My Radiology Note

to be radiology master! insyaAllah

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X-ray to look for scoliosis must be taken in standing position

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Soft tissue ossification and calcification best be viewed by CT scan

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Open mouth view x-ray is to view C1 and C2 vertebra

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x-ray of hand and wrist

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Pathological Fracture

High force is required to fracture a normal bone, but diseased bones may fracture as a result of low impact trauma. A fracture arising within abnormal bone is termed 'pathological.'

ex: osteoporosis, myeloma(moth-eaten feature on x-ray), bone lesion

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angulation fracture

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impacted fracture

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Fracture Displacement

the abnormal position of the distal fragment in relation to the proximal bone

Type: angulation, rotation, change of bone length, loss of alignment

displacement - loss of bone alignment along its long axis

shortening - Proximal migration of the distal fracture component results in shortening of the overall bone length

angulation - direction of the distal bone and degree of angulation in relation to the proximal bone. Medial angulation - 'varus', and lateral angulation - 'valgus'

rotation - Rotation of a long bone fracture may be internal or external

distraction - resulting in increased overall bone length, is due to (widening) of the bone components

impacted - shortening of bone without loss of alignment

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segmental fracture

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butterfly fracture

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Comminuted fractures

A bone injury that results in more than 2 separate bone components is known as a comminuted fracture.

- such as 'butterfly fragment' or 'segmental fracture'

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Introduction to Trauma X-ray

There are 4 anatomical classes of bone - long, short, flat and irregular. Description of a bone fracture depends on the class of bone and the direction of the fracture line.

'Long bone' fractures

Long bone fractures are described with reference to the direction of the fracture line in relation to the shaft of the bone. For example, a fracture passing perpendicular across the bone shaft is described as 'transverse'.

Other fractures passing across a long bone include, 'oblique' and 'spiral' fractures

'Irregular bone' fractures

A fracture of a short, flat or irregular bone requires a description determined by its direction through the bone. Useful terms include - horizontal, vertical, coronal, sagittal and axial.

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Look for the unexpected

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'Treat the patient and not the X-ray!'

When looking at an X-ray always keep the current clinical features at the forefront of your mind.

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2 views are better than 1

In the context of trauma at least 2 views of the body part in question are usually required

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Systemic Approach

Patient and image data 

Bone and joint alignment - Loss of alignment may be due to bone fracture or joint dislocation

Joint spacing - Joint spacing may be narrowed due to cartilage loss or widened due to dislocation/dissociation

Cortical outline - Check the cortical outline (white lines) of ALLbones visible on every X-ray available

Bone texture - In some bones a fine matrix of fine white lines (trabeculae) is seen

Soft tissues