Overview

X-rays are a type of radiation called electromagnetic waves. X-ray imaging creates pictures of the inside of your body. The images show the parts of your body in different shades of black and white. This is because different tissues absorb different amounts of radiation. Calcium in bones absorbs x-rays the most, so bones look white. Fat and other soft tissues absorb less, and look gray. Air absorbs the least, so lungs look black.
Different types of X-rays are used for different purposes. For example, your doctor may order a mammogram to examine your breasts. Or they may order an X-ray with a barium enema to get a closer look at your gastrointestinal tract.

Uses And Types Of X-Ray

Abdomen X-Ray

Abdominal x-ray is a commonly performed diagnostic x-ray examination that produces images of the organs in the abdominal cavity including the stomach, liver, intestines and spleen and may be used to help diagnose unexplained pain, nausea or vomiting.
When an abdominal x-ray is performed to provide pictures of the kidneys, ureters and bladder, it’s called a KUB x-ray.
Abdominal x-ray is also performed to help diagnose conditions such as:

• kidney and urinary bladder stones and gallstones
• intestinal blockages
• perforation of the stomach or intestine
• ingestion of foreign objects
• abdominal aortic aneurysm

Abdominal x-ray may also be used to help properly place catheters and tubes used for feeding or to decompress organs such as the gallbladder and kidneys.

Arthrography

Arthrography is a type of medical imaging used to help evaluate and diagnose joint conditions and unexplained pain. It is very effective at detecting disease within the ligaments, tendons and cartilage. It may be indirect, where contrast material is injected into the bloodstream, or direct, where contrast material is injected into the joint.
Arthrography is used to identify abnormalities within the:

• shoulder
• elbow
• wrist
• hip
• knee
• ankle

Bone Densitometry (Bone Density Scan)

Bone densitometry, also called dual-energy x-ray absorptiometry or DEXA, uses a very small dose of ionizing radiation to produce pictures of the inside of the body (usually the lower spine and hips) to measure bone loss. It is commonly used to diagnose osteoporosis and to assess an individual’s risk for developing fractures.

Bone density testing is strongly recommended if you:

• are a post-menopausal woman and not taking estrogen.
• have a personal or maternal history of hip fracture or smoking.
• are a post-menopausal woman who is tall (over 5 feet 7 inches) or thin (less than 125 pounds).
• are a man with clinical conditions associated with bone loss.
• use medications that are known to cause bone loss, including corticosteroids such as Prednisone, various anti-seizure medications such as Dilantin and certain barbiturates, or high-dose thyroid replacement drugs.
• have type 1 (formerly called juvenile or insulin-dependent) diabetes, liver disease, kidney disease or a family history of osteoporosis.
• have high bone turnover, which shows up in the form of excessive collagen in urine samples.
• have a thyroid condition, such as hyperthyroidism.
• have a parathyroid condition, such as hyperparathyroidism.
• have experienced a fracture after only mild trauma.
• have had x-ray evidence of vertebral fracture or other signs of osteoporosis.

Bone X-Ray (Radiography)

A bone x-ray makes images of any bone in the body, including the hand, wrist, arm, elbow, shoulder, spine, pelvis, hip, thigh, knee, leg (shin), ankle or foot. A bone x-ray is used to:

• diagnose fractured bones or joint dislocation.
• demonstrate proper alignment and stabilization of bony fragments following treatment of a fracture.
• guide orthopedic surgery, such as spine repair/fusion, joint replacement and fracture reductions.
• look for injury, infection, arthritis, abnormal bone growths and bony changes seen in metabolic conditions.
• assist in the detection and diagnosis of bone cancer.
• locate foreign objects in soft tissues around or in bones.

