MSK X-ray Intepretation Skills
Index
Introduction
Objectives
Principles
Examples
References
Introduction
Medical Decision Making
+ INFO
Introduction
X-rays
High density tissue (e.g. bone) – absorb x-rays to a greater degree, and appear white on the film.
Low density tissue (e.g the lungs) – absorb x-rays to a lesser degree, and appear black on the film.
Intermediate density tissue (e.g. muscle and fat) – appears as shades of grey on the x-ray film.
+ INFO
Objectives
Review a systematic approach to interpreting orthopedic trauma x-rays
Review the language of fracture description
Practice X-ray interpretation from given examples
ABCs Approach
Pre ABC: identify pt, read provided info time etc and part imaged
ADEQUACY ALIGNMENT
CARTILAGE
BONES
SOFT TISSUES
ALIGNMENT
ADEQUACY
VIEWS (RULE OF 2S) PENETRATION
Bone alignment vs contralateral side
Bone alignment relative to proximal and distal bones
BONES
BONES
IDENTIFY SPECIFIC BONE BONE DENSITY CORTICAL DISCONTINUITY
BONE ABNORMALITY -LOCATION -SHAPE
Identify specific bones & abnormalities
SOFT TISSUES
Look for soft tissue swelling and joint effusions
+ INFO
Describe this radiograph.
LANGUAGE OF FRACTURES
Important for use to describe x-rays in medical terminology.
Improves communication with orthopedic consultants
OPEN FRACTURES
Fractured bone and/or fracture hematoma are exposed to the external environment via a traumatic violation of the soft tissue and skin
ANATOMICAL LOCATION
LATERALITY
SPECIFIC BONE
Describe the precise anatomic location of the fracture
FEMUR / HUMERUS / ULNA ETC
LEFT / RIGHT
JOINT INVOLVEMENT
LOCATION
INTRAARTICULAR / EXTRAARTICULAR / PERIARTICULAR
PROXIMAL / MIDDLE / DISTAL THIRD
FRACTURE PATTERNS
What type of fractures are these?
FRACTURE FRAGMENTS
Terms to be familiar with when describing the relationship of fracture fragments
ALIGNMENT
Alignment is the relationship in the longitudinal axis of one bone to another
Angulation is any deviation from normal alignment
Lorem ipsum dolor sit amet
Phasellus at viverra risus. Vivamus vulputate consequat.
Angulation is described in degrees of angulation of the distal fragment in relation to the proximal fragment—to measure angle draw lines through normal axis of bone and fracture fragment
Lorem ipsum dolor sit amet
Phasellus at viverra risus. Vivamus vulputate consequat.
+ INFO
Displacement
broad term that refers to angulation, translation and rotation
Bayonette apposition
overlap of fracture fragments
Distraction
displacement in the longitudinal axis of the bones
Translation
displacement / movement of fractured bones away from each other
Dislocation
disruption of normal relationship of articular surfaces
Describe the fracture fragments
ANSWER
This is a closed midshaft tibial fracture….But how do we describe the fragments?
This is an example of partial apposition; note part of the fracture fragments are touching each other
Alternatively you can describe this as translated 1/3 the thickness of the bone
Final answer: Closed midshaft tibial fracture with moderate (33%) lateral translation
+ INFO
DISLOCATION
Articular surfaces of the JOINT no longer maintain their normal CONGRUENT relationship
Dislocations are named by the position of the distal segment relative to the proximal segment
SUMMARY
To review, when seeing a patient with a fracture and the x-ray, describe the following: -Anatomic location of fracture (distal, mid, proximal) and if fracture is intra-articular
-Fracture line (transverse, oblique, spiral, comminuted)
-Relationship of fracture fragments (angulation, displacement, dislocation, etc)
Thank you!
Sebastian Ndlovu
MBChB, MRCS, MSc
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Interpretation of X-rays
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Transcript
MSK X-ray Intepretation Skills
Index
Introduction
Objectives
Principles
Examples
References
Introduction
Medical Decision Making
+ INFO
Introduction
X-rays
High density tissue (e.g. bone) – absorb x-rays to a greater degree, and appear white on the film. Low density tissue (e.g the lungs) – absorb x-rays to a lesser degree, and appear black on the film. Intermediate density tissue (e.g. muscle and fat) – appears as shades of grey on the x-ray film.
