“Unlike Chest Radiographs, interpretation of abdominal radiographs is looked upon with more hesitation and less certainty by most of the family doctors/ general practioners. This can be overcome, if we approach the abdominal x-rays in a systematic manner. Compared to chest x-rays, the tissue contrast in abdominal x-rays is less, and is dependent very much on the build of the patient as well as technical adequacy of the x-ray exposure. Plain radiographs of the abdomen are taken most often in patients with acute abdomen or with calcifications or calculus diseases.
A systematic approach to abdominal X-ray can be made by evaluating the following points:
1.Checking the identity
2.Checking the exposure quality
3.Looking at the flanks, diaphragm
4.Understanding distribution of intraluminal air in bowels
5.Identifying abnormal intraluminal air patterns
6.Searching for abnormal extraluminal/ free peritoneal air
7.Identifying normal soft tissue shadows
8.Identifying organomegaly, soft tissue masses
9.Calcifications: physiological and pathological
10.Bones and joints
11.Iatrogenic tubes and wires
12.Unexpected radio-opaque shadows.
These points will be discussed with ample radiographic images. So next time you encounter with an X-ray abdomen, do not shy away, give a try!
Dr.N.Madhavan Unni MD., DMRD
Senior Consultant Radiologist,
KIMS , Thiruananthapuram.