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Rad interpretation

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  • 1. Principles of radiographic interpretation Islam KassemConsultant oral & maxillofacial surgeon ikassem@dr.com
  • 2. DefinitionInterpretation of radiographs can be regarded asan unraveling process — uncovering all the information contained within the black, white and grey radiographic images. ikassem@dr.com
  • 3. Interpretation of radiographs can be regarded as an unraveling process — uncovering all the information contained within the black, white and grey radiographic images. ikassem@dr.com
  • 4. II-Essential requirements for interpretation1- Optimum viewing conditions2- Understanding the nature and limitations of the black, white and grey radiographic image3- Knowledge of what the radiographs used in dentistry should look like, so a critical assessment of individual film quality can be made4-Detailed knowledge of the range of radiographic appearances of normal anatomical structures5- Detailed knowledge of the radiographic appearances of the pathological conditions affecting the head and neck6- A systematic approach to viewing the entire radiograph and to viewing and describing specific lesions7- Access to previous films for comparison. ikassem@dr.com
  • 5. 1- Optimum viewing conditions• An even, uniform, bright light viewing screen (preferably of variable intensity to allow viewingof films of different densities)• A quiet, darkened viewing room• The area around the radiograph should bemasked by a dark surround so that light passesonly through the film• Use of a magnifying glass to allow fine detail to be seen more clearly on intraoral films• The radiographs should be dry. ikassem@dr.com
  • 6. The nature and limitations of the radiographic image ikassem@dr.com
  • 7. 2- Understanding the nature and limitations of the black, white and grey radiographic image ikassem@dr.com
  • 8. 3- Knowledge of what the radiographs used in dentistry shouldlook like, so a critical assessment of individual film quality can be made ikassem@dr.com
  • 9. 4-Detailed knowledge of the range ofradiographic appearances of normal anatomical structures ikassem@dr.com
  • 10. 5- Detailed knowledge of the radiographic appearances of thepathological conditions affecting the head and neck ikassem@dr.com
  • 11. 6- A systematic approach to viewingthe entire radiograph and to viewing and describing specific lesions ikassem@dr.com
  • 12. 7- Access to previous films for comparison. ikassem@dr.com
  • 13. Principles of Radiographic Interpretation
  • 14. Imaging as an Examination ToolClinical examinationSignsSymptomsOrdering the right type of imaging examinationOrdering the right number of imaging examinationNecessary vs. unnecessary examinationsBenefit to the patient
  • 15. Viewing conditionView boxMonitorPrintsAmbient light reducedQuiet roomIntraoral films mounted on a opaque holderEqual intensity of light on the view boxMonitors: calibrationMagnificationSoftware limitations
  • 16. Systematic ApproachIntraoral images Teeth, periodontium, bone, adjacent structures Tooth #1 to #16, and then #17 to #32Extraoral images; Panoramic, other extraoral plain radiographsCross sectional images CT, MRI
  • 17. Localize the abnormalityHow many lesions?Where is the lesion?Localized vs generalizedSingle arch or both the archesInside the bone or outsideRelation to the crownRelation to the rootSuperior to the mandibular canal
  • 18. PeripheryWell defined or ill defined?Sharp marginsCorticated marginsSclerotic marginsRadiolucent bandBlends into adjacent areaIrregular margins
  • 19. ShapeCircularOvalScallopedMultilocular
  • 20. Internal structuresRadiolucentMixedRadiopaqueTrabeculationSeptaCalcificationsTooth or similar entities
  • 21. Adjacent structuresTeethLamina duraCrestal bonePeriodontal spacesAlveolar boneNerve canalsMaxillary sinusesCortical bones
  • 22. Radiographic findings Abnormal Normal Developmental Acquired TumorsCysts Inflammatory Bone dysplasia Vascular Metabolic Trauma (benign/malig)
  • 23. Vindicate your D/DVascularInfectionNeoplasmDrugsIdiopathic/inflammatoryCongenitalAutoimmuneTraumaEndocrine/metabolic
  • 24. Irrelevant words!Sun-ray appearanceGround glassCotton woolOnion skinDriven snowEtc, etc
  • 25. When not to order imagingYou have not clinically / radiographically evaluated the patientNo benefit to the patientAdditional images may not provide extra informationNo ‘routine’ radiograph
  • 26. What goes on the reportPatient, doctor, clinic identificationDate, type and number of examinationReasons for the examinationClinical informationRelevant observationRadiographic ImpressionsAny further tests, examinations
  • 27. Thank you ikassem@dr.com

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