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An X-ray of the knee joint is the basis for diagnosing the health status of this part of the body. The technique has been in consistently high demand for more than a dozen years, which is explained by its ability to visualizedig out bone and joint structures. The results will indicate various variants of dysfunction of the studied tissues, or will allow you to find pathologies of varying severity with the selected localization site.
Initially, it was believed that the resulting black and white images are suitable only for general idea of the area under study after a recent injury. But experienced traumatologists, thanks to one similarnimku, can set a much larger range of changes any etiology.
It does not do without a well-proven technique while monitoring the dynamics of recovery. This may be the control of healing after the surgical intervention, or conservative treatment. The technology has taken root so much that even dogs and other pets become visitors to the X-ray room. Such devices are specially adapted for veterinary clinics.
Reasons for appointment
The attending physician always sends for x-rays. Despite the popularity of manipulation, it is far from always able to provide a complete picture of what is happening in the knee joint area. Because of this wizards sometimes they send theirpatients on alternative examination method such as magnetic resonance tomography, if there are appropriate indications.
But, usually, patients come with standard symptoms, indicating the most common diseases of this part of the body. What the black-and-white image shows is quite enough to clarify the situation and subsequently build a program of rehabilitation therapy.
Ignore issued doctor direction to survey in no case is it impossible, since such negligence threatens with a sharp deterioration in well-being. The only thing that the patient can independently choose is the place where to do research. It can be a private clinic or a public hospital. In addition to the service provided, they may differ in price. In most cases, the cost It depends on which apparatus the examination is carried out, as well as onnecessary provone day auxiliary contrast.
First moment concerns separation of devices into old generation devices, which usually irradiate the body with a larger dose of radioactive rays, and innovative digital counterparts. The latter are able to store the received information in electronic form, so that lateragent received a visualized conclusion on a digital medium.
Moreover, regardless of the model of equipment, a description of the state of the joint will be done by a radiologist. But the final verdict on the diagnosis will still be made by the surgeon or traumatologist. He must take into account other aspects of the survey, in the form of laboratory results tests, hereditary predisposition, complaints, anamnesis of disease and life.
The main reasons for directions the patient for x-ray confirmation of suspicion is called:
- fractures;
- dislocations;
- cracks, indentations and other relatively minor bone deformities;
- ligament ruptures;
- offsets;
- stretching;
- soft tissue injuries that are easy to detect in two projections;
- tendon destabilization;
- tumors of various etiologies up to malignant oncological neoplasms with metastases;
- even small cysts and only emerging anomalies of this kind;
- arthrosis, arthritis, other common articular abnormalities;
- osteophyte;
- osteoporosis;
- osteosclerosis.
It does not do without a preventive examination with the help of high-tech equipment, so that in the future the patient can count on arthroplasty. Due to the fact that the image usually covers not only the knee joint itself, but also the surrounding areas, this makes it possible to study the degree of damage by inflammatory, infectious, or some other process.
When the laying is done correctly, then it becomes possible at the same time to consider neighboring bones like:
- fibula;
- femoral;
- tibial.
But this will require the use of not only modern formats of medical equipment. You will have to rely on the experience of a particular radiologist, who, in one go, will allow you to shoot several zones combined into a single whole at once. An integrated approach will not only save time and money, but will also become the key to reduced radiation exposure to the patient’s body. This is especially important for a child.
Innovative technologies allow today not only to view incoming information in a standard two-dimensional mode, but also to receive an image that simulates 3D image. It turns out something similar to what MRI offers. But those who were interested in how much a magnetic resonance examination costs know that an x-ray will cost an order of magnitude cheaper. Even in terms of time, it lasts much less.
For a healthy person who is not exposed to radiation exposure, the radiation dose is within the normal range. Therefore, often those who initially doubted which is better: MRI or X-ray, prefer the second.
Projection classification
Figuring out where to go examinationtreatment, the patient will have to follow the instructions x-raylaboratory technician He, based on the prescription physician, will expose the irradiation tube in such a way as to receive one of theoptions projections:
- Direct. The most popular option, which is performed when a person is lying down, in order to identify a possible fracture in him.
- Tangential. The victim must be standing, which makes it possible to identify the main acquired pathologies.
- Lateral. It is also carried out in a standing position, but usually it is not done on its own, but only in conjunction with some other projection format to clarify the diagnosis.
