues cannot be seen and joint spaces and bones not clear
Good positioning and exposure - good view of soft tissues and caneonaviculad coalition seen
Evaluating plain film checklist (2-3;2-1-4)
Initial patient check list - patient info, exposure, patient positioning
Film reading - ABCs - alignment, bone density, cartilage spaces, soft tissues
Alignment questions
Is the alignment consistent with the physical examination
Are there any deviated, subluxed or dislocated joints
Is the alignment consistent with the functional assessment
Subluxation
“Partial dislocation” the 2 bones that form the joint are still partially in contact with each other
Alignment problems
Anomalies
Fractures
Joint deformities - HV, claw toe and hammer toe
Bone questions
Are all the bones there
Are there density changes in the mineral content
Are there erosions
Are there fractures
Do the bones look excessively thick or thin
Bone problems
Joint spacing
Cortical outline - smooth, recognisable, contours
Bone texture - trabecular pattern
Bone density - inconsistency
Bone shape - thickening/thinning
Tabulation - under or over
Differences in density
Cysts
Erosions
Bone proliferation
Cartilage questions
Joint space represents articular cartilage
Is there any increase or decrease in the joint space
Is there any increase or decrease in sub no deal bone
Increase in density
Decreased density
Soft tissue questions
Does the soft tissue follow the contour of the bone
Are there any joint effusions (swellings)
Are there general or local increased or decreased areas of density
Is there any Fat pad displacement
Are there soft tissue calcifications present
Systematic ST Questikos
Is there swelling?
Calcifications?
Ossifications?
Or gas in the soft tissues
Accessory bones
Commonly bilateral
Uniform and round
Contain cortical bone and trabeculae
Asymptomatic
Tarsal coalitions can be
Fibrous (syndesmoisis)
Cartilaginous (synchondrosis)
Osseous (synostosis)
Bipartite seasmoid
1 seasmoid
2nd seasmoid split into 2
