Assessing an X-ray

One system for assessing x-rays is AABCS:

The image displays a normal x-ray (click on the x-ray to enlarge).

A – Adequacy

  • Check it is the correct patient and the correct date
  • Check that the correct side has been x-rayed, the correct views have been taken and that all the areas of interest are included

A – Alignment

  • Is the alignment of the joints correct or is there any dislocation?
  • The area where injuries are commonly missed is the tarso-metatarsal joint

Click on the x-rays to enlarge.

Fig 2a: A normal x-ray with alignment of 2nd MT indicated. The medial border of the 2nd metatarsal (MT) should align with the medial border of the intermediate cuneiform Fig 2b: A normal x-ray with alignment of 4th MT indicated. The medial border of the 4th MT should align with the medial border of the cuboid

B – Bones

  • Trace the outline of every bone to ensure no cortical break
  • Look at the medulla for trabecular pattern

C- Cartilages

  • Look at joint spaces
  • Overlapping of bones may indicate a dislocation

S – Soft tissues

Look for:

  • Swelling
  • Air in tissues, soft tissue calcification, etc.