X-ray (RX) is a diagnostic examination procedure based on the application of X-rays and creates images of the inside of the body.
X-rays are a type of high-energy radiation. An X-ray machine is capable of generating short pulses of X-rays.
Denser tissue structures (e.g. bones), metal and contrast agent components block the majority of X-rays and appear white.
Contrast agent is a special dye for the representation of certain areas of the body compared to other zones of the same density.
These substances are rarely used in a diagnostic examination (X-ray, magnetic resonance imaging, etc.), they are mainly used for the analysis of internal organs, for example, during an X-ray examination of the digestive system.
Air-containing structures appear black, while muscles, fat and fluids are visible through different shades of gray.
Contents
How is an X-ray examination performed?
A film, similar to a photographic film, is positioned behind the patient’s body, the X-ray machine shoots a short volley of X-rays through the body, which then hit the film.
The film is then developed, the radiology department examines it and writes a report (examination result).
During the examination you have to keep still, otherwise the image will be blurred.
What is visible in a radiography?
The study shows:
- Bones, teeth (panoramic image), fractures and other abnormalities of the bones.
- Interstitial spaces of bones in the joints and degenerative changes such as osteoarthritis.
- The size and shape of the heart, in this way some heart diseases can be detected.
- Changes in tissue density in some soft tissues. For example, a tumor in the lungs is more tissue-dense than an air-filled lung and you can see a “shadow” on a chest X-ray. A tumor on the breast is much denser than normal breast tissue and appears brighter.
- Fluid retention – for example, you can see a gray spot in the lungs compared to the normal black of the air-filled thorax.
Risks
There are few risks associated with a single radiography. However, if this examination is repeated often, there is a risk that the X-rays will damage some cells of the body, which can cause a future tumor.
The radiation dose is always set to the lowest required value to obtain a good image of the part of the body to be examined.
If possible, pregnant women should not undergo an X-ray examination, as there is a low risk of malformations for the unborn child.
Processes involving the use of X-rays
In medicine, X-rays are used for many types of examination.
Some examples are:
- radiography (to visualize orthopedic injuries, tumors, infections, foreign bodies, smoker’s lung, etc.);
- mammography to visualize the inside of the breast;
- CT (computed tomography) – used to image the body in cross-sections;
- fluoroscopy – an examination designed to visualize the body in a dynamic way, for example to see where to remove plaques in coronary arteries or where to insert a stent to keep the artery open;
- Radiotherapy in cancer treatment.
Risk/Reward Ratio
In medicine, radiography has improved the ability to quickly detect a disease or injury in order to control, treat or cure it.
If applied and carried out appropriately, this examination can improve health and even save a person’s life.
X-rays can damage living tissue.
The most significant risks are:
1) a slightly increased likelihood of developing cancer as a result; this depends on at least three factors: radiation dose, age and sex of the person being examined, women have an increased risk;
2) Cataract (clouding of the lens of the eye) and radiation burns of the skin in case of high radiation exposure and only during certain types of examinations or medical procedures.
Information for the patient
It is important to inform the radiology staff in advance if you are pregnant or think you are pregnant.
What abnormalities does a radiography show?
- Bone spurs
- Deformations of the spine (for example, scoliosis)
- Dislocations
- Fractures and callus formation on the bone (sutures)
- Bone loss (osteoporosis)
- Reduction of intervertebral spaces
- Cervical spondylosis
- Osteomyelitis
- Different leg lengths and pelvic obliquity
The examination may also be carried out in the following cases:
- Severe cough
- Inflammation of the epithelium (epiglottitis)
- Finding a foreign object
- Tumors
X-ray of the chest
A chest X-ray is a safe and painless examination that uses small rays to visibly visualize a person’s chest.
This representation includes organs and structures such as the heart, lungs, the large blood vessels, diaphragm and parts of the airways, lymph nodes, parts of the thoracic and cervical spine, ribs, collarbone and sternum.
The denser parts of the body such as the heart and bones slow down the beam path through the body and appear white on the X-ray film.
The X-rays radiate through the hollow organs like the lungs, which appear black.
