The radiographic evaluation of the musculoskeletal system and spine

Abstract

Bone and calcified tissues are less permeable to x-rays. They absorb much more of the beam and appear radiopaque (white) on radiographs. Tissues like lung and fat are more permeable, so they absorb less x-ray resulting in a radiolucent (black) view on radiographs. Soft tissues generally appear as gray. Bones are very dense and attenuate a great deal of the x-ray beams. The cortex, which consists of compact bone, appears more opaque; however, the medulla, which consists of trabecular bone, appears less opaque. Dose of radiographs depends on anatomic region, thickness of subcutaneous tissue, and age. Information of age, sex, occupation, and clinical findings of the patient helps us during making a diagnosis. While evaluating the patients, we should obtain at least two plane views. At a trauma case, proximal and distal joints of injured bone should be visualized. Anatomic location and extension of the fracture line and soft tissue swelling should be evaluated. Fracture line should be made differential diagnosis from trace of nutrition artery. At pediatric population, bilateral radiographies should be obtained because of the open growth plates. Localization of the lesion should be evaluated, that is, focal or diffuse, solitary or multiple. Periosteal reaction or bony destruction should be noted. Also morphologic anomalies of bone should be carefully evaluated. While history and physical findings of patient are correlated with radiographic lesions, exact diagnosis is tried to achieve.