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Sonography Guide: Radiographic Anatomy

Introduction

Radiographic anatomy is the study of anatomy or the body using radiographic films or X-rays. Those professionals who specialize in this area are radiographers, orthopedic surgeons and dentists. Radiographic anatomy aims to accurately identify and describe physical structures and conditions within the body.  For example, the radiographic anatomy of the foot identifies all the types of small bones in the foot, their proper location within healthy individuals and the ways in which these bones function.

Radiographic anatomy plays a crucial role in the detection of the early stages of deep-seated bone disease.  Numerous developmental changes which occur in the bone over time can be documented utilizing radiographic anatomy. For example, radiographs of particular bones at different ages often reveal the progressive conversion of cartilage into bone and other abnormalities of the bones.

Radiology Anatomy Teaching Modules
The KU Radiographic Anatomy Program: Case Studies
Surgical and Radiologic Anatomy

Hallux Valgus

Hallux valgus, or bunion deformity, is one of the most common foot problems seen today by foot and ankle specialists. Bunions are hereditary, but may also be caused by aggravated shoe ware. Radiographic anatomy has enabled medical professionals to recommend and perform the appropriate surgical procedure in order to correct the bunion. The decision to perform a particular type of surgery is based upon the extent and magnitude of the bunion deformity, the presence of arthritis in the toe joints, and the amount of space between the first and second metatarsals, which is called the intermetatarsal angle. Radiographic image and knowledge of radiographic anatomy allow professionals to discern the extent of the deformity and conditions such as arthritis in order to recommend the proper surgery, such as distal osteotomy, diaphyseal osteotomy, and proximal osteotomy.  Such images have been particular helpful for providing medical treatment among elderly patients.

Radiographic Correlates of Hallux Valgus in Older People
Radiographic Evaluation of Hallux Valgus
The Anatomy of Hallux Valgus

Spine Problems

Metastatic disease, myeloma, and lymphoma are among the most common malignant spinal tumors. Radiographic images and anatomical knowledge have greatly contributed to diagnosing these types of spinal tumors as well as serving as recommendation for further surgical steps and procedures. Due to the complex anatomy of the vertebrae, computed tomography (CT) is more useful than conventional radiography in order to evaluate abnormalities such as lesions, bone destruction and condensation. The diagnosis of spinal tumors is based on patient age, topographic features of the tumor, and lesion pattern as seen at CT and magnetic resonance (MR) imaging. In addition, full-spine x-rays enable the surgeon to make important decisions regarding overall spinal balance and the need for stabilization.

Anatomical Shape Representation in Spine X-ray Images
Radiology Anatomy of the Spine and Upper Extremity
Radiography of the Spine
Diagnostic Imaging of Solitary Tumors of the Spine: What to do and Say

Upper and Lower Extremities

Radiographic imaging and anatomy have enabled surgeons to identify and diagnose a number of types of bone injuries (such as breaks and fractures).  More significant, perhaps, is the ability of surgeons and other medical professionals to use radiographic anatomy in order to assess the various stages of fracture healing. In the first stage, the inflammatory stage, radiographic imaging demonstrates that a blood clot has formed at the specific location of the fracture. During the second stage (reparative phase), the bone at the fracture margins is deprived of its vascular supply resulting in resorption at the bone ends.

The cells lining the cortex begin to produce immature bone, or callus. This callus may be viewed through radiographic images as faint calcification around the fracture. In the final stage (remodeling phase), the immature callus is replaced by a denser bone in the cortex.

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