-
8/12/2019 X-ray Interpretation by a.pornpen Orthopedic
1/28
X-ra inter retation
-
8/12/2019 X-ray Interpretation by a.pornpen Orthopedic
2/28
Normal diarthrodial joint (diagram)
Bare area
Copyright 1972-2004 American College of Rheumatology
Slide Collection. All rights reserved.
-
8/12/2019 X-ray Interpretation by a.pornpen Orthopedic
3/28
2 dimension image
A central
B eccentric
C juxtacortical
cortical
Mettler: Essentials of Radiology, 2nd ed.
-
8/12/2019 X-ray Interpretation by a.pornpen Orthopedic
4/28
T e
Structure, right/left
ViewPatientFilm quality
A lignment
B one density
C artilage, calcification
D eformity, distribution ros on
S oft tissue swelling
-
8/12/2019 X-ray Interpretation by a.pornpen Orthopedic
5/28
A lignment Reference position
B one density
C artila e, calcification
Trunk
Neutral position
D eformity,
distribution
Subluxation
Translation
E rosion
ankylosis
Terminolo
P eriosteal
Anterior-posterior
Volar- dorsal
Radial-ulnar
Medial-lateral
-
8/12/2019 X-ray Interpretation by a.pornpen Orthopedic
6/28
A lignment Mineralization
B one density
C artila e, calcification
Increased/decreased
Site
D eformity,
distribution
E rosion
Diffuse osteopenia
P eriosteal
Osteosclerosis
-
8/12/2019 X-ray Interpretation by a.pornpen Orthopedic
7/28
A lignment Cartilage
B one density
C artila e, calcification
Joint space narrowing
D eformity,
distribution
Concentric/eccentric
E rosion
Diffuse/localized
P eriosteal
-
8/12/2019 X-ray Interpretation by a.pornpen Orthopedic
8/28
A lignment Calcification
B one density
C artila e, calcification Cartila e:
D eformity,
distribution
chondrocalcinosis
Linear/punctate
E rosion
Vessel: CPPD
Tendinous
P eriosteal
Soft tissue: periarticular/.
-
Ligament: DISH
-
8/12/2019 X-ray Interpretation by a.pornpen Orthopedic
9/28
A lignment Deformity
B one density
C artila e, calcification
Swan neck deformity
Boutonnire deformit
D eformity,
distribution
Zigzag deformity
E rosion
P eriosteal
-
8/12/2019 X-ray Interpretation by a.pornpen Orthopedic
10/28
A lignment Distribution
B one density
C artilage, calcification
Peripheral/axial e orm y, s r u on
E rosion
ymme r ca asymme r ca
Lower/upper extremities
P eriosteal involvement
Transverse plane
Central/cortical/ uxtacortical
Longitudinal plane
Epiphysis/Metaphysis
-
8/12/2019 X-ray Interpretation by a.pornpen Orthopedic
11/28
Digit
DIP and PIP: OA, erosive OA, PsA
MCP and PIP: RA, PsA, Reiters syndrome, AS MCP: inflammatory
arthropathies, CPPD
Random: Gout
Carpal RA, SpA : all compartment
OA, erosive OA 1st CMC, greater multangular-navicular joint
CPPD- radiocarpal, capitate-lunate joint out carpometacarpa
compartment
-
8/12/2019 X-ray Interpretation by a.pornpen Orthopedic
12/28
A lignment Marginal/central/variable
B one density
C artila e, calcification
Benigh/aggressive
Bone resor tion
D eformity,
distribution
Subperiosteal
Intracortical
E rosion
Endosteal Subchondral
P eriosteal
Subphyseal
TrabecularSubligamentous/subtendino
us
-
8/12/2019 X-ray Interpretation by a.pornpen Orthopedic
13/28
A lignment Periarticular soft tissue
B one density
C artila e, calcification
swelling
entire digit: sausage-
D eformity,
distribution
shaped finger
Lumpy, bumpy soft tissue
E rosion
swelling
P eriosteal
Effusion
Bursa Muscle
-
8/12/2019 X-ray Interpretation by a.pornpen Orthopedic
14/28
A lignment Benign
B one density
C artila e, calcification
Thick single layer of
periosteal pattern
D eformity,
distribution
Malignant
Onion-peel pattern
E rosion
Codmans triangle Sunburst pattern
P eriosteal
a r-on-en pa ern
-
8/12/2019 X-ray Interpretation by a.pornpen Orthopedic
15/28
New bone: periostitis, entesitis, ankylosis
Periosteal new bone formation: PsA
Tendinous insertion: SpA Bone ankylosis: bony bridging SpA,
erosive OA
Reparation response: Overhanging edge: gout
Subchondral bone: OA
Osteophytes: bone extensions of a normal articular surface
-
8/12/2019 X-ray Interpretation by a.pornpen Orthopedic
16/28
-
8/12/2019 X-ray Interpretation by a.pornpen Orthopedic
17/28
-
8/12/2019 X-ray Interpretation by a.pornpen Orthopedic
18/28
Diffuse osteopenia
-
-
8/12/2019 X-ray Interpretation by a.pornpen Orthopedic
19/28
-
Uniform joint space narrowing
-
8/12/2019 X-ray Interpretation by a.pornpen Orthopedic
20/28
Psoriatic arthritis: progressive joint changes
Copyright 1972-2004 American College of Rheumatology
Slide Collection. All rights reserved.
-
8/12/2019 X-ray Interpretation by a.pornpen Orthopedic
21/28
Non aggressive erosion
Fine sclerotic border outlinin
the edge of the erosion
Repairing process in
inflammatory arthritis Gout: adjacent to tophus
Overhanging edge
-
8/12/2019 X-ray Interpretation by a.pornpen Orthopedic
22/28
Subchondral bone sclerosis
-
8/12/2019 X-ray Interpretation by a.pornpen Orthopedic
23/28
Copyright 1972-2004 American College of Rheumatology
Slide Collection. All rights reserved.
-
8/12/2019 X-ray Interpretation by a.pornpen Orthopedic
24/28
,
Copyright 1972-2004 American College of Rheumatology
Slide Collection. All rights reserved.
-
8/12/2019 X-ray Interpretation by a.pornpen Orthopedic
25/28
Elbow, joint effusion (radiograph)
Copyright 1972-2004 American College of Rheumatology
Slide Collection. All rights reserved.
-
8/12/2019 X-ray Interpretation by a.pornpen Orthopedic
26/28
orma nee, so ssues ra ograp , a era
Copyright 1972-2004 American College of Rheumatology
Slide Collection. All rights reserved.
-
8/12/2019 X-ray Interpretation by a.pornpen Orthopedic
27/28
hand, soft-tissue swelling
Copyright 1972-2004 American College of Rheumatology
Slide Collection. All rights reserved.
-
8/12/2019 X-ray Interpretation by a.pornpen Orthopedic
28/28
Arthritis in black and white, 2nd edition
Bone and joint imaging, 3rd edition
Arthritis and allied conditions: A textbook ofrheumatology, 15th
edition
ACR slide collection
