X-rays

Question 1

What colour does bone appear on an X-ray?

Answer 1

White

Question 2

What colour does soft tissue appear on an X-ray?

Answer 2

Light grey

Question 3

What colour does fat appear on an X-ray?

Answer 3

Dark grey

Question 4

What colour does air appear on an X-ray?

Answer 4

Black

Question 5

The lighter the colour, the more … the tissue.

Answer 5

Dense

The lighter the colour, the more dense the tissue.

Question 6

What would an joint afflicted with osteoarthritis look like on an X-ray?

Answer 6

No different in early stages

Later on: think LOSS

L - loss of joint space
O - osteophytes
S - subarticular sclerosis
S - subchondral cysts

Question 7

What are osteophytes?

Answer 7

Bony projections/growths

Question 8

What does sclerotic bone look like on an X-ray?

Answer 8

More white since it’s more dense

Question 9

Where is ‘subchondral’?

Answer 9

Under cartilage

Question 10

What would an joint afflicted with rheumatoid arthritis look like on an X-ray?

Answer 10

Soft tissue swelling

Osteopenia of bone near affected joins

Decreased joint space

Bony erosions

Joint deformity: Swan Neck, Boutonniere

Question 11

What is Swan Neck deformity?

Answer 11

Distal interphalangeal joint hyperflexion

Proximal interphalangeal joint hyperextension

Question 12

What is Boutonniere deformity?

Answer 12

Distal interphalangeal joint hyperextension
Metacarpophalangeal joint hyperextension

Proximal interphalangeal joint hyperflexion

Question 13

What would a spine afflicted with Ankylosing Spondylitis look like on X-ray?

Answer 13

Syndesmophytes (like stalactites and stalagmites) at the edges of each vertebrae

In time these fuse, looks like a bamboo shoot

Bamboo spine

Question 14

What would a joint afflicted with psoriatic arthritis look like on X-ray?

Answer 14

Erosive changes

Pencil in cup deformity

Periostitis

Loss of bone architecture

Question 15

What is pencil in cup deformity?

Answer 15

In hands:

Bone is effectively ‘sharpened’, tip is narrowed

Looks like a pencil in a cup

Question 16

What would a joint afflicted with reactive arthritis look like on X-ray?

Answer 16

Enthesitis

Reaction of the periosteum

Question 17

What would a joint afflicted with gout look like on X-ray?

Answer 17

Large areas of erosion

Punched out lesions

Sclerotic overhanging edges

Joint spaces are usually preserved

Question 18

What would a joint afflicted with septic arthritis look like on X-ray?

Answer 18

Normal in early stages

Effusion can be seen

Narrowing of joint space

Juxta-articular sclerosis

Question 19

What do osteoporotic bones look like on X-ray?

Answer 19

Not a lot different until about 50% bone density is lost

Will appear darker

Question 20

What does an aggressive bone tumour look like on X-ray?

Answer 20

Permeated

Moth-eaten

Question 21

What does osteomyelitis look like on X-ray?

Answer 21

Permeated

Moth-eaten

Question 22

What is pepper-pot skull?

Answer 22

Black holes seen on an X-ray of the skull

A sign of multiple myeloma

Question 23

What is scalloping of a bone likely to be caused by?

Answer 23

Multiple myeloma

Question 24

What is likely to be the cause of a bone that looks permeated and moth-eaten?

Answer 24

Infection (osteomyelitis)

An aggressive bone tumour

Question 25

If you see a lesion on a bone that you are able to draw an outline round, is it likely to be benign or malignant?

Answer 25

Benign

Or non-aggressive malignant

Question 26

If you see a lesion on a bone that is ill-defined, is it likely to be benign or malignant?

Answer 26

Malignancy

Or infection

Question 27

If you see on an x-ray a bone that looks bent, what fracture is it likely to be?
What type of patient is it?

Answer 27

Plastic deformation

A child

Question 28

What does a buckle (torus) fracture look like on an X-ray?

Answer 28

Outward protrusion at the joining of the metaphysis and diaphysis

Question 29

You see an X-ray of a bone with outward protrusion at the joining of the metaphysis and diaphysis. What fracture is it?

Answer 29

A buckle or torus fracture