X-ray of the Skull

X-ray of the Skull

Radiographic Evaluation of the Cranium

Understanding the essentials of cranial X-ray interpretation is crucial for medical students. Here’s a concise guide:


  • Head Trauma: Assess for fractures, skull base injuries, or foreign bodies.
  • Suspected Intracranial Pathology (when advanced imaging is not available): Evaluate for tumors, hydrocephalus, abscesses, or vascular abnormalities.
  • Chronic Conditions: Monitor conditions like hydrocephalus or skull abnormalities.
  • Follow-Up: Track progress post-surgery or intervention.


  • Pregnancy: Minimize exposure, especially during the first trimester.
  • Unnecessary Exposure: Avoid when clinical history and physical examination provide sufficient information.
  • Advanced Imaging Needed: If CT or MRI is indicated for detailed assessment.


  • Fractures: Look for linear fractures, depressions, or signs of healing.
  • Soft Tissue: Assess for swelling, foreign bodies, or gas in the scalp.
  • Skull Abnormalities: Identify congenital anomalies or bony growths.
  • Sutures and Fontanelles: Evaluate the closure status in infants.
  • Foreign Bodies: Check for presence and location.

Potential Findings:

  • Fractures: Linear, depressed, or basilar fractures.
  • Skull Abnormalities: Enlarged sella turcica, thinning of bone.
  • Tumors: Presence of abnormal masses or calcifications.
  • Hydrocephalus: Enlarged ventricles.
  • Foreign Bodies: Presence of metallic objects or projectiles.

Actions to Be Taken:

  • Consult with Radiologist: Seek expert opinion for complex cases.
  • Clinical Correlation: Correlate findings with clinical history and physical examination.
  • Further Imaging: If X-ray is inconclusive, consider CT or MRI for detailed assessment.
  • Timely Reporting: Communicate findings promptly for appropriate patient management.
  • Consider Patient Factors: Age, comorbidities, and clinical presentation influence the approach.




Verified by Dr. Petya Stefanova