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.