Paranasal Sinuses Case Study

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X-Ray Joints
As we already know that knowledge of normal bone, joint and soft tissue appearances enables accurate description of abnormalities seen on X-ray.
Systematically check the alignment of bone structures, joint spacing, integrity of bone cortex, medullary bone texture, and for abnormalities of any visible surrounding soft tissue structures.
In Osteoarthritis look for LOSS:
L-Loss of joint space
S-Subcondral sclerosis
S-Subchondral cysts
Paranasal sinuses are air containing chambers surrounding the nasal cavity. Different Pathological conditions involving the sinuses, may present as alterations in the translucency of the sinuses on the radiograph. Some pathological conditions affecting the para nasal sinuses may produce fluid hence effort should be made to demonstrate this fluid level.
The radiographic positions used to study paranasal sinuses are:
1. Water's view (Occipito-mental view)
2. Caldwel view (Occipital-frontal
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The patient is made to sit facing the radiographic base line tilted to an angle of 45 degrees to the horizontal making the sagittal plane vertical. The radiological beam is horizontal and is centered over a point 1 inch above the external occipital protruberance. In obese patients with a short neck it is virtually impossible to obtain an angulation of 45 degrees. These patients must be made to extend the neck as much as possible and the xray tube is tilted to compensate for the difference in angulation. The mouth is kept open and the sphenoid sinus will be visible through the open mouth. If the radiograph is obtained in a correct position the skull shows a foreshortened view of the maxillary sinuses, with the petrous apex bone lying just beneath the floor of the maxillary antrum. In this view the maxillary sinuses, frontal sinuses and anterior ethmoidal sinuses are seen. The sphenoid sinus can be seen through the open

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