Ribs x-ray in traumatology is prescribed if a fracture of one or two ribs is suspected. In case of multiple fractures, a sighting is usually performed in combination with a chest X-ray. At the same time, an overview image makes it possible to assess the condition of all the organs of the chest, exclude or confirm the presence of complications, and targeted radiography of the ribs allows you to accurately determine the number and nature of fractures that are not always clearly visible on the overview image. The method is not indicated in childhood and during gestation. There are no contraindications for life-threatening and urgent conditions.
An ribs x-ray, chest is shown when:
- any mechanical injuries of the chest;
- tumors and inflammatory diseases of the chest organs;
- the presence of signs of bone tuberculosis;
- the defeat of the skeleton with rickets;
- pathologies, including congenital, of the spine.
It is possible to prescribe an X-ray in other situations, this should be decided by the attending physician.
Ribs x-ray and chest organs allows you to identify the following pathologies:
- malignant tumors;
- fractures and cracks;
- Titze syndrome;
- pathology of intercostal muscles, nerves;
- herniated intervertebral discs of the thoracic spine;
- intercostal neuralgia;
- pathological inflammation of the pleura;
- pleurisy (acute, dry);
- neoplasms of the pleura.
Rib fracture x ray
Rib fractures are one of the most common reasons why patients go to the emergency room. This is due to the anatomical feature of the structure of the rib bones, their small thickness and comparative fragility. Initially, an examination is carried out to determine the fracture. With complex fractures, you can notice the protrusion of fragments. With palpation, the doctor can determine a violation of the integrity of the bones, it may be possible to understand where the fragments are displaced. During the probing of the damaged area, a kind of crunch occurs due to the friction of the fragments against each other. Crepitation can be heard during auscultation of the chest, it manifests itself with a characteristic click.
An X-ray will put an end to the diagnosis of a rib fracture. On an X-ray of a broken rib, you can see:
- the fracture line (darkening);
- the presence of bone fragments;
- offset of a fragment of edges by length or width;
- on an overview radiograph, it is possible to determine the accumulation of air or fluid in the pleural cavity.
If the X-ray did not detect any of the listed signs, most likely, there is not a fracture, but a bruise.It is worth noting that sometimes a fracture of the rib bones does not have pronounced signs, and the patient may not even guess about the problem. Perhaps he feels a little discomfort in the chest area, but does not associate it with a fracture in any way. An ribs x-ray, as practice shows, does not always clearly visualize a fracture, especially if it has small dimensions. For additional examination of the chest, the patient may be assigned a computer or magnetic resonance imaging or ultrasound.
Ribs x-ray and chest requires minimal preliminary preparation. It consists in the fact that the day before the procedure, the patient should exclude from the diet foods that cause excessive gas formation in the intestine. This is necessary because the swollen intestine is able to lift the diaphragm and put pressure on the lungs. Immediately before the X-ray, you need to take off your outer clothing, all jewelry, accessories, so that there are no extraneous spots on the ribs when they appear. It is better to put long hair up so that they do not fall into the shooting area.
To protect the lower part of the body that does not fall into the study area, a special lead apron is put on the patient, which will prevent the penetration of ionizing radiation.
Methodology of conducting
The standard examination of the ribs in traumatology is performed in one projection. The choice of projection is determined by the localization of the fracture. The following options are possible:
- a direct shot of the posterior sections of the upper and middle ribs.
- direct radiograph of the posterior part of the lower ribs.
- a direct snapshot of the anterior divisions.
- lateral radiograph.
- oblique image of the anterolateral sections.
- oblique radiograph of the posterolateral sections.
For a picture of the posterior parts of the patient, they are placed on his back, for radiography of the anterior – on his stomach. Side shots are taken in the position of the patient lying on his side with his hands raised and placed behind his head. An oblique X-ray of the anterolateral sections is performed by placing the patient on his stomach (the head is turned to the side, the arm on the sick side rests on the table, lifting the trunk). An oblique picture of the posterolateral sections is made by laying the patient on his back and placing a pillow under the healthy side so that the trunk is at an angle of 40-45 degrees to the table.
The decoding of the X-ray results is started immediately after its execution. At the same time, no specific diagnoses are made, but simply all the features visualized in the pictures are described. First, the clarity of the resulting image and its contrast are evaluated. Then the analysis of specific indicators is performed:
- the symmetry of the structures of the chest and rib bones;
- bone integrity;
- structure of lung roots;
- structure and density of rib bones.
X-rays of the cervical ribs and chest can not be done for pregnant women and nursing mothers. There is a possibility that ionizing radiation will negatively affect the development of the unborn child or the composition of breast milk. It is better to use alternative diagnostic methods during these periods (for example, ultrasound) if it is not possible to postpone the examination to a later date.
It is also necessary to prescribe X-rays with caution to children under 15 years of age and patients in serious condition.