- Transcondylar. The patient should be in an upright position. It is necessary to detect bone necrosis at different stages of development, or osteoarthritis.
In order to get a normal picture, you must remain completely still.
Based on the information received, along with the decoded conclusion, it will be possible to correctly build the treatment, as well as understand the etiology of poor health.
Contraindications and precautions
Schematically, all contraindications can be divided into two equal categories: relative and absolute. The second includes pregnancy at different timing. Despite the fact that the apparatus irradiates a person within the permissible norm, even the slightest fluctuation in the radiation background can be harmful for the fetus. We are talking about subsequent mental, physical developmental abnormalities.
Because of this wizards usually insist on replacing the use of X-rays with a more gentle way: ultrasound or MRI. But sometimes alternative suggestions or unable to fully describe what the supposedly affected joint looks like, or there are contraindications for, for example, MRI diagnostics. Then expectant mothers have to take risks. They will come to the aid of special protective devices such as aprons and dampers made of a certain material. They are designed to reduce the harmful load on the baby.
Another feature is obesity. Because of it, a black-and-white “photo” can be distorted, since the fatty layer lubricates the visualization.
Separately, two points are considered, on which the standard of image quality depends:
- The farther away the area for research is, the clearer the result will be. The paradox is explained by the fact that the rays like to scatter, giving good quality at a distance.
- Even modern devices are not able to cover the conditions of the knee cartilage due to the specifics of their structure. But the bones are well visible due to the high calcium content. The tendons and ligaments became the golden mean, it’s not for nothing that sometimes a joint rupture is sent to be rechecked for magnetic resonance tomography.
A person who is far from medicine is unlikely to be able to figure out the identified deviations in the resulting picture. Therefore, all attempts to independently decipher the image without a radiologist almost always fail, since people are simply not able to distinguish synovitis from of normal condition.
Myths and stereotypes
Many potential visitors to the clinic are afraid to go for x-rays, having heard about its dangers. This is especially true of hospitals, where devices manufactured during the Soviet Union still operate. Such devices are long overdue. Scientists have proven that the worse the quality apparatus, the greater the radiation load it affects on a patient who already has health problems.
Depending on which area will be examined and what apparatus is used, the radiation dose varies. The average parameter for the knee joint is about 0,001 m3t. The body receives an almost identical level of radiation per day while existing in its usual habitat. For example, an x-ray of the large intestine by radiation exposure is equal to almost two years of standard human radiation.
But even the lowest dose for a knee assessment can become a huge problem if the patient is sent to have the image redone several times and then asked to take control tests two or three more times.threads. They are needed to monitor the dynamics of recovery during injuries, or others pathological processes.
Therefore, before you pick up your direction on survey, Nagent is obliged to warn the attending physician that he has recently undergone an X-ray or computed tomography, even if it is of another part of the body.
If the benefit from the intended result is more significant than the harm, the patient will still be sent for diagnosis to find the cause of the pathology. But if there is a gentle alternative that is ideal for a particular case, excess radiation exposure can be successfully avoided.
X-ray scheme
The principle of classical radiography remains almost the same for examining different parts of the body. Before you stand or lie down in front of the screen, your knee will need to be freed from clothing. The only exception is a plaster cast, which is life-threatening to get rid of.
Roentgen-lthe attendant will definitely warnagent on the need to preserve A couple of minutes absolutely motionless posture. A carelessly made movement becomes reason dynamic blurring, which will become the basis for the need to re- examinations, which means radiation.
Depending on the suspicions, the doctor reserves the right to decide whether it is required to capture the meniscus in one projection, or several. But with fractures, you still have to do at least two images to eliminate risks. availability fragments of bone. Sometimes the patient has to be examined even with a flexed lower limb to monitor functionality knee joint.
The result of radiography allows us to detect both large inflammatory processes, which are quite common, and rare hereditary anomalies of a congenital nature. Usually the results point to:
- bone deformities;
- hereditary pathologies;
- changes in the average thickness of cartilage tissue with end plates;
- neoplasms located in the bones.
Thanks to the same technique, in a short time it is possible to control course regeneration in case of previously recorded injuries of varying severity.
If everything is fine, then the radiologist will definitely write that no pathological neoplasms were found. Instead, all articular surfaces have smooth edges, and no cracks or splinters were found.
