Abdominal x-ray densities

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.

Reference article

This is a summary article; we do not have a more in-depth reference article.

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
• 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