Abdominal X-Rays - Dr Helen Wright
Summary
This on-demand teaching session by Dr. Helen Wright familiarizes medical professionals with the process of reporting an x-ray in an objective structured clinical examination (OSCE) setting. Attendees will learn how to systematically analyze and report findings from abdominal x-rays (AXRs) using examples. The comprehensive guide touches on identification of specific anatomical features, determination of technical quality, and identification of potential abnormalities. You will also have a chance to practice reporting using verbal templates provided. This session is beneficial for medical practitioners seeking to improve their diagnostic acuity and reporting precision in radiology. Links to useful resources will be provided for self-study and further clarification.
Learning objectives
- Understand and apply a systematic approach to reporting an abdominal x-ray in an OSCE.
- Interpret findings from various abdominal x-rays using a structured verbal reporting format.
- Identify characteristics of both technically adequate and inadequate x-ray images.
- Recognize and differentiate major anatomical elements in abdominal x-rays to diagnose any abnormalities.
- Apply the knowledge gained in analysis and reporting of actual abdominal x-rays during the practical session.
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AXR – an OSCE guide Dr Helen Wright Helen.wright69@nhs.net 1/28/2025 1Objectives • Provide a structured framework for how to report an x-ray in an OSCE • Show how the structured reporting system works with an abdominal x- rays • Provide examples of AXR’s with a scripted verbal reportVerbal reporting template Structure Whatyouwantto describe ‘Thisis a…’ Descriptionofthe imagesyouare seeing ‘ForMr/Mrs…’ Patient demographics ‘Itis technically…’ Adequate or poortechnical quality ‘Thismost obviousabnormalityis…’ Ifyoucan see somethingsay it ‘I’mnowcheckingmyreviewareas…’ Go throughyourreview areas ‘Insummary…’ Singlesentence only Describing an abdominal film • Supine or erect? 'Thisisa supineabdo…’nalfilmPatient demographics • If you know them say it “Theisa supineabdominalx-rayfor Mrs. Smitha 49 yearoldfemale” • If you don’t know it, you can use a generic phrase “Thisisa supineabdominal x-rayforpatientof unknown demographics” T echnical quality • Rotation – look at the hips • Penetration – can you see the spine • Is all anatomy included? – both diaphragms to bottom of pubic symphysisWorked example • 1.Thisisasupine abdominal film of a skeletally mature patient withunknown demog raphics • 3.Itistechnicallyadequate with no rotation and good penetration. To complete the series, I would want a further image to visualize both the hemidiaphragms. • I have no previous films for comparison. 1/28/2025 7Review of abdominal anatomy Systematic review • Bowel gas • Soft tissue – look at the organs • Bones • Edge of film (skin) • Lines and tubes • foreign objects Worked example I can not see any obvious abnormality, so I am going to check my review areas. The bowel gas pattern is within normal limits – there is some fecal matter in the ascending colon Checking the internal organs – there is a small, well-defined area of calcification superimposed on the liver, this is likely to represent a gallstone. No other soft tissue abnormalities. • There is mild scoliosis of the lumbar spine, no further bone abnormalities • No abnormalities around the edge of the film This would be in keeping with gallstone on an otherwise normal abdominal x-rayTime to practice1. This is a … 2. For a patient … 3. It is technically … 4. The most obvious abnormality is… 5. I'm checking my review areas … 6. These findings would be in keeping with…1. This is a … 2. For a patient … 3. It is technically … 4. The most obvious abnormality is… 5. I'm checking my review areas … 6. These findings would be in keeping with…1. This is a … 2. For a patient … 3. It is technically … 4. The most obvious abnormality is… 5. I'm checking my review areas … 6. These findings would be in keeping with…1. This is a … 2. For a patient … 3. It is technically … 4. The most obvious abnormality is… 5. I'm checking my review areas … 6. These findings would be in keeping with… 1. This is a … 2. For a patient … 3. It is technically … 4. The most obvious abnormality is… 5. I'm checking my review areas … 6. These findings would be in keeping with… 1/28/2025 161. This is a … 2. For a patient … 3. It is technically … 4. The most obvious abnormality is… 5. I'm checking my review areas … 6. These findings would be in keeping with…1. This is a … 2. For a patient … 3. It is technically … 4. The most obvious abnormality is… 5. I'm checking my review areas … 6. These findings would be in keeping with…1. This is a … 2. For a patient … 3. It is technically … 4. The most obvious abnormality is… 5. I'm checking my review areas … 6. These findings would be in keeping with…1. This is a … 2. For a patient … 3. It is technically … 4. The most obvious abnormality is… 5. I'm checking my review areas … 6. These findings would be in keeping with…Feedback please :-) Questions? • Useful websites: https://www.radiologymasterclass.co.uk/ https://radiopaedia.org/ https://radiologyassistant.nl/