Bone X-rays

The 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 during life, in the whole organism, under the influence of various environmental factors on a person. Even in the pre-X-ray era, when anatomy was based mainly on the analysis of cadaveric material, the outstanding Russian anatomist P.F. Lesgaft wrote: "... a dead preparation should serve only as a check and supplement to the living organism being studied." X-ray studies made it possible to take a new look at the traditional manifestations of skeletal diseases, to revise the previously existing classifications of its lesions, and to describe many previously unknown pathological processes in bones.

Radiographs are the main method for studying the radiation morphology of bones in normal and pathological conditions.

To study early changes in the endplates of the epiphyses and the subchondral bone layer, images are taken with direct magnification of the X-ray image. When studying complex skeletal sections (skull, spine, large joints), conventional (linear) tomography is of great benefit.

Computer tomography is gradually moving into the ranks of the most effective methods of studying the musculoskeletal system. Magnetic resonance imaging has proven to be the most valuable method of studying bone marrow, as it has opened up ways to detect edema, necrosis and infarction of the bone marrow and thus the initial manifestations of pathological processes in the skeleton. In addition, magnetic resonance imaging and spectrometry have given the doctor the opportunity to study the morphology and biochemistry of cartilage and soft tissue formations of the musculoskeletal system during life.

Sonography has also opened up new ways of diagnosing diseases of the musculoskeletal system. Sonograms display foreign bodies that weakly absorb X-ray radiation and are therefore invisible on radiographs, articular cartilage, muscles, ligaments and tendons, accumulations of blood and purulent fluid in periosteal tissues, periarticular cysts, etc. Finally, radionuclide scintigraphy has proven to be an effective way of studying metabolic processes in bones and joints, since it has provided the opportunity to study the activity of mineral metabolism in bone tissue and the synovial membrane of joints.

Radial anatomy of the skeleton

The skeleton goes through a complex development path. It begins with the formation of the connective tissue skeleton. From the second month of intrauterine life, the latter is gradually transformed into a cartilaginous skeleton (only the cranial vault, facial bones and clavicle bodies do not go through the cartilaginous stage). Then a long transition from the cartilaginous to the bone skeleton occurs, which is completed on average by the age of 25. The process of ossification of the skeleton is well documented with the help of X-rays.

X-ray anatomy of the skeleton

Radiation symptoms and syndromes of skeletal damage

Pathological processes developing in the musculoskeletal system lead to various and very polymorphic radiographic manifestations. 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 hand, pathological conditions of opposite nature and prognosis are sometimes accompanied by very similar changes. In this regard, radiographic data should be assessed only taking into account the clinical picture and laboratory test results. It should also be borne in mind that an X-ray image that displays only the mineralized bone base may be normal in cases of soft tissue lesions of the musculoskeletal system. As a result, a latent ("X-ray negative") period is distinguished in the course of many diseases. Such patients need other radiation studies - CT, MRI, sonography, osteoscintigraphy.

X-ray symptoms and syndromes of skeletal damage

Bone and joint injuries

X-ray examination of the skeleton is performed as prescribed by the attending physician. It is indicated for all injuries of the musculoskeletal system. The basis of the examination is X-ray photography of the bone (joint) in two mutually perpendicular projections. The images should show an image of the entire bone with adjacent joints or a joint with adjacent bone sections. All victims who are conscious and do not have life-threatening signs of damage to internal organs and blood vessels are subject to examination in the X-ray room. Other victims, according to clinical indications, can be examined in a ward or dressing room using a mobile X-ray machine. Refusal to perform X-ray photography in case of damage to bones and joints is a medical error.

X-ray signs of damage to bones and joints

Diseases of bones and joints

Radiodiagnosis of musculoskeletal diseases is a fascinating and at the same time very complex area of knowledge. Over 300 diseases and anomalies of bone and joint development have been described. Each disease is characterized by a certain dynamics - from initial manifestations, often elusive during radiological examination, to gross deformations and destruction. In addition, the pathological process can develop both in the entire skeleton and in almost any of the 206 bones that make it up. The symptoms of the disease are affected by age-related features of the skeleton, the properties of the pathogen, numerous regulatory, including endocrine, influences. In connection with the above, it is clear how heterogeneous the radiographs of each patient are, how thoughtfully the doctor must consider the totality of anamnestic, clinical, radiological and laboratory data in order to make the correct diagnosis.

X-ray signs of bone and joint diseases