Rad interpretation

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Rad interpretation

  1. 1. Principles of radiographic interpretation Islam KassemConsultant oral & maxillofacial surgeon ikassem@dr.com
  2. 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. 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. 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. 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. 6. The nature and limitations of the radiographic image ikassem@dr.com
  7. 7. 2- Understanding the nature and limitations of the black, white and grey radiographic image ikassem@dr.com
  8. 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. 9. 4-Detailed knowledge of the range ofradiographic appearances of normal anatomical structures ikassem@dr.com
  10. 10. 5- Detailed knowledge of the radiographic appearances of thepathological conditions affecting the head and neck ikassem@dr.com
  11. 11. 6- A systematic approach to viewingthe entire radiograph and to viewing and describing specific lesions ikassem@dr.com
  12. 12. 7- Access to previous films for comparison. ikassem@dr.com
  13. 13. Principles of Radiographic Interpretation
  14. 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. 15. Viewing conditionView boxMonitorPrintsAmbient light reducedQuiet roomIntraoral films mounted on a opaque holderEqual intensity of light on the view boxMonitors: calibrationMagnificationSoftware limitations
  16. 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. 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. 18. PeripheryWell defined or ill defined?Sharp marginsCorticated marginsSclerotic marginsRadiolucent bandBlends into adjacent areaIrregular margins
  19. 19. ShapeCircularOvalScallopedMultilocular
  20. 20. Internal structuresRadiolucentMixedRadiopaqueTrabeculationSeptaCalcificationsTooth or similar entities
  21. 21. Adjacent structuresTeethLamina duraCrestal bonePeriodontal spacesAlveolar boneNerve canalsMaxillary sinusesCortical bones
  22. 22. Radiographic findings Abnormal Normal Developmental Acquired TumorsCysts Inflammatory Bone dysplasia Vascular Metabolic Trauma (benign/malig)
  23. 23. Vindicate your D/DVascularInfectionNeoplasmDrugsIdiopathic/inflammatoryCongenitalAutoimmuneTraumaEndocrine/metabolic
  24. 24. Irrelevant words!Sun-ray appearanceGround glassCotton woolOnion skinDriven snowEtc, etc
  25. 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. 26. What goes on the reportPatient, doctor, clinic identificationDate, type and number of examinationReasons for the examinationClinical informationRelevant observationRadiographic ImpressionsAny further tests, examinations
  27. 27. Thank you ikassem@dr.com

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