rad interpretation
TRANSCRIPT
Principles of radiographic interpretation
Islam Kassem Consultant oral & maxillofacial surgeon
Definition
Interpretation of radiographs can be regarded as
an unraveling process — uncovering all the information contained within the black, white and grey radiographic images.
Interpretation of radiographs can be regarded as an unraveling process — uncovering all the information contained within the black, white and grey radiographic images.
II-Essential requirements for interpretation
1- Optimum viewing conditions 2- Understanding the nature and limitations of the black,
white and grey radiographic image 3- Knowledge of what the radiographs used in dentistry
should look like, so a critical assessment of individual film quality can be made
4-Detailed knowledge of the range of radiographic appearances of normal anatomical structures
5- Detailed knowledge of the radiographic appearances of the pathological conditions affecting the head and neck
6- A systematic approach to viewing the entire radiograph and to viewing and describing specific lesions
7- Access to previous films for comparison.
1- Optimum viewing conditions
• An even, uniform, bright light viewing screen (preferably of variable intensity to allow viewing
of films of different densities) • A quiet, darkened viewing room • The area around the radiograph should be masked by a dark surround so that light passes only through the film • Use of a magnifying glass to allow fine detail to be
seen more clearly on intraoral films • The radiographs should be dry.
2- Understanding the nature and limitations of the black, white and grey radiographic image
3- Knowledge of what the radiographs used in dentistry should look like, so a critical assessment of individual film quality can be
made
4-Detailed knowledge of the range of radiographic appearances of normal
anatomical structures
5- Detailed knowledge of the radiographic appearances of the
pathological conditions affecting the head and neck
6- A systematic approach to viewing the entire radiograph and to viewing
and describing specific lesions
Principles of Radiographic Interpretation
Imaging as an Examination Tool
Clinical examination
Signs
Symptoms
Ordering the right type of imaging examination
Ordering the right number of imaging examination
Necessary vs. unnecessary examinations
Benefit to the patient
Viewing condition
View box Monitor Prints Ambient light reduced Quiet room Intraoral films mounted on a opaque holder Equal intensity of light on the view box Monitors: calibration Magnification Software limitations
Systematic Approach
Intraoral images
Teeth, periodontium, bone, adjacent structures
Tooth #1 to #16, and then #17 to #32
Extraoral images;
Panoramic, other extraoral plain radiographs
Cross sectional images
CT, MRI
Localize the abnormality
How many lesions?
Where is the lesion?
Localized vs generalized
Single arch or both the arches
Inside the bone or outside
Relation to the crown
Relation to the root
Superior to the mandibular canal
Periphery
Well defined or ill defined?
Sharp margins
Corticated margins
Sclerotic margins
Radiolucent band
Blends into adjacent area
Irregular margins
Shape
Circular
Oval
Scalloped
Multilocular
Internal structures
Radiolucent
Mixed
Radiopaque
Trabeculation
Septa
Calcifications
Tooth or similar entities
Adjacent structures
Teeth
Lamina dura
Crestal bone
Periodontal spaces
Alveolar bone
Nerve canals
Maxillary sinuses
Cortical bones
Radiographic findings
Abnormal
Developmental Acquired
Cysts Tumors
(benign/malig) Inflammatory Bone dysplasia Vascular Metabolic Trauma
Normal
Vindicate your D/D
Vascular Infection Neoplasm Drugs Idiopathic/inflammatory Congenital Autoimmune Trauma Endocrine/metabolic
Irrelevant words!
Sun-ray appearance
Ground glass
Cotton wool
Onion skin
Driven snow
Etc, etc
When not to order imaging
You have not clinically / radiographically evaluated the patient
No benefit to the patient
Additional images may not provide extra information
No ‘routine’ radiograph
What goes on the report
Patient, doctor, clinic identification
Date, type and number of examination
Reasons for the examination
Clinical information
Relevant observation
Radiographic Impressions
Any further tests, examinations
