This document provides an overview of orthopedic x-rays, including their purpose and history. It describes x-ray machines and the five densities visible on radiographs. Key orthopedic terminology is defined. Normal anatomy of multiple body regions is shown on radiographs, along with common orthopedic conditions like fractures, infections, arthritis, and tumors. Features to assess on spinal radiographs like vertebral alignment, disc height, and soft tissues are outlined.

1. ORTHOPAEDIC
X-RAYS
BY,
HEMAMALINI M
MPT I YEAR

2. Objectives
why radiograph
History of radiograph
X machine
Radiograph
Densities of x-ray
Terminology
Normal x- rays
Fracture
 Infection
Arthritis
Metabolic disorders
Tumors
Spine

3. Why radiography
Easily available
Initial investigation to evaluate bone and joints
Initial investigations for chest
For follow up
For better communication with orthopedics and
radiology department

4. History of radiograph
Father of x-ray - Willian Conrad Roentgen was invented in 1895

5. X- machine

6. Radiograph
X-rays are the beam of ionizing radiation emitted from the X-ray tube during the
exposure. Although “X-ray" is a term frequently used to refer to the image/film produced,
radiograph is the correct term.
The radiograph, irrespective of the projection/view, is a 2-dimensional representation of
a 3-dimensional structure.

7. Five densities vary from radiolucent to very radiopaque.

8. Terminology
 sclerotic
lytic
cortex
medulla
articular
demineralization
 ankylosis
osteo-
chondro
fibro-
arthro-
spondylo-
dactyl

10. SHOULDER

12. ARM

13. ELBOW

14. FOREARM

15. FOREARM

16. HAND

17. PELVIS
`

18. HIP

19. THIGH

20. KNEE

22. LEG

23. ANKLE

24. FOOT

26. CERVICAL SPINE
AP
AP OPEN
MOUTH

28. THORACIC SPINE

29. LUMBAR SPINE

30. SACRUM

31. FRACTURE

34. INFECTIONS

38. ARTHRITIS

39. Metabolic disorders

40. Tumors

41. Spine
The following features should be assessed when reviewing
the films;
— vertebral alignment
— spinous processes alignment
— vertebral body height
— disc space height
— prevertebral soft tissues

42. Vertebral alignment
3 smooth unbroken lines (or arcs) should be present in the normal spine, which are
— along the anterior margins of the vertebral bodies
— along the posterior margins of the vertebral bodies
— along the bases of the spinous processes (spinolaminar line)

43. Alignment of spinous processes
 the spinous processes should lie in a straight line on the AP view and be equidistant on the lateral
view.
splaying of the interspinous space on the lateral view will indicate ligamentous disruption and a
degree of subluxation. Loss of alignment on the AP view suggests unilateral problems with abnormal
rotation at the injured level e.g. unilateral facet dislocation.

44. Vertebral body and disc space height
• the vertebral bodies should have a relatively uniform square/rectangular shape and the disc spaces
be of uniform height.
• loss of height of a vertebral body indicates a compression fracture.
• widening of a disc space indicates severe injury with disruption of the disc.
• narrowing of the disc space may be due to chronic disc damage, and is common in old age.
However, subluxation of the vertebrae must be excluded when there has been an acute injury.

46. Pre vertebra I soft tissues
on the lateral view the normal prevertebral soft tissues should be no more than 30% of the
vertebral body width from Cl to C4 and no more than 100% of the vertebral body width at C5 to
C7
 abnormal prevertebral soft tissue swelling is seen in approximately 50% of patients with
bonyinjury. It is important to remember that absence of soft tissue swelling does not exclude a
significant injury

47. Thank you