X rays interpretation

Question 1

Acronym for X rays interpretation

Answer 1

P A S S M

P - patients details & patient safety

(Is a pt safe and stable? if not, do ABCDE before x ray interpretation)

A - Adequacy (RIPE)

Question 2

Acronym for adequacy on CXR

Answer 2

R - rotation (are the clavicles equal distance from spinal processes on both sides?)

I - inspiration - sufficient if at least 5 or 6 ribs visible (>8 COPD hyperinflation)

P - picture area - is the area from apices to costodiaphragmatic recess visible?

Sapula out of the way

E - exposure - vertebral bodies visible through the lower part of cardiac shadow)

Question 3

Adequacy of abdominal x-ray

Answer 3

Area - diaphragm to the pelvis

Rotation - normal if spinal processes and hips are adequately aligned

Penetration - sufficient when the lumbar vertebrae are visible

Question 4

Acronym for abdo X ray interpretation

Answer 4

A B C S

A - air

B - bone

C - calcifications

S - soft tissues

Question 5

Comment on ‘A’ on abdo X ray

Answer 5

A - air

• air (in the bowel) - intraluminal, extraluminal (perforation)
• dilation of the bowel (measure through the computer viever programme)

Question 6

What is characteristic of a large bowel on abdo X Ray

Answer 6

• peripheral position
• faecal content (mottled appearance)
• haustra (pouches that protrude into the lumen)
• should be <6 cm in diameter (enlarged in bowel obstruction)

Question 7

Characteristics of a small bowel on abdo X ray

Answer 7

• should be <3 cm in diameter
• central position
• plicae circulares/ valvulae conniventes present (mucosal folds across the whole width of the bowel)

Question 8

Comment on ‘C’ on abdominal X ray

Answer 8

C - calcification

• pancreas (chronic pancreatitis)
• abdominal aorta (atherosclerosis)
• renal/gall stones

Question 9

Comment on ‘B’ in abdominal x ray

Answer 9

Bones

Include: lower ribs, pelvis, lumbar spine

• Paget’s disease lytic/sclerotic pattern
• Osteoarthritis - loss of joint space, osteophytes, subchondral sclerosis, cysts
• vertebral fractures

Question 10

Comment on S - soft tissues

Answer 10

Soft tissues shadows may be seen

• liver
• spleen
• kidney
• gallbladder
• psoas shadow