TERMS RADIOLOGY OF

ORTHOPEDI
PRECEPTOR :
DR. ASWEDI PUTRA. SP.OT.,FICS

PRESENT :
MUHAMMAD ALVIN ROBBANI
 Radiology

 Radiology is medical science to see parts of the human body using radiation
or wave radiation, both electromagnetic waves and mechanical waves. At
first the frequency used is in the form of x-rays.
 Bone X-rays can provide information:
 Bone lesions & surrounding soft tissue
 There is a fracture / threat of pathological fracture
 The origin / nature of a lesion (benign / malignant)
 As a guide for biopsy
 Disease follow-up
 Some Term of X-rays

Density:
 Tissue ability to absorb x-rays
 The more compact of the consistency and volume of an object, the higher the
density.
 Solid or liquid consistency will be white on x-rays.
 The lower the consistency, the more black the image of the object will be on an x-
ray.
 Examples of high density objects are dense tissues such as bones, organs, and soft
tissues.
 Examples of low density objects are gas.
Radioopasity
 solid white areas on x-rays due to good x-ray absorption in tissues,
or high-density organs

Radiolusensy
 areas that are black in x-rays due to poor absorption of x-rays on
tissues, or low-density organs
AP Projection
 It stands for antero posterior, which is the position of the patient during
an x-ray examination, where the direction of X-rays comes from the
front of the patient's body backwards.

PA Projection
 It stands for postero anterior, namely the position of the patient during
an x-ray examination, where the direction of X-rays comes from the
back of the patient's body forward.
 Fractures

Definition:
 Disconnection of structural and bone continuity, or
cartilage, which is generally caused by trauma.

Trauma
 Direct Trauma >>>>> Impact fracture
 Indirect Trauma >>>>> Fractures on the bones are far apart from
the impact area
 The reading of X-ray Bone Fractures

1. Reading Preparation.
2. Assessment of Condition of X-Ray Photographs of
Bone Fractures.
3. Description X-ray Photo of Bone Fracture.
 Reading Preparation

 Turn on the illuminator.

 Place an x-ray photo on the illuminator, with the right side of the
photo on the left side of the reader.
 make sure the position of the photo is right or in accordance with
the anatomical position.
 Photo Condition Assessment

 The patient's identity must be clearly stated: name, age and gender.
 The date of making the photo must be included.
 The left and right mark must be included.
 The strength of X-rays (Kv, mA) needs to be included.
 Make sure the x-ray meets the "rule of two", especially "two views",
and "two joints".
 “Rule of Two”
1. Two Views :
 Make two photos with two projections, for example A.P with lateral, or oblique.
 If the patient's condition is not possible, make two photos with projections perpendicular to
each other.

2. Two Joints :
 The proximal joint, and distal to the fractured part of the bone must be visible.
 The joints closest to the fracture area must also be photographed.

3. Two Limbs :
 Healthy limbs can also be photographed, for comparison.
 For example epiphise is immature in children, which can confuse fracture diagnosis, so that
photos of healthy limbs need to be made.
4. Two Injuries :
 Making x-rays on other parts of the body, to see whether there are injuries to other
body parts.
 For example in a femur fracture, x-rays need to be made in the spine, or in the pelvis.

5. Two Occasions :
 Making repeat x-rays several weeks after trauma to show lesions that are not clearly
visible after trauma.
Description of bone fracture x-ray photos
(systematic sequential from top to bottom)

1. Site
2. Type
3. Configuration
4. Correlations between fractured bone fragments.
5. Correlations between bone fragments and the
outside.
6. Complication
 Site

 Identification of bones that are being observed, such as the tibia, or femur.
 Determine bone on the right, or left.
 Observe whether there is a fracture line.
 If you see a fracture line, determine the part of the bone where there is a
fracture line.
 If the fracture line is in a bone shaft long bones are usually divided into
three parts: namely whether in 1/3 proximal, 1/3 medial, or 1/3 distal.
1/3 Proksimal (a), 1/3 medial (b). 1/3 distal (c)
 Type
 Complete fracture
 When the fault line passes through the entire cross section of the bone, or
through both sides of the bone cortex, as seen in the photo.
 Caused by high force force.
 Incomplete fracture
 If the fracture line is not through the entire cross section of the bone (intact
periosteum), for example:
 Greenstick fracture: fault line on one of the bone cortices with angulation of the
other cortex.
 Hairline fracture: the fault line looks smooth like a hair.
Fraktur Greenstick Fraktur Hairline
 Configuration

If the fracture is complete type, specify:

 Form a fault line, for example:
 Transverse, because of direct trauma
 Oblique, due to trauma angulation
 Spiral, because of rotational trauma
 Number of fault lines:
 Comminutive fracture (broken lines more than one, and interconnected)
 Comminutive segmental (broken lines more than one, but not interconnected)
 Comminutive multiple (broken lines more than one, occurs in different bones)
 Configuration (broken line shape)

Transverse Fracture Oblique Fracture Spiral Fracture

 Configuration (number of broken lines)

Comminutive Fracture Segmental Fracture Segmental & Multiple

Fracture
 Correlation Between Bone Fragments

 Undisplaced  Type :

 The broken line is complete,  Translation

but the bone fragments do not  Angulation
shift.  Rotation
 Length :
 Displaced
 Keep away from each other
 There is a shift in bone fragments
against other bone fragments  Overlapping (bone shortening
occurs)
Displaced Type Angulation Displaced Type Overlapping
 Correlations between bone
fragments and the outside
Closed fracture
 If no correlations between bone fragments and the outside.
 open/compound fracture
 If have Correlations between bone fraktur with fragments and the outside
 Classification According :
 First degree
 Second degree
 Third degree
 Open Fracture Classification

 First degree  Second degree

 Wounds <1 cm  Wounds >1 cm
 Minimal soft tissue damage  Soft tissue damage is not
 Simple fracture: transverse, extensive
or oblique  Comminutive fracture
 Minimal contamination  Medium contamination
 Third degree
 Damage or loss of extensive soft tissue includes
the skin, muscles, blood vessels, and nerves.
 Bones are exposed.
 High contamination.
Third Degrees Cruris Open Fractures
 Complications

 Local Complications:
 Soft tissue damage:
1. Skin
2. Muscle
3. Neurovascular
 Joint dislocation
1. Systemic complications, such as shock
2. Late complications, such as infection (osteomyelitis), osteophorosis
post trauma, or myositis ossificans