Illustrated Manual guide for X-rayReading & Interpretation

By/Ahmad Saeed Youssef

Interpretation of Bone images

• Identify the type of film.• Identify view.• Identify the illustrated bones and joints.• Look generally.• mention if growing child, splints, cast, screws..etc.• close to area of interest and comment on any pathology ( see before).

• NORMALLY: No interruption of bone trabeculae or volume & bones are smooth. Cortical line intact No cloudy periosteal reaction. Joint space is smooth and approprioate. Compare with other side.

Normal Radiographic Anatomy

1) Upper extremety

2) Lower extremety

3) Spine

Plain X-ray, Ap illustrating Left shoulder joint, humerus , scapula, clavicle and upper 7 ribs. There is a simple oblique fracture in lateral 3rd of shaft of clavicle.

Plain X-ray, Ap illustrating Right shoulder joint, humerus , scapula, clavicle and upper 6 ribs. There is an oblique fracture at junction of upper and midlle thirds of humerus.

Plain X-ray, Lateral view for a growing child (note grwoing bone) illustrating right elbow and wrist joints, both ulna and radius.There is transverse fracture at mid-shaft of radius.

Plain X-ray, Ap view for right shoulder showing an empty glenoid, and dislocated humerus.Diagnosis: anterior dislocation of shoulder.

Plain X-ray, Ap view ( except lower Rt is lateral view) iluustrating the Lt wrist , showing fracture of scaphoid bone.

Plain X-ray, Ap view illustrating both hip joints of osteoporotic bone. Showing complex fracture of Lt femur at junction of its upper and middle 3rd.

Plain X-ray, Ap view illustrating Right hip jointShowing complex fracture of RT femur at junction of its upper and middle 3rd.

Plain X-ray, Ap view illustrating both Lt tibia and fibula.Showing simple transverse fracture of tibia at medial maleolus and simple spiral fracture of fibula at junction of its lower and middle 3rds.

Plain X-ray, Ap view illustrating both Lt tibia and fibula. And knee joint.Showing simple spiral fracture of tibia at mid shaft.

Plain X-ray, Ap view illustrating both RT tibia and fibula.Showing expansile well-defined osteolytic bone lesion at distal end of fibula.

Plain X-ray, Ap view showing Rt knee joint, both femur , tibia and fibula.There is narrowing of joint space, sclerosis line , marginal osteophytes, and subarticular bone cysts. There is genu varum deformity evident by angel between axis of femur and axis of tibia.

Diagnosis: Osteoarthritis.

Plain X-ray, Ap view showing both hands, radius and ulna.There is swan neck deformity of index finger.Narrow joint spaces, together with marginal bone erosins.

Diagnosis: Rheumatoid arthritis.

Plain X-ray, Ap view showing both hands, radius and ulna.There is irregularity and narrowing of the left first metacarpal-phalangeal , together with sclerosis.There is also soft tissue swelling suggestive of subcutaneous tophious nodule.

Diagnosis: Gouty arthritis.

Plain X-ray AP of Rt hand showing Periosteal elevation, cortical disruption and medullary involvement with rarefaction of bone and reactive new bone formation at 1st and the second metacarpal (arrow). Diagnosis: Osteomyelitis.