II. Background

  1. Five Radiographic Densities (in order of increasing brightness)
    1. Air (e.g. lung, dark)
    2. Fat
    3. Fluid and soft tissue (e.g. heart)
    4. Bone or calcifications
    5. Metal or Contrast Material (very bright)
  2. Differences in radiographic density allows for differentiation of structures on XRay
    1. Adjacent objects with similar densities will have indistinct abbutting margins
    2. Blurred structural margin suggests an adjacent structure (Silhouette Sign)
  3. Image Geometry
    1. Orthogonal views (90 degrees) reduces distortion
    2. Objects further from the xray film are distorted
      1. Objects close to XRay film or cassette have sharp edges without significant magnification
      2. Objects further from XRay film or cassette have blurred edges and greater magnification

III. Approach: Check Written Information

  1. Patient Name
  2. Exam Date and Time
  3. Technician Notations (e.g. Expiration film)

IV. Approach: Patient Position

  1. Supine
  2. Semiupright
  3. Erect

V. Approach: Patient Alignment

  1. Rotation
  2. Lordosis or kyphosis

VI. Approach: Penetration

  1. Over-penetration: Dark films
    1. Consider using "bright-light" to see details
  2. Under-penetration: White films

VII. Approach: Systematic Review

  1. Prowl the film
    1. View film from different angles and distances
  2. Establish strong, even illumination
    1. Turn off surrounding light panels
    2. Dim room lights

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