Indications for Use

Radiographs are commonly obtained to work up a wide variety of problems and symptoms of the chest, abdomen, pelvis, extremities and spine. Radiographs are relatively inexpensive, widely available, and easily accessible.

It is beyond the intentions of this submodule to discuss all of the potential uses of radiography, but this should serve as a foundation to help one understand some of the general uses.

BONES

As bones are easily visible on radiographs, X-rays are a great way to evaluate for bone pathology. The outer edge of long bones, called the cortex, is more dense than the inner portion, the medulla. Disruptions of the cortex, as occurs in fractures, are readily seen on x-ray.

The hand radiograph on the right reveals an acute fracture of the 5th metacarpal (arrow). The smooth outer edge of the bone is disrupted at the site of the break. Note the bone distal to the break is angulated anteriorly. This is known as a "boxers" fracture, as the mechanism of injury is usually a punch, where the force is transmitted to the 5th metacarpal bone. Click here to see a magnified view.

In addition to fractures, radiography is an excellent way to look for focal lesions like tumors or infections that cause bone destruction. Other indications for use include evaluation of joint spaces for infection, arthritis, and disclocations.