1. Axial and Appendicular Skeleton William Ursprung, DC
Normal X-Ray Anatomy
Axial and Appendicular
Skeleton
William Ursprung, DC

2. Lesson Objectives
Identify anatomical structures on plain film radiographs
Identify the views commonly used to radiograph the skeletal system
Utilize a basic search pattern to screen plain film radiographs for pathology

3. Basic Rules for Interpretation
Plain films are a 2 dimensional gray scale image of a 3 dimensional anatomical structure
Four basic densities
Metal = very bright (white)
Bone = bright (white)
Water/soft tissue = (various shades of gray)
Air = dark (black)

4. Basic Rules for Interpretation
Rule of thumb for radiographs: min. of 2 views that are offset by 90° for any body part
ABOLTS search pattern
A = anatomy
B = breaks or step defects in the cortex
O = opacities (ie blastic lesion, impacted fx)
L = lucencies (ie lytic lesion, displaced fx)
T= trabecular architecture
S = soft tissues (swelling, mass, fascial planes)

5. Cervical Spine

6. Anterior Posterior Open Mouth

7. Anterior Posterior Lower Cervical

8. Lateral Cervical

9. Cervical Oblique

10. Thoracic Spine

11. Posterior Anterior Chest

12. Anterior Posterior Thoracic Spine

13. Lateral Thoracic Spine

14. Lumbar Spine

15. AP Lumbar

16. Lateral Lumbar

17. Pelvis and Hips

18. AP Pelvis

19. AP Pelvis

20. Shoulder

21. Normal Shoulder

22. Normal Shoulder

23. Elbow and Forearm

24. Normal Elbow

25. Normal Elbow

26. Forearm

27. Wrist and Hand

28. Normal Wrist

29. Normal Wrist

30. Normal Hand

31. Normal Hand

32. Knee

33. Normal Knee

34. Ankle and Foot

35. Normal Ankle

36. Normal Ankle

37. Normal Ankle

38. Boehler’s Angle

39. Normal Foot

40. Normal Foot