Radiographs have been used in diagnosis for over 100 years. Despite the many technical advances in imaging, they retain an important role in the diagnostic workup of many ailments particularly in bone and joint pathology. They are often used in imaging follow-up of disease states to evaluate progression, monitor treatment or assess metalwork or implants following surgery. It is possible from the radiographs to make measurements which aid in diagnosis or subsequent management of a condition. Sometimes, these measurements are crude representing an observation such as the presence of prevertebral soft tissue swelling in a patient with a history of cervical spine injury where that observation signals a very high probability of either bone or soft tissue injury. On other occasions, precise measurements may be required such as in leg length evaluation which may determine the degree and extent of surgical intervention if indeed any. They also are often used for measuring distances and angles in musculoskeletal work to assist in the planning of management including surgery. There are inherent advantages in using radiographs for such measurements, but there are also certain limitations often related to technical factors of which clinicians and radiologists need to be aware. This chapter addresses the general role of radiography in measurements undertaken in musculoskeletal work. The specific role of radiography in measurements of different anatomical and pathological states is made in the relevant chapters.
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