How I read X-Rays

The next series of articles will be about reading  X-rays. These are the basics and the follow up will be more in-depth. X-rays are a quick and easy tool for me to be able to get a good idea of what is going on in the spine. You may want to refer to my article on anatomy for a better idea about the structures being described.

 

There are specific criteria for Spinal X-ray/ Diagnostic evaluation: They are as follows:

• Traumatic injuries especially those with a dangerous mechanism of injury, fracture risks with low bone density, 

• Neurological signs and symptoms such as radicular pain or muscle weakness

• Persons who don't progress and heal as expected are also sent for diagnostic imaging. 

The classic way to read a spinal X-ray is to look at the ABCD, that is the Alignment, quality of the Bone, the Cartilage and joints and the Dense soft tissue.  I'll show a few X-rays and comment on them to show what can be seen. 

 

As a basic evaluation:

 

Alignment: 

Are the vertebrae stacked neatly on top of each other?

Is there a curvature or scoliosis?

Bone

The quality of the bone, fractures, bony outgrows and signs of injury are examined.

Cartilage and Joints

Are the joints symmetrical, are they close together indicating a loss of disc height or a loss or cartilage, are there signs of arthritis or stenosis?

Dense Soft Tissue

Spamming Muscles can become visible, thickening of ligaments, metastatic tissue, visceral spaces, signs of bleeding show up on X-ray. 

The follow up article I will be giving more of a chiropractic evaluation and discussing these films with you.

If you have a set of films you would like to discuss or if you have any questions regarding this article, please give me a call or leave a comment.