Purpose and Structures Shown An alternate view of the lumbar spine in PA projection to protect radiosensitive organs from exposure. Video Credit : Vien Chunggia Lumbar Spine PA Ferguson Method The patient should be asked to stop breathing when the exposure is taken. Position of part The patient’s knees are bent to ensure the back is flat on the table. In trauma patients, a lumbar spine X-ray is done in the AP or PA position with minimal movement of the patient. Injured patients should NOT be turned over. Purpose and Structures Shown A basic view of the lumbar spine. On lateral projections, the intervertebral disc spaces and intervertebral foramen as well as the superior and inferior articular processes should be visible along with the vertebral bodies and spinous processes. Radiologists consider a lumbar spine radiographic film of good quality when it demonstrates the lower ribs, lumbar vertebral bodies, transverse processes, pedicles, spinous processes, sacrum, and sacroiliac joints. This article discusses radiographic positioning of the lumbar spine for the Radiologic Technologist (X-Ray Tech). Anatomy & Physiology, Connexions Web site. Lindsay Davidson, annotated by Mikael Häggström.Joint dislocation of the metacarpophalangeal joint. When assessing a fracture, apply a structured approach paying particular attention to the location, type and displacement of the fracture.There are several sub-types of fractures, each associated with different mechanisms of injury and patient factors.The ABCS approach provides a generic framework to assess most types of X-rays (alignment and joint space, bone texture, cortices and soft tissues).Always begin X-ray interpretation by carefully checking the details of the patient and radiograph.By applying a structured approach to musculoskeletal X-ray interpretation you reduce the risk of missing pathology.Rotation: usually difficult to appreciate on an x-ray.If translation is further away than the width of the bone, it is said to be ‘off-ended’. translation of 25% of the width of the bone). Described using the width of the bone as context (e.g. Translation: movement of the fractured bones away from each other.Angulation: changes in the axis of the bone, usually described as dorsal/palmar or varus/valgus or radial/ulnar.Is there displacement?ĭisplacement is described in terms of the distal fragment to the body (e.g. This is important to state because of the risk of infection with open fractures. If a fracture is associated with a puncture of the skin or open wound, this is classed as an open fracture. Black arrow demonstrates the fracture line while the white arrow marks the growth plate. Subchondral sclerosis (increased bone density) is often present along the joint lines in patients with osteoarthritis.Īn X-ray of the left ankle showing a Salter-Harris type 3 fracture of the medial malleolus. 1Ĭarefully look at the joint space to identify changes such as joint space narrowing due to cartilage loss, cartilage calcification (as in chondrocalcinosis) or new bone formation (e.g. Joint dislocation of the metacarpophalangeal joint of the 5th digit. The radiograph below demonstrates why it is important to have more than one view. When describing the displacement, the position of the fragment distal to the fracture site is always described. Alignment and joint spaceĬhanges in alignment suggest a fracture, subluxation (partial dislocation) or dislocation. If you spot one abnormality, do not lose focus until you have reviewed all areas of the image, otherwise, you might miss important pathology. The ABCS approach of X-ray interpretation involves assessing the following:ĭon’t forget to review all views, compare both sides and re‐examine any previous imaging. You might also be interested in our premium collection of 1,000+ ready-made OSCE Stations, including a range of radiology interpretation stations ✨ X-ray interpretation (ABCS approach)
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