A Primer on X-Rays
You hear the expression "you need an X-ray" at the Doctor's office and although the concept is easy to understand, this primer -- in the form of frequently asked questions -- is focused on providing a better understanding of what that expression means.
What is an X-ray?
An x-ray or radiograph is similar to having a photograph taken in a portrait studio. A licensed radiologic technologist (RT) uses x-rays to create an image similar to a photographer using visible light. X-rays (ionizing radiation) demonstrate body structures proportionally with their density. The denser the tissue (bone versus fat), less radiation passes through the tissues. This difference in body tissue density is why bone (high body tissue density) appears white on a radiograph, as compared to fat (low body tissue density), which appears gray or air (no density), which appears black.
Why did my doctor order an X-ray?
Radiographs are a reliable and accurate means of obtaining information to help your physician diagnosis the source of a condition or complaint. An x-ray examination is commonly used to determine or confirm the presence or absence of disease, e.g. a bony fracture, joint arthritis, or some other cause of a painful condition.
Who performs and interprets my radiograph?
Your examination should be performed by a qualified radiologic technologist (RT) licensed by the state where you live, and then interpreted by a radiologist.
How is an X-ray performed?
The radiologic technologist (RT) will escort you to a dressing room where you will be given an examination gown (if necessary) and instructed to remove specific articles of your clothing that may interfere with the radiograph. If is important that the radiograph is free of artifacts (e.g. material from your clothing, snaps, buttons, clips, etc...). You will lie, sit or be positioned on an x-ray table. The radiologic technologist (RT) may use special positioning blocks and sponges to achieve optimal positioning.
What should I do to prepare for the examination?
No preparation is required for a routine x-ray examination. If you are pregnant or think you may be pregnant, be sure to inform your physician, and the technologist prior to the start of the x-ray examination. Most examinations using x-ray will not be performed on pregnant women unless the benefits of the examination outweigh the risks of radiation exposure to the fetus. Extremity examinations can safely be performed with appropriate lead shielding.
What are the risks?
An X-ray is ionizing radiation. Lead aprons and shields are used to protect the rest of the body from radiation exposure other than the area being examined. The equipment should be routinely inspected by both the city and state where you live for safety and adequate shielding to prevent unnecessary radiation scatter. The technologists are trained to use the minimal dose to achieve optimal results. Alternate diagnostic tests such as MRI or ultrasound, may be performed without utilizing ionizing radiation, however, their use is dependent on your suspected condition and the information your doctor requires.
What happens with the results?
The radiologist generates a written report, which is sent to the physician who referred you for the examination. The radiograph and the report become part of your medical record. Depending on the findings on the x-ray, additional tests may be ordered including other x-ray exams utilizing different views/positions, a CT examination, bone scan, MR, ultrasound, or special interventional procedures that utilize imaging guidance. It should be recognized that radiologist do not self refer. Radiologists collaborate with your physician to determine what imaging tests are truly required to help diagnosis your condition; your physician actually orders the required imaging study.