1. COMMON ERRORS IN XRAY INTERPRETATION DR SALLY CANDY DEPARTMENT OF RADIOLOGY GSH

6. Misinterpretation Forgivable Regrettable Leave town

7. The questions CORRECT PATIENT ? CORRECT HISTORY? CORRECT LABELLING? CORRECT POSITIONING ? CORRECT EXPOSURE ? 0PTIMAL VIEWING CONDITIONS? 2 VIEWS? PREVIOUS FILMS ? REVIEW AREAS?

8. The Billion Dollar questions Is it real ? Technical / artefact Is it incidental ?Normal structure Variant Is it significant ?

9. “ …you can’t see what you don’t know ….”

10. CXR - REVIEW AREAS APICES HILA BEHIND THE HEART CP ANGLES BREASTS BONES PARASPINAL

11. CXR - MASSES THAT AREN’T COSTOCHONDRAL JUNCTION STERNUM NIPPLES HAIR BRAIDS / ACCESSORIES BUTTONS SKIN LESIONS LOCULATED FLUID

12. LEFT UPPER LOBE COLLAPSE

13. LEFT LOWER LOBE COLLAPSE

14. Pseudotumor – loculated pleural fluid

15. NB THE RIGHT HEART BORDER

16. CXR CHILDREN AP FILM CTR 60% THYMUS HYPERINFLATION SUBTLE OPACIFICATION NODES

17. The Thymus

18. ASPIRATION OF FB

19. PNEUMOMEDIASTINUM

20. Pleural effusion -

21. The widened mediastinum

22. Abdominal XRay

23. BOWEL PERFORATION

24. DANGEROUS ABDOMENS

25. AIR!

26. AIR IN THE WRONG PLACE

27. ABDOMINAL CALCIFICATION

28. BONES NB 2 VIEWS - ALWAYS COMPARE WITH OPPOSITE SIDE REPEAT XRAY IN 2 WEEKS ( PANNUS ) CONSULT FRIENDLY TEXT ( KEATS )

29. THE VEXATIOUS CERVICAL SPINE 12MM 10mm

30. CERVICAL SPINE Base of skull to T1! Longitudinal lines Prevertebral soft tissue ADI ( adults 3mm, kids 5mm ) Normal variants

31. TECHNIQUE,TECHNIQUE, TECHNIQUE

32. THE OPEN MOUTH VIEW

33. MISCHIEVOUS FRACTURES

34. LIS-FRANC Fracture –dislocation or fracture subluxation of the TMT joints. History axial load to plantar flexed foot 3 views - weightbearing

36. Segond fracture Internal rotation and varus Cortical avulsion of tibia at insertion of LCL Assoc with internal injuries (ACL and menisci) Reverse Segond

37. Maisonneuve fracture Pronation external rotation # upper third fibula rupture distal tibiofibular syndesmosis and interosseous membrane UNSTABLE OUT OF ANKLE VIEW

38. The normal adult wrist

39. Lunate dislocation Lunate loses its articulation with both the capitate and the radius and is displaced volarly with up to 90 degrees rotation. The capitate remains aligned with the radius but sinks proximally

40. Perilunate dislocation The lunate maintains its normal articulation with the radius. The capitate articular surface is dislocated from the lunate, normally dorsally

41. Salter Harris Physeal Injuries

42. Scaphoid fractures

43. THE PAEDIATRIC ELBOW Unossified epiphyses Fracture may be invisible INDIRECT signs: fat pads and lines POSTERIOR (OLECRANON) *** ANTERIOR ( CORONOID ) (SAIL SIGN) Not all fractures have fat pad sign

44. THE ELEVATED FAT PAD ANT CORONOID POST OLECRANON

45. Normal alignment elbow Anterior humeral line

46. RADIOCAPITELLAR LINE

47. Ossification centres elbow CR I T O L E CAPITELLUM RADIAL HEAD INT EPICONDYLE TROCHLEA OLECRANON LATERAL EPICONDYLE

49. THANK YOU!