NORMAL RADIOLOGICAL

ANATOMY
The study of Anatomy by using X- Rays is referred to as
Radiological Anatomy
Properties:
Penetrating Effect- Absorption & Scattering
Higher the atomic wt. & density-greater the absorbtion of X rays
Eg: Bone – High in Calcium content – absorbs X-rays more than
skin & muscle
Radiolucent & radioopaque

Standard Views:
Antero-posterior (AP)
Postero-anterior (PA)
Lateral
Oblique
Types of X-rays:
1) Plain: Translucent areas – appears BLACK
Dense / opaque areas- appears WHITE
2)Contrast : Opaque – Barium sulphate
Translucent- Air/ oxygen- for ventricles of brain

Structure of mature Bones &

immature bones:
How to read the X Ray
• View- plain & contrast
• Identify all bones
• Joints

USES
• To diagnose fractures & dislocations, diseases
• Developmental defects
• Age determination
UPPER EXTREMITY
 SHOULDER—AP VIEW
ACROMIOCLAVICULAR
JOINT

CLAVICLE ACROMION

HUMERAL
HEAD
GREATER TUBERCLE

CORACOID

BICIPITAL
LESSER GROOVE
GLENOID TUBERCLE

VERTEBRAL BORDER
OF SCAPULA
ELBOW
AP VIEW
HUM
ERU
S
OLECRANON

LATERAL EPICONDYLE

CAPITULUM
OLECRANON
FOSSA
RADIAL HEAD

RADIAL
TUBEROSITY
MEDIAL
EPICONDYLE
UL
NA
CORONOID RA
TROCHLEA DI
PROCESS US
 ELBOW-LATERAL VIEW

US
ER
M
HU

RADIAL CORONOID
RADIAL
HEAD PROCESS
OLECRANON TUBEROSITY
FOSSA
RADIUS

ULNA
OLECRANON
 FOREARM
LATERAL EPICONDYL AP VIEW

RADIAL HEAD

MEDIAL
EPICONDYLE

RADIUS

STYLOID PROCESS
OF RADIUS
ULNA

STYLOID PROCESS OF
ULNA
 WRIST – PA VIEW

TRAPEZOID HAMATE
U M
UETR
TR

T RI Q
AP
EZ

CAPITATE
IU
M

PISIFORM
SCA
PH ULNAR STYLOID
(NA OID PROCESS
VIC LUNATE
UL
AR
)

RADIAL STYLOID ULNA

PROCESS

RADIUS
Appearence & ossification of carpal bones:
1yr -2 carpals- C H
3yr- 3 carpals - T
4yr-4 carpals - L
5yr-7 carpals -S, T, T
12yr-8 carpals- P
HAND
PA VIEW

*
*DISTAL PHALANGES * *
(DP) *
* * *
*PROXIMAL PHALANGES * * *MIDDLE PHALANGES
(PP) * * (MP)

*
* SESAMOID
BONE
* * * *
* *METACARPALS
III IV (MC)
II V
* I

CARPAL
A
BONES ULN
RADIUS
HAND & WRIST
LATERAL VIEW

DIGITS
PHALANGES

HAND METACARPALS

CARPALS
WRIST
LOWER EXTREMITY
 FEMORAL HEAD

ACETABULUM

FEMORAL NECK

GREATER
TROCHANTER AP HIP
FOVEA CAPITIS

LESSER
TROCHANTER

CORTICAL BONE

MEDULLARY BONE
Knee joint:
AP View
Knee Joint –
Lateral View
 LOWER LEG
TIBIAL
HEAD OF TUBEROSITY
FIBULA

FIBULA

TIBIA FIBULA

LATERAL
MEDIAL MALLEOLUS
MALLEOLUS

AP LATERAL
AP ANKLE

Tibial
Fibular shaft
shaft

Medial malleolus
of the tibia

Lateral malleolus
of the fibula
Talus
 LATERAL ANKLE

ia
ti b
fibula

l ar
i cu
talus

nav
calcaneus cuboid
 DIP
AP FOOT
PIP

DISTAL PHALANX
PHALANGES
MIDDLE PHALANX
MTP
PROXIMAL PHALANX CUNEIFORMS

METATARSALS SESAMOID 3RD

2ND 1ST
IV III II I BONES
V

NAVICULAR
CUBOID

TALUS
TARSALS
CALCANEUS
 LATERAL FOOT

(NAVICULAR)

(3) CUNEIFORMS

TALUS
ALS
TATARS
ME
PHALANGES
SUSTENTACULUM
TALI
CA
LC
AN
EU
S

CUBOID

SESAMOID
CALCANEAL
BONE
TUBEROSITY
Ossification centres that are normally present at birth
3 long bones- Femur (distal epiphysis)
Tibia (proximal epiphysis)
Humerus (proximal epiphysis)