Catheter Angiography

Catheter angiography uses a catheter, x-ray imaging guidance and an injection of contrast material to examine blood vessels in key areas of the body for abnormalities such as aneurysms and disease such as atherosclerosis (plaque). Catheter angiography is used to examine blood vessels in key areas of the body, including the:

• brain
• neck
• heart
• chest
• abdomen (such as the kidneys and liver)
• pelvis
• legs and feet
• arms and hands

Physicians use the Catheter angiography procedure to:

• identify abnormalities, such as aneurysms, in the aorta, both in the chest and abdomen, or in other arteries.
• detect atherosclerotic (plaque) disease in the carotid artery of the neck, which may limit blood flow to the brain and cause a stroke.
• identify a small aneurysm or arteriovenous malformation (abnormal communications between blood vessels) inside the brain or other parts of the body.
• detect atherosclerotic disease that has narrowed the arteries to the legs and help prepare for endovascular intervention or surgery.
• detect disease in the arteries to the kidneys or visualize blood flow to help prepare for a kidney transplant or stent placement.
• guide interventional radiologists and surgeons making repairs to diseased blood vessels, such as implanting stents or evaluating a stent after implantation.
• detect injury to one or more arteries in the neck, chest, abdomen, pelvis or extremities in patients after trauma.
• evaluate arteries feeding a tumor prior to surgery or other procedures such as chemoembolization or selective internal radiation therapy.
• identify dissection or splitting in the aorta in the chest or abdomen or its major branches.
• show the extent and severity of the effects of coronary artery disease and plan for a surgical operation, such as a coronary bypass and stenting.
• examine pulmonary arteries in the lungs to detect pulmonary embolism (blood clots, such as those traveling from leg veins) or pulmonary arteriovenous malformations.
• look at congenital abnormalities in blood vessels, especially arteries in children (e.g., malformations in the heart or other blood vessels due to congenital heart disease).
• evaluate obstructions of vessels.

Chest X Ray

It is used to evaluate the lungs, heart and chest wall and may be used to help diagnose shortness of breath, persistent cough, fever, chest pain or injury. It also may be used to help diagnose and monitor treatment for a variety of lung conditions such as pneumonia, emphysema, lung cancer, heart failure, tuberculosis, sarcoidosis, and lung tissue scarring, called fibrosis.

Coronary Angiography

Blockages prevent your heart from getting oxygen and important nutrients. This procedure is used to diagnose coronary heart disease and coronary microvascular disease after chest pain, sudden cardiac arrest, or abnormal results from tests such as an electrocardiogram (EKG) of the heart or an exercise stress test. It is important to detect blockages because over time they can cause chest pain, especially with physical activity or stress, or a heart attack.

Cystogram

A cystogram is an x-ray examination of the urinary bladder, which is located in the lower pelvic area; which can show the bladder’s position and shape, and the exam often is used to diagnose a condition called reflux, which causes repeated urinary tract infection. Cystograms also are used to detect polyps or tumors in the bladder.

Discography (Discogram)

Discography, also called discogram, uses imaging guidance to direct an injection of contrast material into the center of one or more spinal discs to help identify the source of back pain. It also is used to help guide the treatment of abnormal intervertebral discs – sponge-like cushions located between the vertebrae of the spine.

Fluoroscopy

Fluoroscopy is a study of moving body structures. It’s much like an X-ray “movie” and is often done while a contrast dye moves through the part of the body being examined. A continuous X-ray beam is passed through the body part and sent to a video monitor so that the body part and its motion can be seen in detail. Fluoroscopy, as an imaging tool, allows healthcare providers to look at many body systems, including the skeletal, digestive, urinary, cardiovascular, respiratory, and reproductive systems.
Fluoroscopy is used in many types of exams and procedures including:

• Barium X-rays. In barium X-rays, fluoroscopy used alone allows the healthcare provider to see the movement of the intestines as the barium moves through them.
• Cardiac catheterization. In cardiac catheterization, fluoroscopy is used to help the healthcare provider see the flow of blood through the coronary arteries to check for arterial blockages.
• Electrophysiologic procedures. During clinical electrophysiologic procedures, fluoroscopy is used to to treat patients with arrhythmias.
• Arthrography. X-ray to view a joint or joints.
• Placement of intravenous (IV) catheters (thin, hollow tubes put into veins or arteries). For IV catheter insertion, fluoroscopy is used to guide the catheter into a specific location inside the body.
• Hysterosalpingogram. X-ray of the uterus and fallopian tubes.
• Percutaneous vertebroplasty/kyphoplasty. A procedure used to treat compression fractures of the vertebrae (bones) of the spine.