Risks of chest X-ray
Usually, chest X-rays are very safe. Although any radiation exposure poses some risk to the body, the amount of radiation necessary to examine the chest cavity is small and is not considered a hazard.
Children of developing age are more sensitive to radiation and therefore have an increased risk.
A chest X-ray has a radiation dose similar to that one is exposed to daily for about 2-3 days.
An X-ray of the lumbar spine causes the absorption of an amount of radiation equivalent to 7 months of exposure to natural radiation sources.
Why is an X-ray horax scan?
First of all, the chest X-ray can be used to assess the functional tissue of the lungs (lung parenchyma), whether it contains fluids, foci of infection, nodules, etc. You can see the signs of pneumonia or tuberculosis.
There are many indications for radiography:
- Chest pain
- Trauma
- shortness of breath or constant cough
- Suspected cardiovascular problem
- Diseases in other organs, which also affect the chest cavity
- Control the position of some devices: drains, pacemakers, central venous catheter, etc.
- Preparation for surgery
- Control of critical patients
Radiography for scoliosis
Children with scoliosis have a spine that bends to one side and can have an S or C shape.
As a rule, a slight curvature does not cause any problems, but larger deviations can be visible to the naked eye and therefore cause discomfort.
A curvature of the spine can tilt the body to the right or to the left.
One shoulder blade may be elevated compared to the other and the pelvis may be irregular with a tendency to lean to one side.
If scoliosis is severe, it can affect respiratory and heart function, it can also cause damage to the vertebral joints and lead to pain in adulthood.
During the school doctor examination, the doctors regularly check the children to see if the children have such a deformity.
If scoliosis is suspected, the doctor may order an X-ray examination to measure the curvature of the spine.
The angle of inclination is measured on the X-ray in degrees, these values are used by the doctor to decide whether there is a need for treatment and how to intervene.
X-rays help determine the type of scoliosis and the maturity of the child’s skeleton, so the doctor can predict whether the scoliosis will continue to progress.
Radiography of the abdomen
An abdominal X-ray is an examination that reveals a picture of the structures and organs of the abdomen (abdomen): stomach, liver, spleen, intestines and diaphragm; this is the muscle that separates the chest and abdomen.
Often two X-rays are taken in different positions.
What is being investigated?
The abdominal X-ray is taken to determine:
- Cause of pain and swelling in the abdomen with nausea and continued vomiting.
- Cause of bilateral pain in the lumbar region (flank pain). Size, shape and position of the liver, spleen and kidneys.
- Presence of stones in the gallbladder, kidneys, ureters or bladder.
- Presence of air outside the intestine.
- Presence of objects that have been swallowed or inserted into a body orifice.
- Shape, length and any extensions or constrictions in the esophagus.
- The correct fit of tubes that the doctor has inserted during certain treatments, such as a nasal and gastric tube, a gastric tube, a urinary catheter, a catheter for dialysis, a shunt to drain fluid from the brain to the stomach, etc.
Is X-ray or magnetic resonance imaging better?
An X-ray examination is a quick, easy and relatively cheap examination.
It may be sufficient to diagnose or assess health problems.
However, a normal X-ray has limited applications.
There are other diagnostic examinations that present the body tissues in much more detail, for example, CT, magnetic resonance imaging (MRI), etc. The internal organs and soft tissues are better assessed by magnetic resonance imaging, this examination is also indicated to determine whether there is a lesion of the tendons, menisci or cruciate ligaments of the knee.
To assess the bones, the X-ray is the first choice, but to demonstrate a microfracture you need CT or an MRI.
The advantage of radiography is that it allows the assessment of the joints while they are burdened by body weight; for example, the knee is often x-rayed while standing up to evaluate gonarthrosis.
Magnetic resonance imaging and CT are performed lying down, so you can’t see the effect of gravity on the body, so the images do not exactly reflect reality.
Not all patients can undergo an MRI examination, because this creates a strong magnetic field that can react with devices and prostheses inside the body.
Cost and waiting time for an X-ray examination are much lower compared to MRI.
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