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Dasar-Dasar Anatomi Radiologi 2022

This document provides an overview of radiographic anatomy and techniques for evaluating x-rays. It introduces the ABCs systematic approach for assessing plain x-rays, where A stands for anatomy, B for bones, C for cartilage, and the remaining letters stand for adequacy, alignment, and soft tissue. The document also provides examples of fractures and injuries illustrated on x-rays and describes techniques for documenting findings using medical terminology.

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ramdani rachmat siddiq
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93 views50 pages

Dasar-Dasar Anatomi Radiologi 2022

This document provides an overview of radiographic anatomy and techniques for evaluating x-rays. It introduces the ABCs systematic approach for assessing plain x-rays, where A stands for anatomy, B for bones, C for cartilage, and the remaining letters stand for adequacy, alignment, and soft tissue. The document also provides examples of fractures and injuries illustrated on x-rays and describes techniques for documenting findings using medical terminology.

Uploaded by

ramdani rachmat siddiq
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Radiographic Anatomy

(The Basic)

Vini Nilasari, dr. SpRad


 Study of shape and body structure by
means of radiography ( X-ray imaging)

Radioanatomy
 2 dimension
 Doesn’t cover the whole body
 Affected by magnification

Difference with normal anatomy


Soft tissue:
 Cutis
 Subcutis
 Subcutis adipose
tissue
 Muscle

Skeletal Radiogram
 Periosteum
 Cortex
 Endosteum
 Spongiosum

Bone
 Epiphysis
 Epiphyseal plate/
growth plate/
epiphyseal line
 Metaphysis
 Diaphysis

Bone Structure
 Routine
◦ PA / AP
◦ Lateral
 Additional
◦ Oblique (RAO/LAO)
◦ Tangensial
◦ Etc

Positioning
1. Bone
◦ Size
◦ Shape
◦ Trabecular structure
◦ Integrity and alignment
2. Joint Space
3. Joint surface
4. Soft tissue

Joint
How to learn your

radiographic imaging?

• We need to use a systematic approach, which is logical and


easy to remember

• It helps to minimise interpretive errors

Introductions
• The ABCs systematic approach is the
simplest and widely used system for the
assessment of plain x-rays.

• Its as simple as ABC!

Introductions
 natomy, dequacy, lignment
 ones
 artilage
 oft Tissue

Apply ABCs approach to every orthopedic film you


evaluate

Introductions
 Basic radiological anatomy is ‘the bread
and butter’ of radiology.

Know your anatomy and you know radiology!

Anatomy
Which bone?
 All x-rays should have an adequate
number of views
◦ Two views (minimum)
◦ One view is “No view”

 All x-rays should have adequate


penetration

Adequacy
 Alignment: anatomic relationship between
bones on x-rays
 Normal x-rays should have normal
alignment
 Fractures and dislocation may affect the
alignment on the x-rays

Alignment
 Closed right intertrochanteric fracture

 Sometimes difficult to appreciate on x-ray


but will clearly show on CT scan or MRI
 Examine the size and shape of the bone
(the entire length)
 Examine the trabecular pattern
 Examine bones for fracture line or
distortions
 Remember → fractures may subtle

Bones
Chan, O., ABCs of Emergency Radiology 3rd Ed., 2013
 Cartilage implies to examine the joint
spaces on x-ray
 Examine the space and the surface of the
joint
 Widening or narrowing the joint spaces
signifies ligamentous injury and/or
fractures

Cartilage
 Look for soft tissue swelling and joint
effusions
 These can be signs of occult fractures

Soft Tissue
R R

Case #1
 Follow the ABCs approach
 There are problems with alignment
 There are fracture lines through the 2nd
proximal phalanx and 3rd distal phalanx

Case #1
 Use medical terminology to describe
fractures
 It is better to communicate with
orthopedic and trauma surgeons

Fracture nomenclature
 Fracture description

 Open/closed fracture
 Anatomic location
 Fracture line shape
 Interfragmentary position

Fracture nomenclature
 Closed fracture
◦ No skin wound at or near fracture site

 Open fracture
◦ Skin wound
◦ Bony fragment may protude
◦ Open fracture often comminuted and dislocated

Open/Closed Fractures
Describe anatomic fracture location
 Left/right side
 Which bone?
 Location within the bone
◦ Proximal/middle/distal part
◦ Bone is devided into1/3 or epi-, meta-, diaphysis
◦ Propagation of fracture into a joint →
intraarticular fracture

Anatomic Location
Fracture line shape
 Angulation
 Apposition
 Displacement
 Bayonette apposition
 Distraction
 Impaction
 Dislocation

Interfragmentary position
ANATOMICAL PLANE & POSITION
R R

Case #1
 Closed transverse 2nd proximal phalanx
fracture of the right hand, with
displacement
 Open avulsion 3rd distal phalanx fracture
of the right hand

Case #1
Case #2
 Closed midshaft transverse fracture of left
femur

 Or

 Closed 1/3 medial transverse fracture of


left femur

 With displacement and shortening

Case #2
Case #3
 The left shoulder joint is not longer
maintain their normal relationship
→ problem with alignment

 Dislocation of shoulder → when the head


of humerus is out of the shoulder joint

Case #4
 Dislocation are named by the position of
the distal segment
 Dislocation anteroinferior of left humeral
head

Case #3
Case #4
 Problem with trabecular pattern
 Destruction of the base of 5th metatarsal
with moth eaten appearence
 Non visualization of the 3rd and 4th
tarsometatarsal joint space
 Loss of normal tarsometatarsal joint
planes
 The intermediate and lateral cuneiform,
and the cuboid intertarsal planes are lost

Case #4
 Secondary osteomyelitis due to diabetes.
 It is important to use a systematic
approach, which is logical and easy to
remember
 It helps to minimise interpretive errors
 The ABCs systematic approach is the
simplest and widely used system for the
assessment of plain x-rays.

Take home message


Thank you
 Chan, O., ABCs of Emergency Radiology
3rd Ed., 2013, Wiley-Blacwell, London
 Patel, N., Basic of Orthopedic Radiology,
2008, Paterson, New Jersey

References

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