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ORTHOPAEDIC
X-RAYS
BY,
HEMAMALINI M
MPT I YEAR
Objectives
why radiograph
History of radiograph
X machine
Radiograph
Densities of x-ray
Terminology
Normal x- rays
Fracture
 Infection
Arthritis
Metabolic disorders
Tumors
Spine
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
History of radiograph
Father of x-ray - Willian Conrad Roentgen was invented in 1895
X- machine
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.
Five densities vary from radiolucent to very radiopaque.
Terminology
 sclerotic
lytic
cortex
medulla
articular
demineralization
 ankylosis
osteo-
chondro
fibro-
arthro-
spondylo-
dactyl
SHOULDER
ARM
ELBOW
FOREARM
FOREARM
HAND
PELVIS
`
HIP
THIGH
KNEE
LEG
ANKLE
FOOT
CERVICAL SPINE
AP
AP OPEN
MOUTH
THORACIC SPINE
LUMBAR SPINE
SACRUM
FRACTURE
INFECTIONS
ARTHRITIS
Metabolic disorders
Tumors
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
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)
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.
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.
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
Thank you

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ORTHOPEDIC XRAYS.pptx