Abdominal X-ray Projections and Interpretations

What structures can be identified as landmarks for invisible soft tissue structures in an abdominal X-ray?

Which of the following structures is immediately superior to the left kidney as seen on an abdominal X-ray?

What is the variable appearance of the urinary bladder on an abdominal X-ray dependent on?

Which bones are highlighted as clearly visible on an abdominal X-ray?

What is meant by the 'vesico-ureteric junctions' and where are they located in relation to the anatomy?

What is the most commonly used projection for abdominal X-ray?

Which feature of the bowel is difficult to differentiate in an abdominal X-ray?

What is the upper limit of normal diameter for the small bowel in an abdominal X-ray?

In which quadrant is the liver located as seen in an abdominal X-ray?

Which of the following organs is typically NOT visible on an abdominal X-ray?

What anatomical feature shields the liver from being fully visible on an abdominal X-ray?

Which muscles are usually visible on an abdominal X-ray as a near straight line?

What visible structure may be seen at the costophrenic angle on an abdominal X-ray?

Abdominal X-ray Projections

Different projections can be used for abdominal X-rays
The most common is the supine or erect anterior-posterior projection
X-rays pass through the patient from front to back
Diagram shows supine A-P position

Normal Abdominal X-ray (AP view)

Diagram shows anatomical structures
Includes organs like liver, spleen, kidneys, stomach, intestines, colon, and bladder
Important anatomical structures are labelled in the illustration showing supine A-P position

Interpretation: Normal Gas Pattern

Gas or air in the bowel creates contrast against surrounding tissues
Difficult to differentiate between normal small and large bowel, especially when not distended
Normal bowel diameter:
- Small bowel: ~3 cm
- Colon: ~6 cm
- Cecum: ~9 cm

Interpretation: Soft Tissues

Organs visible include: liver, spleen, kidneys, psoas muscles, and bladder (pelvis)

Interpretation: Liver

Located in the right upper quadrant (RUQ)
Appears as a grey/bland area on X-ray
Superior edge forms the right hemi-diaphragm contour
Breast shadow (red line) may overlay liver, and markings from the right lung are sometimes visible

Interpretation: Lung Bases

Lung bases can be seen behind liver and diaphragm
Some abdominal X-rays may show costophrenic angles (asterisks)

Interpretation: Psoas Muscles

Arise from transverse processes of lumbar vertebrae
Combine with iliacus muscles to form the iliopsoas tendon
Appear as a near straight line on X-rays,
Iliacus muscles are not visible due to their position over the iliac bones

Interpretation: Kidneys

Natural contrast with low-density retroperitoneal fat allows X-ray visibility

Interpretation: Spleen

Located in the left upper quadrant (LUQ), superior to the left kidney

Interpretation: Urinary Bladder

Variable appearance depending on fullness

Interpretation: Bones

Visible structures include ribs, lumbar spine, sacrum, coccyx, pelvis, and proximal femurs
Bones can function as landmarks for hidden soft-tissue structures (e.g., ureters)
Vesico-ureteric junctions are located at level of ischial spine
Sacroiliac joint formed by overlapping of sacrum and iliac bones
Labelled diagram shows locations of significant bones and joints.

This quiz explores different projections used in abdominal X-rays, with a focus on the common supine anterior-posterior view. You will learn about the normal gas patterns, organ identifications, and their anatomical significance within an X-ray. Test your knowledge on the interpretations of various soft tissue visibility in abdominal imaging.