1.3

• Radiographs (Rads) provide information about bone, joint and soft tissue structures
• Radiograph analysis


  • Requires systematic approach
  • Ensures critical structures viewed in orderly fashion
  • Minimizes tendency to focus on pre-conceived pathology
• Rads should complement a history & physical exam
• Key points of radiograph analysis

  • Look at all views available; compare with other side if taken
  • Compare with old images
  • Look for the unexpected
  • Don't stop after identifying one abnormality
  • Assess image quality
• Systematic approach to radiograph analysis

  1. Patient and image data

  2. Bone and joint alignment

  3. Cortical outline

  4. Bone texture

  5. Joint spacing

  6. Soft tissues
• Patient and image details

  • Ensure you are looking at correct image
  • Check patient's details; date of Radiograph
  • Look at the correct side
  • L and R marker identifies which extremity or which side of trunk
• Displaying & viewing image

  • Place on viewbox or computer screen as if person in anatomic position facing you
  • Assess quality of film
  • Develop system of looking at projections/views
• Projections


  • Describes path of the x-ray beam as it travels from the x-ray tube, through patient, to image receptor
  • All bones/joints have standard (routine) examination projections
  • Optional views taken to assess certain pathology
  • Never order or make interpretation on one view
• ABCS search pattern


  • A: Anatomic appearance and alignment
  • B: Bony density
  • C: Cartilage spaces
  • S: Soft tissues
• Anatomic appearance


  • Assess size, appearance, number of bones
  • Assess for normal bone shape and contour
  • Assess articulating bones for normal positional relationships
• Bone density


  • Assess general bone density for changes
  • Assess local bone density for changes
• Cartilage spaces


  • Assess for joint space narrowing
  • Look for spurs, erosions or sclerosis
  • Evaluate growth plate
  • Evaluate intervertebral discs
• Soft tissues


  • Assess muscles, fat pads and fat lines, periosteum, joint capsules
• Identified one search pattern and provided examples for each aspect of the pattern
• Demonstrated the value of being routine in radiograph analysis