radio graphic errors

RADIOGRAPHIC ERRORS

Dr. Aarthi MBDS,

lecturer, Oral Medicine Department

Films with errors should be avoided due to the following reasons:Retake will lead to:•Expose the patient to unnecessary radiation.•Waste film & time (money).•Interfere with accurate interpretation and diagnosis.

Causes of faulty radiographThe majority of the errors produced can be categorized into three groups:

I. Processing errors.II.Technique & Projection

errors.III.Exposure errors.

I. Processing errorsChemical errors:•Light image.•Dark image.•Blank image.•Reticulation.•Black spot or patch.•Black line.•White spot or patch.•Yellowish brown discoloration.

Film Handling errors:•Writing lines•Developer cut off•Fixer cut off•Overlapped film•Finger nail artifact•Smudge.•Scratched film•Static electricity

Processing errorsChemical errors

ReticulationWhen the film subjected to a sudden temperature changes between the developer and water.Appear as cracked film.

Processing errorsChemical errors

Black spot or patchDeveloper contamination before immersion into the developer solution.

Black lineProcessing errors

Chemical errors

Developer contamination processing hanger clipsDirty roller in automatic processor

White spot or patch

Processing errorsChemical errors

Contamination with fixer before processing

Yellowish brown discolorationProcessing errors

Chemical errors

Exhausted solution or insufficient rinsing

Processing errorsFilm Handling errors

Writing linesAppear on the radiograph due to writing on the film packet with ballpoint pen or lead pencil.It may appear black or white.

Finger nail artifactBlack or whit crescent shape mark due to rough handling of the film.

Developer cut offProcessing errors

Film Handling errors

A straight blank white border due to underdeveloped portion. The film may not be completely immersed in the developer solution.

Fixer cut offProcessing errors

Film Handling errors

A straight black border. The film may not be completely immersed in the developer solution.

Processing errorsFilm Handling errors

Overlapped filmFilm that overlap in developer are white, while that overlap in fixer are black

Processing errorsFilm Handling errors

Smudge (finger print)When the film touched by fingers contaminated with developer or fixer

Processing errorsFilm Handling errors

Scratched film

White lines appear on the film due to careless handling of the film.

Processing errorsFilm Handling errors

Static electricityThin black branching lines Occurs when two surfaces are rubbed together against each other vigorously, this creates an electric charges with visible light emitted which is capable of exposing the x-ray film, thus leading to ionization of AgBr crystals at this area.Occur most frequently during periods of low humidity

Metallic partial denture

Blurred

Reverse image

Apices cut off

Dropped corner

Distortion

Elongation

Horizontal overlap

Double image

Low denisty

Static electricity

White spot or patch

Yellowish brown discoloration

Reverse image

Cone-cut

Developer cut off

II. Exposure errors.

Blank image.Low density image.High density image.Image with high and low contrast.

Exposure errors

Blank imageA film that didn’t receive radiation will have no image and will appear clear.

Low density (faint) imageExposure errors

Exposure errors

High density image

III. Technique & Projection errors:

a. Patient preparation error:

b. Film placement artifact:

•Blurred image •Radiopaque artifact•Pressure mark

•Reversed film •Double image•Apices cut off •Dot artifact•Dropped film corner •Crown not shown •Black line •Area of interest not shown

•Distortion

c. Projection errors:•Incorrect vertical angulation.•Incorrect horizontal angulation•PID alignment artifact

Technique & Projection errorsa. Patient preparation error

Radiopaque artifactDental appliances, body piercings, jewelry & eye glasses left in the mouth during exposure will appear as radiopaque artifact superimposed over the dental image. Correction: all this items should be removed before placing of the film.

Blurred imageMovement of the film, patient or X-ray tube head during exposure will result in a blurred image.Correction: the operator should explain for the patient & remind him to remain motionless during exposure.

Technique & Projection errorsa. Patient preparation error

Pressure markPressure from the incisal edge & cusps of the teeth (mostly in the pediatric occlusal radiograph).May appear black or white.Correction: ask the patient to bite gently.

Technique & Projection errorsa. Patient preparation error

Double imageWhen an exposed film is re-exposed the resulting film will have 2 superimposed images

Technique & Projection errorsa. Patient preparation error

Reversed filmLow density with herring bone, tire-track or dotted pattern, as a result of directing the X-ray through the lead foil side of the film back.

Technique & Projection errorsb. Film placment artifact

Dot artifactThe identification (embossed) dot produce a circular radiolucent artifact on the final radiograph. This may interfere with interpretation of the apical areas of the teeth.

Technique & Projection errorsb. Film placment artifact

Apices cut offOccur when the film is not positioned apically enough to record the entire tooth.

Technique & Projection errorsb. Film placment artifact

Crown not shown There is no enough film extending occlusally.

Technique & Projection errorsb. Film placment artifact

Dropped film cornerThe film edge is not placed parallel to the occlusal surface of the teeth.

Technique & Projection errorsb. Film placment artifact

Area of interest not shownThis is the result of not placing the film to cover all the teeth in the area of interest and not centralizing the film over the area of interest.

Technique & Projection errorsb. Film placment artifact

Black lineDue to excessive bending of the film prior to its placement inside the patient’s mouth (pressure causes ionization of silver halide upon processing will be darker).

Technique & Projection errorsb. Film placment artifact

DistortionDue to bending of the film to eliminate the patient’s discomfort specially in lower premolar area and upper central incisors.

normal distorti

on

Technique & Projection errorsb. Film placment artifact

Incorrect vertical angulationIt will lead to:•Elongated image due to insufficient v. angulation ( too flat), or•Shortened image due to excessive v. angulation ( too steep)

Technique & Projection errorsb. Film placment artifact

Technique & Projection errorsc. Projection errors

Technique & Projection errorsc. Projection errors

Incorrect horizontal angulationIs the appearance of the interproximal surfaces of the adjacent teeth over each other. This is due to improper H.A. due to improper alignment of the C.R. through the contact points i.e. not // to interproximal surfaces.

Technique & Projection errorsc. Projection errors

Technique & Projection errorsc. Projection errors

Technique & Projection errorsc. Projection errors

PID alignment artifactIf the PID is misaligned and the x-ray is not centered over the film, a partial image is seen on the resultant radiograph, this partial image is called cone-cut.It appear as a clear area with curved outline.