Separately, indicators are noted withstructure joints, which must correspond to each other. The gap remains the same in width on both sides without suspicious inclusions, spots, other formations that would replace a healthy lumen.
Interpretation of the radiograph
Despite the fact that the layman is unlikely to be able to independently deal with the features of the resulting black-and-white “photo”, he can recognize the symptoms of the most common ailments. Signs of their development are indicated by pradiologistWhich makes conclusion given to the treating doctor.
So, if a patient is suspected of arthrosis, then in the official concluding its confirmation can be found by reading the following theses:
- unevenly narrowed gap;
- deformation of the gap according to the degree of neglect of the process;
- bone growth along the articular margin;
- osteophytes of various sizes;
- compaction of bone tissue at the border with cartilage;
- limestone plaque on ligaments.
But it is much easier to recognize fractures even without proper medical skills. They are visible on closer inspection. pictureswhere damage is pronounced. More difficult with fresh cracks and depressions, which are better seen a few days after the injury.
Arthritis, unlike arthrosis, gives expansion of the joint space. Anatomically, the phenomenon is explained presence inflammatory effusion in the cavityand joint. In some cases, to establish the exact degree of damage without a magnetic resonance tomograph, it is still not enough.
It is relatively easy to recognize a dislocation. It is characterized by bone displacement, where one part does not correspond in shape to the surface of the second. The main victim of dislocations is the kneecap.
With sprains or destabilization, the functioning of the ligaments is a little more difficult due to the structural features of the soft tissues. But even such anomaliesaecan be found if you pay attention to the possible increase in the distance between the surfaces of the bones of the lower leg with the thigh.
A little by a similar principle, they are looking for a violation of the integrity of the patellar tendon. The image will show the displacement of the kneecap. When the tendon has additionally undergone the process of sclerosis, its outline can be seen more clearly. To create a picture of increased accuracy, you can use an artificial technique by adjusting the radiation hardness.
Since people usually seek advice from a surgeon or traumatologist at the “I can’t take it anymore” stage, they develop expressed degenerative-dystrophic process. X-ray study will reveal it due to the growth of bone tissue formed on the sides of the articular surfaces. Outgrowths in the form of osteophytes gradually lead to irreversible deformities that significantly impair the quality of life of the victim.
Another common reason for visiting the radiography room is referrals from oncology dispensaries. Tumors benign or malignant character are arranged not only in the joint, but also in the periarticular soft tissues of the knee. You can find them by marks without a clear shape with cells destroyed around them. The more amazed area around pathological focus, the higher the chances that next formed metastases.
Final common disease is osteoporosis. Here, only a doctor with experience will be able to figure it out, who will pay attention to the lack of calcium in the bones. Photo will confirm the fears if transparent inserts become visible there when the borders are sealed.
Relatively rare diseases
In addition to the standard cases of a number of common ailments affecting the functionality of the knee in general and the joint in particular, there are a number of more rare diseases. They can also be detected with the help of X-rays, if you study results will experienced doctor.
The list of relatively rare diseases includes:
- cyst;
- foreign bodies;
- osteochondropathy;
- congenital deformities;
- osteomyelitis;
- tuberosity of the tibia.
Alarming bells for the patient should be manifestations of rounded enlightenments, which is typical for a typical cyst.
Bone tissue degeneration, osteoporotic areas, sequesters – all of the above indicates incipient osteomyelitis. But to see a foreign body that accidentally or intentionally got into the articular cavity during an injury will only work if the object has a high density.
It is also difficult to suspect Koenig’s disease based on X-ray alone. The reason for this is the ability of osteochondropathy to form an articular mouse. It is a consequence of necrosis of the bone, which is part of the knee joint. Due to the fact that such a mouse is a common symptom of other, more common diseases of the musculoskeletal system, other analyzes have to be involved.
At the primary stage the development of Osgood-Schlatter disease, the image will show uneven, blurry borders of the tibia, where the tuberosity is visible even without magnification. Over time, it develops into fragmentation.
Congenital pathologies should be dealt with separately each time. Symptoms and their external manifestation vary from case to case, but most often suspicions begin with the asymmetry of the sides of the bones.her and joint.
For reinsurance and making a final diagnosis, the patient is almost always sent to undergo an ultrasound examination. This is necessary to minimize the risks of destruction of muscles, cartilage located in the neighborhood.