How to Read a Radiograph (X-Ray)

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This is a fun section designed to test your diagnostic abilities. Periodically we will show new x-rays (the proper word is radiograph) for you to test your skills, so remember to come back and see what new rads (that is the slang word we sometimes use) are posted on our site.

Before we get started, lets get some basics out of the way. There are five radiographic densities:

Soft tissue– internal organs like the liver and kidneys with a whitish color

Fat– the fat around the internal organs, also with a whitish color. Without this fat you would not be able to differentiate the different internal organs like the liver or kidneys, since they are soft tissue, and have the same radiographic density.

Air– this is black, and is what you see for the lungs in a chest radiograph

Bone– which is brighter than soft tissue or fat

Metal– Vivid, very bright, and hard to miss

Look at each x-ray closely (sometimes very closely) and see if you can figure out what is wrong. We have a couple of clues to help you make an interpretation:

  • Use symmetry when you can. Compare both sides, legs, or whatever else that might be useful.
  • Pull your face away from the screen and scan the whole x-ray before you jump into the details.
  • After you have scanned the whole radiograph look very closely for subtle changes.

First we will show a bunch of fun radiographs of the more unusual pets we see at our hospital. After that we will do some radiograph reading lessons, teaching you about the normal anatomy of dogs and cats. After that is a little test to see how you did. We will stick to abdominal radiographs for the test to make it easier. Good luck, and have fun!

Exotic Animal Radiographs

These first few rads are for a little fun, and to get your eyeballs warmed up for later.

Pregnant Guinea Pig

Iguana bladder stones. Click here to see the surgery to remove a bladder stone in an Iggie. 

Female rabbit with mummified fetuses that are several months old

California Desert Tortoise (CDT) with eggs

Two white bladder stones in a Guinea Pig

 

Normal hawk from our Wildlife Care Program

Calcium sludge in the bladder of a rabbit. This is called hypercalciuria, and you can read our detailed page on it

Did you also see the microchip and the calcium in the kidney?

Chinchilla incisor and molar teeth

 Snake with eggs

Rabbit with a fluid filled uterus

Do you see the two pellets in this hawk’s wing?

Did you also see the fracture in this wing? How should this be handled? You can see what we did in our Wildlife  Care Page

Normal X-Rays of dogs and cats

This is a radiograph of the abdomen of a normal cat that is laying on its right side. The head is towards the left. Use the diagram below to identify the organs.

The stomach has food in it, and the large intestine contains feces. All five radiographic densities are present in this abdominal radiograph. Do you see all of them? 

Air- is in the lungs along with gas in the intestines

S.T. -soft tissue is the liver and kidney

Fat- this is abdominal fat

Bone- lumbar vertebrae

Metal- the R marker to indicate this cat is laying on its right side is made of metal

Here is another normal cat abdominal radiograph, this time with an empty stomach

Here is another one, this time with the spleen and metallic sutures from a spay.

You can easily see the liver (L), stomach (S) kidneys (K) , the small intestines (SI), the large intestine (LI), the urinary bladder (UB), and the Spleen (Sp). The arrow points to stainless steel sutures in the muscle layer from a spay operation.

Abnormal X-Rays

This dog is having a difficult time urinating. Can you tell what is wrong?

Look towards the right side of this abdominal radiograph

Does labeling the organs help in your diagnosis?

The bladder is huge, because this dog is having a difficult time urinating. It is probably due to nerve dysfunction, since the spinal cord has changes called spondylosis. The circle points this out on one of the vertebrae

You can learn more about this problem, called spondylosis, from our arthritis page

This is a dog abdominal radiograph. Notice anything unusual?

Again, look towards the right side

You can see the circle around the numerous stones (called calculi) in the urinary bladder

Did you also notice the stones in the kidney and pelvic urethra?

Our web page on bladder stones has lots of good information

This cat is labeled for you. Anything fishy?

Look towards the left side of the radiograph this time

Did you see the pellet in the neck? Look again at the radiograph above, its plain as day.

Now that you are an expert at reading radiographs give the following one a try. It is from a cat that is straining to urinate and has blood in its urine. The answer is below, along with a picture with arrows pointing to the abnormalities.

This cat has 2 stones in its urinary bladder (click here to learn more about them and see a surgery of how they are removed). The stones are radiopaque, which means they show up easily on the radiograph. Some bladder stones are radiolucent, and can only be seen by injecting dye or air into the urinary bladder.

The arrows point to the bladder stones, along with the faint metallic sutures from a spay

Pretty easy so far, huh? Don’t get too confident just yet, our next few are a little harder. Look over the next few abnormal radiographs and send us an e-mail with your answer. If you aren’t sure and just need some clues e-mail us also and we will help you. Good Luck!

Abnormal X-Rays

Now that you are experts at reading x-rays, you can put your newfound skills to work. Email us at vet@lbah.com for the answers.

  1. What do you think about this cat radiograph?

2. This radiograph is an abdomen view from a very sick dog. It is 13 years old and losing weight

 

3. This is from an elderly dog that is losing weight

3. This dog is limping on its rear leg