X-ray of the bones
Last reviewed: 22.11.2021
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X-ray method (X-ray) made it possible to obtain new data on the anatomy and physiology of the musculoskeletal system: to study the structure and function of bones and joints in vivo, in an integral organism, when various factors of the environment influence the person. Even in the pre-Roentgen era, when anatomy was based mainly on the analysis of cadaveric material, the outstanding Russian anatomist P.F. Lesgaft wrote: "... The dead drug should serve only as a test and addition to the living organism under study." X-ray studies made it possible to take a fresh look at the traditional manifestations of skeletal diseases, to revise the previous classification of its lesions, and to describe many pathological processes in the bones that were unknown until then.
Radiographs are the main way to study the radial morphology of bones in normal and pathological conditions.
To study the early changes in the endoplastic plates and the subchondral layer of the bone, images are taken with a direct increase in the X-ray image. In the study of complex structures of the skeleton (skull, spine, large joints), a common (linear) tomography is of great benefit.
Gradually, in a number of the most effective ways of studying the musculoskeletal system, a computer tomography is put forward. Magnetic resonance imaging proved to be the most valuable method of bone marrow research, as it opened the way for the detection of edema, necrosis and bone marrow infarction and, thus, the initial manifestations of pathological processes in the skeleton. In addition, magnetic resonance imaging and spectrometry enabled the physician to study morphology and biochemistry of cartilage and soft tissue formations of the musculoskeletal system in-vivo.
New ways of diagnosing diseases of the musculoskeletal system were discovered by sonography. On sonograms, foreign bodies absorbing X-ray radiation and therefore invisible on radiographs, articular cartilage, muscles, ligaments and tendons, accumulation of blood and purulent fluid in the periosteal tissues, periarticular cysts, etc., are obtained on sonograms. Finally, radionuclide scintigraphy proved to be an effective method for studying metabolic processes in bones and joints, because it provided an opportunity to study the activity of mineral metabolism in bone tissue and the synovial membrane of the joints.
Radiation anatomy of the skeleton
The skeleton passes a complex path of development. It begins with the formation of a connective tissue skeleton. From the second month of intrauterine life, the latter is gradually transformed into a cartilaginous skeleton (only the cranial vault, the bones of the facial skull and the body of the clavicles do not pass the cartilaginous stage). Then a prolonged transition from the cartilaginous to the bone skeleton takes place, which ends on average to 25 years. The process of ossification of the skeleton is well documented with the aid of radiographs.
Radiation symptoms and skeletal syndrome
Pathological processes that develop in the musculoskeletal system lead to various and highly polymorphic radiographic manifestations. However, on the one hand, the same diseases, depending on the individual characteristics of the patient and the stage of the disease, can cause various symptoms, and on the other - the pathological states, which are opposite in nature and prognosis, are sometimes accompanied by very similar changes. In this regard, assess the radiographic data should only be taken into account the clinical picture and the results of laboratory studies. It should also be borne in mind that the radiograph showing only the mineralized basis of the bone can be normal in cases of soft tissue damage to the musculoskeletal system. As a consequence, during the course of many diseases, a latent ("x-geno-negative") period is isolated. Such patients need to make other radiation studies - CT, MRI, sonography, osteoscintigraphy.
X-ray symptoms and skeletal syndrome
Damage to bones and joints
Radiation examination of the skeleton is performed according to the prescription of the doctor in charge. It is indicated for all injuries of the musculoskeletal system. The basis of the study is the radiography of the bone (joint) in two mutually perpendicular projections. The images should be taken with an image of the entire bone with adjacent joints or a joint with adjacent bones. All victims are subject to examination in the X-ray room, in which consciousness is preserved and there are no life-threatening signs of damage to internal organs and vessels. The remaining victims according to clinical indications can be examined in the ward or dressing room with the help of a mobile X-ray machine. Refusal of radiography with damage to bones and joints is a medical error.
X-ray signs of damage to bones and joints
Diseases of bones and joints
Radiation diagnosis of diseases of the musculoskeletal system is an exciting and at the same time very complex area of knowledge. Over 300 diseases and anomalies in the development of bones and joints have been described. Each disease is characterized by a certain dynamics - from the initial manifestations, often elusive in the radiation study, to gross deformations and destruction. In addition, the pathological process can develop both in the entire skeleton, and almost in any of the 206 constituent bones. Symptoms of the disease affect the age-related features of the skeleton, the properties of the pathogen, numerous regulatory, including endocrine effects. In connection with the foregoing, it is clear how heterogeneous the radiographs of each patient are, how thoughtfully the doctor should consider a set of anamnestic, clinical-x-ray and laboratory data in order to make the correct diagnosis.