Fluoroscopy is also used for:

• Lumbar puncture
• Biopsies
• Locating foreign bodies
• Guided injections into joints or the spine

Intravenous Pyelogram (IVP)

Intravenous pyelogram (IVP) is an x-ray exam that uses an injection of contrast material to evaluate your kidneys, ureters and bladder and help diagnose blood in the urine or pain in your side or lower back. An IVP may provide enough information to allow your doctor to treat you with medication and avoid surgery. The IVP exam can enable the radiologist to detect problems within the urinary tract resulting from:

• kidney stones
• enlarged prostate
• tumors in the kidney, ureters or urinary bladder
• scarring from urinary tract infection
• surgery on the urinary tract
• congenital anomalies of the urinary tract

Lower Extremity Radiography

Lower extremity radiography is another way of saying x-ray images of the toes, feet, ankles, lower leg, knee, upper leg or hip. These types of examinations are performed to detect conditions such as fractures, soft tissue damage and arthritis.

Lower GI Series (Barium Enema)

A lower GI series is a procedure in which a doctor uses x-rays and a chalky liquid called barium to view your large intestine. A lower GI series can help a doctor find the cause of:

• bleeding from your anus
• changes in your bowel activity
• chronic diarrhea
• pain in your abdomen
• unexplained weight loss

A lower GI series can also show:

• cancerous growths
• diverticula
• a fistula
• polyps
• ulcers

Myelography

Myelography uses a real-time form of x-ray called fluoroscopy and an injection of contrast material to evaluate the spinal cord, nerve roots and spinal lining (meninges). It is particularly useful for assessing the spine following surgery and for assessing disc abnormalities in patients who cannot undergo MRI.
Myelography is most commonly used to detect abnormalities affecting the spinal cord, the spinal canal, the spinal nerve roots and the blood vessels that supply the spinal cord, including:

• to show whether a herniation of the intervertebral disk between the successive vertebral bodies is compressing the nerve roots or the spinal cord.
• to depict a condition that often accompanies degeneration of the bones and soft tissues surrounding the spinal canal, termed spinal stenosis. In this condition, the spinal canal narrows as the surrounding tissues enlarge due to the development of bony spurs (osteophytes) and thickening of the adjacent ligaments.

Myelography can also be used to assess the following conditions when MR imaging cannot be performed, or in addition to MRI (when MR does not provide sufficient information):

• tumors involving the bony spine, meninges, nerve roots or spinal cord
• infection involving the bony spine, intervertebral discs, meninges and surrounding soft tissues
• inflammation of the arachnoid membrane that covers the spinal cord
• spinal lesions caused by disease or trauma

Panoramic Dental X-Rayy

A panoramic x-ray is a commonly performed examination by dentists and oral surgeons in everyday practice and is an important diagnostic tool. It covers a wider area than a conventional intraoral x-ray and, as a result, provides valuable information about the maxillary sinuses, tooth positioning and other bone abnormalities. This examination is also used to plan treatment for full and partial dentures, braces, extractions and implants.
A panoramic x-ray can also reveal dental and medical problems such as:

• advanced periodontal disease
• cysts in the jaw bones
• jaw tumors and oral cancer
• impacted teeth including wisdom teeth
• jaw disorders (also known as temporomandibular joint or TMJ disorders)
• sinusitis

Radiography of the Paranasal Sinuses

The paranasal sinuses are a group of air-filled cavities located in the facial area. The maxillary sinuses are located under each of the eyes, the frontal sinus is located in the area of the forehead directly above the nose, the ethmoidal sinuses are located in the area of the eyes and the upper part of the nose, and the sphenoid sinuses are located deeper within the midpoint of the head. Radiography of the paranasal sinuses is performed to detect sinusitis (inflamamation of the sinuses), as well as to detect fluid in the sinuses or polyps.

Skull Radiography

X-ray images of the skull are taken when it is necessary to see the cranium, facial bones or jaw bones. These examinations often are performed when a patient has experienced a head injury, is having head pain or is suspected of having a sinus infection. Among other things, x-ray exams of the skull can show fractures.

