X-ray Interpretation

Question 1

What should you include when describing any imaging?

Answer 1

• Name
• Age
• State what you are looking at:
  
  • Plain radiograph, USS, MRI
  • What view e.g. AP, lateral
  • Joint/what body part, which side R or L
• Date and time taken
• Most obvious abnormality
  
  • e.g. fracture- if so talk about type of fracture, displacement, any classification systems
  • e.g. dislocation, where is dislocation
• Review any soft tissue

Question 2

What might a fracture look like on x-ray?

Answer 2

• Dark line
• White line (bones have crushed in together resulting in bone superimposed on bone so white line)
• Irregularity in cortex

Question 3

What types of abnormality are you looking for on x-rays?

Answer 3

• Fractures
• Dislocations/subluxations
• Bony abnormalities e.g. lytic, sclerotic, mixed

Question 4

When describing displacement how do we always describe it?

Answer 4

Describe where distal part is with respect to proximal part

Question 5

What is meant by displacement?

What types of displacement are there?

Answer 5

Displacement=loss of normal alignment of bones

• Angular (does long axis of distal and proximal segements align)
• Length (distracted is increase in length, impacted is decrease in length)
• Translation (loss of bony apposition because distal fragment is now lateral or medial to proximal fragement)
• Rotation

Question 6

When looking at articular injuries what do you need to consider/review?

Answer 6

• Alignment
• Gaps
• Steps
• Subluxation
• Dislocation

Question 7

What criteria can be used to predict risk of pathological fractures in pts with long bone metastases?

Answer 7

Mirel’s criteria

Question 8

What is a pathological fracture?

Answer 8

A fracture of a diseased or weakened bone caused by a force that would not have fractured a healthy bone.

Question 9

What is a butterfly fracture?

Answer 9

Butterfly fragments are large, triangular fracture fragments seen commonly in comminuted long bone fractures.The term is commonly used in orthopedic surgery, and results from two oblique fracture lines meeting to create a large triangular or wedge-shaped fragment located between the proximal and distal fracture fragments, and resembles a butterfly.

Question 10

Remind yourself of the types of bone fracture

Answer 10