Shin x-ray is prescribed if there is a suspicion of a diaphyseal fracture of both shin bones, isolated fractures of the tibial and fibular diaphyses. The standard study is performed in two projections (straight and lateral). For a direct snapshot, the patient is laid on his back. Legs are straightened. Lateral radiography of the shin bones is performed by placing the patient on the sick side. The affected leg is slightly bent at the knee and hip joints. The healthy limb is sharply bent at the knee and hip joints and is located in front of the diseased leg.
Indications
Radiography of the lower leg can be carried out in the presence of various indications and it can be prescribed by different specialists.
In traumatology
Fractures of the lower leg, foot can have a very diverse localization, size, complexity. An X-ray will help to identify the features of the fracture, see if there are bone fragments and how they are located. Also, X-rays are used after the broken bones have been joined and plastered. In this case, it is important to observe in dynamics how the fusion of bone tissue occurs.
In oncology
Oncological foci, as is known, can occur not only in internal organs or soft tissues, but also in bone tissue. Most often, bone cancer affects areas located near the knee joint, such as the shin. It is worth clarifying that we are talking about primary cancer, that is, cases when cancer cells first originate in the bone, and are not the result of metastasis of a soft tissue tumor. There are three main types of oncology that can affect the ankle joint:
- Osteosarcoma. This pathology is the most common, and the risk group includes mainly teenagers who are in the stage of active growth and physical development. Osteosarcoma originates in new, developing bone tissues.
- Chondrosarcoma. This pathology often originates in the cartilage of the joints and affects people aged 40 to 60 years.
- Ewing’s sarcoma. This disease mostly affects young children. It is characterized by the appearance of small cancer foci in the bone marrow of the child. If such a pathology is detected at an early stage, then it responds well enough to treatment.
In purulent surgery
The bones of the lower leg can also be affected by purulent diseases. The most common of them is osteomyelitis. Such pathology can affect all elements of the bone: bone marrow, periosteum and bone tissue itself. Osteomyelitis can be acute, that is, it has arisen for the first time, and chronic. In both cases, an shin x-ray helps to accurately determine the focus of pathology, assess its size, the degree of bone damage. Also, an X-ray is necessary if an operation is planned on the lower leg, aimed at eliminating foci of osteomyelitis.
Preparation
Shin x-ray does not require special preparation. The only thing you need to warn the doctor about is the presence of metal implants in the ankle joint.
What shows
The X-ray image of the lower leg, as in a black-and-white photo, shows the location of the bones of the ankle joint. Their connection, cartilage tissue, is also visualized. Fractures of the joint will be visualized as darkening on a white background of the bone. Tumor-like malignant neoplasms are also defined as darkening, but have fuzzy boundaries. Sometimes, in order to make the pathology picture more clearly, pictures of the lower leg are taken of two legs at once, even if only one is affected. When comparing images, their symmetry is easier to find a deviation and make a diagnosis. Osteomyelitis of the lower leg has special signs on the X-ray:
- Thickening of the bone at the sites of inflammation.
- Necrosis foci can be visualized on bones and muscles. They look like dark circles on the bone or light – on soft tissues, having an irregular shape.
- In the picture, the bone marrow canal is not visualized in osteomyelitis.
Methodology of conducting
Shin x-ray takes little time and does not require special training. The patient’s body, with the exception of the studied area, at the time of the survey should be protected by a special apron that shields ionizing radiation. Shin x-ray is performed in two projections: straight and lateral. If these projections are not enough to make a diagnosis, an X-ray is done in oblique projections (at different angles), as well as an X-ray of the foot with a load.
Interpretation
After the development, the pictures need to be deciphered. To do this, certain indicators are used, which are compared with standard values:
- The location of the bones in relation to each other, as well as their shape and size. In cases where the bones increase when the load is received, hyperostosis is diagnosed, that is, an increase in bone matter. Reduced bone size occurs with atrophy due to limited physical activity and nerve diseases.
- The condition of the surface of the shin bones. In oncological diseases, foci of destruction of the upper layer of bone tissue are observed in the shin area. There may be a reverse situation, that is, there is ossification of periosteal tissues, detachment.
- The structure of the bones of the lower leg. When the images show shaded areas on white areas of bone structures, osteoporosis can be diagnosed. At the same time, the outer layer of the bone is thinner, and the medullary canal is expanded. With increased bone density, osteosclerosis is diagnosed.
- The size of the gap between the joints. Uneven narrowing of this gap indicates the presence of arthritis or arthrosis.
- The angle of the foot. Normally it should be 130. Deviation from the norm is a sign of flat feet, the degree of which will be determined by the doctor.
Contraindications
The following contraindications can be distinguished for an X-ray of the lower leg:
- pregnancy;
- early childhood;
- severe general condition of the patient.
