common radiological images in Orthopaedic practise

1. MSK Radiology
Dr Yasim Khan
Senior Resident
MBBS, MS Ortho, DNB Ortho,
MNAMS

3. Mind Palace

4. Know what is normal
and a variant of normal looks like
If you spot one
abnormality, do not lose
focus until you have
reviewed all areas of the
image, otherwise, you
might miss important
pathology.
Eyes cant see what mind doesn't know

5. Adequacy
Radiographer related –
exposure
Penetrance
Cassette related issues
Magnification
orientation
focus
centering
tube angle
patient positioning

6. Adequacy
Interpreter related-
view angle
Too far or too near to screen
brightness of view box
eye level
proper orientation of limb in 3 dimensions
right person, date, time
See everything available on image- multiple injuries
Assess magnification
Asses view is standard AP/lateral, amount of rotation or obliquity ??
Comfort level, Noise cancellation
How much time do we need to stare on one Xray (fatigue ?)

12. Rule of Two’s
2 views- orthogonal AP, Lateral,
2 Joints- above & below injury
2 limbs- normal side for comparison
2 Occasions- for comparison
2 Observer
2 injuries

13. If you are in doubt on your findings
Discuss with colleagues
Reassess patient
Repeat x-rays
Special views
CT or MRI

14. Shoulder

20. Pregnant female
Do just AP view
Assess rotation

23. What is more dangerous

24. Correlate the radiological finding with the natural history of disease pathology and clinically (history + examination)

26. ELBOW

34. Hand & Wrist

44. Pelvis & Hip

62. Apley

63. Look trabeculae for
valgus impacted
NOF #

65. AFF

74. KNEE

78. ANKLE & FOOT

83. Quadri-malleolar #

89. SPINE

100. Facetal cyst

104. ONCOLOGY

121. PEADIATRIC ORTHO

129. INFECTION

130. Spina ventosa

134. Degenerative

139. INFLAMATORY

144. Thank You