Upper Extremity Radiography

Upper extremity radiography is the production of x-ray images of the fingers, hand, wrist, elbow, forearm, upper arm or shoulder. These types of examinations are performed to detect conditions such as fractures, soft tissue damage and arthritis.

Upper Gastrointestinal (GI) Series

An upper GI series can help a doctor find the cause of:

• nausea and vomiting
• pain in the abdomen
• problems swallowing
• unexplained weight loss

An upper GI series can also show:

• abnormal growths such as cancer
• esophageal varices
• gastroesophageal reflux
• a hiatal hernia
• scars or strictures
• ulcers

Venography

Venography is an x-ray examination that uses an injection of contrast material to show how blood flows through your veins. Your doctor may use it to find blood clots, identify a vein for use in a bypass procedure or dialysis access, or to assess varicose veins before surgery.

Virtual Colonoscopy

Virtual colonoscopy is a procedure in which a radiologist uses x-rays and a computer to create images of your rectum and colon from outside the body. Virtual colonoscopy can show ulcers, polyps, and colorectal cancer.
Factors that make you more likely to develop colorectal cancer include:

• someone in your family has had polyps or cancer of the colon or rectum
• a personal history of inflammatory bowel disease, such as ulcerative colitis or Crohn’s disease
• other factors, such as if you weigh too much or smoke cigarettes

Preparation For X-Ray

Tell your doctor and the technologist if:

• there is a possibility you are pregnant
• you have an intrauterine device (IUD)
• you have recently had a barium sulfate contrast material x-ray
• taken medicines such as Pepto Bismol
• if you have metal implants from prior surgeries, as this can block X-rays from passing through your body and creating a clear image.

If you’re having an X-ray to examine your gastrointestinal tract, your doctor may ask you to fast for a certain amount of time beforehand. You will need to avoid eating anything while you fast. You may also need to avoid or limit drinking certain liquids. In some cases, they may also ask you to take medications to clear out your bowels.

Leave jewelry at home and wear loose, comfortable clothing. You may be asked to wear a gown.

Some drugs should be stopped one or two days before (in case of) myelography. These include certain antipsychotic medications, antidepressants, blood thinners, and some other drugs. The most important type of medication that must be stopped is blood thinners (anticoagulants). If you are taking blood thinners, you should speak with your physician about alternative methods of maintaining anticoagulation while you are undergoing a myelogram.

You should talk with your doctor about any medical conditions you have and all prescribed and over-the-counter medicines, vitamins, and supplements you take, including:

• arthritis medicines
• aspirin or medicines that contain aspirin
• blood thinners
• diabetes medicines
• nonsteroidal anti-inflammatory drugs, such as ibuprofen or naproxen
• vitamins that contain iron or iron supplements

As in colonoscopy, a health care professional will give you written bowel prep instructions to follow at home before the procedure. A health care professional orders a bowel prep so that little or no stool is present in your intestine. A complete bowel prep lets you pass stool that is clear and liquid. Stool inside your colon can prevent the x-ray machine from taking clear images of the lining of your intestine.

You may need to follow a clear liquid diet the day before the procedure. The instructions will provide specific direction about when to start and stop the clear liquid diet. In most cases, you may drink or eat the following:

• fat-free bouillon or broth
• gelatin in flavors such as lemon, lime, or orange
• plain coffee or tea, without cream or milk
• sports drinks in such flavors as lemon, lime, or orange
• strained fruit juice, such as apple or white grape—doctors recommend avoiding orange juice and red or purple beverages
• water

Procedure Of X-Ray

An X-ray technologist or radiologist can perform an X-ray in a hospital’s radiology department, a dentist’s office, or a clinic that specializes in diagnostic procedures such as Prime Med in Ozark.

Once you’re fully prepared, your X-ray technician or radiologist will tell you how to position your body to create clear images. They may ask you to lie, sit, or stand in several positions during the test. They may take images while you stand in front of a specialized plate that contains X-ray film or sensors. In some cases, they may also ask you to lie or sit on a specialized plate and move a large camera connected to a steel arm over your body to capture X-ray images.

It’s important to stay still while the images are being taken. This will provide the clearest images possible.

The test is finished as soon as your radiologist is satisfied with the images gathered.