3 short bones-Calcaneum
Talus
Cuboid
CHEST RADIOGRAMS
Procedure for taking chest X ray:
CHEST X-RAY
1) PA view
2) Cardiovascular Shadows
3) Angles- Cardiophrenic & Costophrenic
4) Diaphragm ( domes, tenting, free air, margins)
5) Fundus of stomach
6) Hilar shadows
7) Lung fields
8) Bones-Ribs, scapulae
9) Trachea
10) Penetration-Is the film over or under penetrated if under penetrated you will not be
able to see the thoracic vertebrae

Verify Right and Left sides (Gastric bubble should be on the left side)
2) Cardiovascular shadows

• Size
• Shape
• Silhouette-margins should be sharp
• Diameter (>1/2 thoracic diameter is enlarged
heart)

Remember: AP views make heart appear larger than it actually

is.
Right Border of heart is formed by:
• Right Innominate vein
• SVC
• Right Atrium
• IVC

Left Border of heart is formed by:

 Left Subclavian artery
 Arch of aorta (aortic knuckle)
 Auricle of Left atrium
 Left ventricle
Loss of Sharp Costophrenic Angles
 Check the hilar region
• The hilar – the large
blood vessels going to
and from the lung at the
root of each lung where
it meets the heart.
• Check for size and
shape of aorta,
nodes,enlarged vessels
 Finally, Check the Lung Fields
• Infiltrates
• Increased interstitial markings
• Masses
• Absence of normal margins
• Air bronchograms
• Increased vascularity
ABDOMEN RADIOGRAMS
• Date of Film
• Patient Name
• Patient Age
• Sex
• Adequate area
covered
• Intraluminal gas
• Calcification
• Soft tissues
• Bones
• Foreign objects
• Periphery of film
 Normal Intraluminal Gas

• Stomach : Always
• Small Bowel : Two or three loops of non-distended
bowel
– Normal diameter < 3.5 cm (jejunum)
– Normal diameter < 2.5 cm (ileum)
• Large Bowel : Almost always in rectum/sigmoid
– Normal diameter < 5 cm (colon)
– Normal diameter < 9 cm (caecum)
 Stomach gas

Gas in
ascending
colon Gas in a few loops
of small bowel

Gas in rectum
 Liver (homogeneous
shadow in RUQ)

Spleen

Stomach (c gas)

Parts of colon (c gas)

hepatic flexure

transverse colon

cecum & ascending colon

Gas, though natural,

is a negative contrast
media. In the history
of radiography, gas (air)
was injected in the bladder
and ventricles of the brain.
Carbonated soda is given
to children to create a
“window” to the kidneys
Radiographic Anatomy of the plain film abdomen
 Large or small bowel?
Small Bowel
Large Bowel

• Centrally placed
•• Peripheral
Narrow angle of curvature
•• Multiple
Only a loops
few loops
• Mucosal folds cross the full width of the bowel (valvulae
• Mucosal
conniventes) folds only cross part of the bowel
width (haustra)
Detail of urine filled bladder Radiographic Anatomy
of the plain film abdomen

The bladder is
often seen, if
contrasted by
urine.

Gas in the sigmoid

colon
may obscure it
Bladder stones
Ankylosing Spondylitis

Bamboo spine

Fused sacro-iliac joints

SPECIAL RADIOGRAMS ABDOMEN
BARIUM SWALLOW
• Barium Swallow
Indentations- Aortic Arch, Lt Bronchus & Ltatrium
• Barium Meal
Barium Meal:
BARIUM MEAL
• Barium Follow Through
• This barium enema radiograph shows the large intestine of a patient
Cholecystogram
• Cholecystogram is used to diagnose problems related
to the gallbladder.
• The X-ray can show inflammation of the organ, and
other abnormalities like polyps, tumors, and
gallstones.
• Iodine-based contrast is used.
• Routes – Oral and intravenous
Pyelogram

Intravenous pyelogram
In which a contrast
solution is introduced
through a vein into the
circulatory system. This is
a form of anterograde
pyelogram.

Dye - iodine contrast

solution
 Anterograde pyelogram - Indications

• kidney stones
• enlarged prostate
• tumors in the kidney, ureters or urinary
bladder
• surgery on the urinary tract
• congenital anomalies of the urinary tract
Retrograde pyelogram
The pyelogram in which
contrast medium is
introduced into the
lower urinary tract and
flows toward the kidney
(i.e. in a "retrograde"
direction, against the
normal flow of urine).
Retrograde pyelogram - Indications
• The IVP does not show a reason for urinary
symptoms.
• The IVP cannot be done because of kidney
problems such as chronic kidney disease.
• Allergy to the iodine-based dye (
contrast material) used in the IVP.
Hysterosalphingography
HFN RADIOGRAMS
AP view- Skull
Waters view
Adult Facial Bones - Occipito Mental 30° (OM30) WATER’S View
Caldwell’s view
Caldwell’s view
• a
Adult Skull - Lateral View
Adult Skull - Townes View
X ray cevical spine- AP view
X ray cevical spine- lateral view
Carotid arteriogram
Vertebral arteriogram
Cerebral angiography
• Vertebral Angiography
• Both
THANKS