+ INFO
Objectives
Review a systematic approach to interpreting orthopedic trauma x-rays
Review the language of fracture description
Practice X-ray interpretation from given examples
ABCs Approach
Pre ABC: identify pt, read provided info time etc and part imaged
ADEQUACY ALIGNMENT
CARTILAGE
BONES
SOFT TISSUES
ALIGNMENT
ADEQUACY
VIEWS (RULE OF 2S) PENETRATION
Bone alignment vs contralateral side Bone alignment relative to proximal and distal bones
BONES
BONES
IDENTIFY SPECIFIC BONE BONE DENSITY CORTICAL DISCONTINUITY
BONE ABNORMALITY -LOCATION -SHAPE
Identify specific bones & abnormalities
SOFT TISSUES
Look for soft tissue swelling and joint effusions
+ INFO
Describe this radiograph.
LANGUAGE OF FRACTURES
Important for use to describe x-rays in medical terminology. Improves communication with orthopedic consultants
OPEN FRACTURES
Fractured bone and/or fracture hematoma are exposed to the external environment via a traumatic violation of the soft tissue and skin
ANATOMICAL LOCATION
LATERALITY
SPECIFIC BONE
Describe the precise anatomic location of the fracture
FEMUR / HUMERUS / ULNA ETC
LEFT / RIGHT
JOINT INVOLVEMENT
LOCATION
INTRAARTICULAR / EXTRAARTICULAR / PERIARTICULAR
PROXIMAL / MIDDLE / DISTAL THIRD
FRACTURE PATTERNS
What type of fractures are these?
FRACTURE FRAGMENTS
Terms to be familiar with when describing the relationship of fracture fragments
ALIGNMENT
Alignment is the relationship in the longitudinal axis of one bone to another Angulation is any deviation from normal alignment
Lorem ipsum dolor sit amet
Phasellus at viverra risus. Vivamus vulputate consequat.
Angulation is described in degrees of angulation of the distal fragment in relation to the proximal fragment—to measure angle draw lines through normal axis of bone and fracture fragment
Lorem ipsum dolor sit amet
Phasellus at viverra risus. Vivamus vulputate consequat.
+ INFO
Displacement
broad term that refers to angulation, translation and rotation
Bayonette apposition
overlap of fracture fragments
Distraction
displacement in the longitudinal axis of the bones
Translation
displacement / movement of fractured bones away from each other
Dislocation
disruption of normal relationship of articular surfaces
Describe the fracture fragments
ANSWER
This is a closed midshaft tibial fracture….But how do we describe the fragments? This is an example of partial apposition; note part of the fracture fragments are touching each other Alternatively you can describe this as translated 1/3 the thickness of the bone Final answer: Closed midshaft tibial fracture with moderate (33%) lateral translation
+ INFO
DISLOCATION
Articular surfaces of the JOINT no longer maintain their normal CONGRUENT relationship Dislocations are named by the position of the distal segment relative to the proximal segment
SUMMARY
To review, when seeing a patient with a fracture and the x-ray, describe the following: -Anatomic location of fracture (distal, mid, proximal) and if fracture is intra-articular -Fracture line (transverse, oblique, spiral, comminuted) -Relationship of fracture fragments (angulation, displacement, dislocation, etc)
Thank you!
Sebastian Ndlovu
MBChB, MRCS, MSc
Got an idea?
Use this space to add awesome interactivity. Include text, images, videos, tables, PDFs... even interactive questions! Premium tip: Get information on how your audience interacts with your creation:
Got an idea?
Bring it to life with an interactive window
Create a new layer with all the Genially features.
Got an idea?
Bring it to life with an interactive window
Create a new layer with all the Genially features.
Got an idea?
Bring it to life with an interactive window
Create a new layer with all the Genially features.
Got an idea?
Bring it to life with an interactive window
Create a new layer with all the Genially features.
Got an idea?
Use this space to add awesome interactivity. Include text, images, videos, tables, PDFs... even interactive questions! Premium tip: Get information on how your audience interacts with your creation:
Got an idea?
Use this space to add awesome interactivity. Include text, images, videos, tables, PDFs... even interactive questions! Premium tip: Get information on how your audience interacts with your creation:
Got an idea?
Use this space to add awesome interactivity. Include text, images, videos, tables, PDFs... even interactive questions! Premium tip: Get information on how your audience interacts with your creation:
Got an idea?
Bring it to life with an interactive window
Create a new layer with all the Genially features.
Got an idea?
Bring it to life with an interactive window
Create a new layer with all the Genially features.
Got an idea?
Bring it to life with an interactive window
Create a new layer with all the Genially features.
Got an idea?
Bring it to life with an interactive window
Create a new layer with all the Genially features.
Got an idea?
Use this space to add awesome interactivity. Include text, images, videos, tables, PDFs... even interactive questions! Premium tip: Get information on how your audience interacts with your creation: