Abdominal x-ray review is a key competency for medical students, junior doctors and other allied health professionals. Using ABDO X is a helpful and systematic method for abdominal x-ray review, where D refers to the assessment of dense structures such as the bones and areas of calcification.
Summary
-
introduction
- several bony structures are visible on an abdominal x-ray and should be evaluated carefully
- calcification may also be visible and may provide a clue as to the cause of the patient's symptoms and signs
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procedure
- evaluate all of the bones visible on the x-ray as you would on any other x-ray
- look at the contours, density, trabecular pattern, areas of lysis or sclerosis
- you may see the lower thoracic vertebral bodies, all of the lumbar vertebral bodies, sacrum, iliac blades, ischium, femoral heads and necks, and lowest ribs
- Paget disease of the pelvis is frequently identified on abdominal x-rays
- examine the renal shadows and paths of the ureters for small densities which indicate stones
- gallstones are radiopaque in approximately 15-20% of cases
- small pelvic calcifications are likely to be phleboliths
- calcified lymph nodes are also sometimes identified
- other calcifications include:
- vascular, e.g. aorta, splenic artery, phleboliths
- uterine fibroids
- calcified mesenteric lymph nodes
- hepatic/splenic granuloma
- gluteal injection site granuloma
- encapsulating peritoneal sclerosis
- evaluate all of the bones visible on the x-ray as you would on any other x-ray
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