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X-ray is a diagnostic test also known by names such as X-ray or X-ray, or X-ray for short. It is an imaging test that results in a two-dimensional image.
What is X-ray?
X-ray examination consists in irradiating a selected area of the body with a beam of X-rays. These rays are produced by a device called an X-ray tube and they pass partially through the patient’s body, and then fall on the so-called X-ray film, which is a type of photographic film that is sensitive to X-rays.
The image is formed because different tissues absorb X-rays, also called X-rays, to different degrees. This radiation is one type of electromagnetic radiation and covers the wavelength range between ultraviolet and gamma radiation.
X-ray radiation has been the subject of research by many scientists, and its name comes from the name of the German scientist Wilhelm Röntgen, who in 1895 publicly announced its existence for the first time, proposing the name X-ray. Today, both names are commonly used, and Wilhelm Röntgen received it in 1901 year for his discovery of the Nobel Prize in Physics.
X-ray examination is performed with the use of radiological equipment and accessories.
- X-ray apron – a sleeveless jacket worn over the torso to protect the thyroid and genitals. It is made of rubber and composite materials containing lead. The apron absorbs radiation that should not pass through the tissue that is not tested.
- X-ray film – a type of photographic film sensitive to X rays. It is composed of a flexible polyester film, a photographic emulsion layer covered with gelatin, polymer and matting agent, as well as silver halide microcrystals – photosensitive elements.
- X-ray machine – a device that, thanks to an X-ray tube, produces X-rays.
Also read: “Effects of ionizing radiation”
X-ray – diagnostics
Virtually any part of the body can be x-rayed using X-rays. Nowadays, X-ray examination is one of the basic diagnostic techniques in medicine. In some cases, an x-ray is performed as a routine and screening test. This applies, for example, to a lung examination.
The standard examination is a chest X-ray, which is the basic tool for the detection of diseases such as pneumonia, tuberculosis and lung cancer, thanks to the possibility of visualizing changes within them. The chest X-ray also allows you to assess the size and position of the heart.
X-ray is also the first examination I will conduct for any problems with the locomotor system, both after injuries and rheumatoid arthritis. A special feature of X-rays is the very clear visualization of the skeletal system. Therefore, they allow to visualize or exclude all kinds of fractures or bone dislocations, as well as degenerative changes.
An abdominal X-ray is also a frequently used examination – a pictorial photo allows you to visualize pathological changes and suggest the direction in which to conduct further diagnostics in the case of abdominal pain of unknown origin. X-rays are also essential in dental and orthodontic diagnostics, they are the basic tool of maxillofacial surgery.
LS X-ray is an abbreviated name for X-ray examination of the sacro-lumbar spine. It is the same as a chest X-ray and also requires preparation: a diet that excludes raw vegetables, fruit and dark bread on the day before the test, bowel movements before the test, fasting, and the use of a drug to reduce gas production in the intestines.
Another use of X-rays
In addition to the X-ray examination, there are a number of other imaging tests that use X-rays. Its use is distinguished, among others, in:
- computed tomography – the principle of imaging is the same as in the X-ray examination, but unlike it, it allows obtaining an image of soft tissues,
- mammography, i.e. breast examination, which uses special equipment with X-ray tubes; much lower doses of X-rays are used,
- pantomogram – an X-ray image taken in the jaw area, used in the diagnosis of maxillary surgery and laryngology,
- angiography – X-ray examination of the arteries using contrast agents injected into the veins,
- densitometry – an X-ray examination of the bone, measuring its density in order to visualize injuries and diseases.
X-ray – course and preparation
You do not need to prepare for an X-ray examination, unless it concerns the abdominal cavity or a part of the body in its area – then the doctor will recommend taking a drug that dissolves gas bubbles in the intestines a few days before the examination. The idea is that the excess gases in the intestines do not disturb the image of the abdominal cavity. The day before the X-ray examination, you should eat an easily digestible diet and your doctor will advise you to take an appropriate laxative to get rid of the intestinal contents, which will improve the image quality.
The patient must be fasting on the day of the abdominal X-ray. In the case of x-rays of other parts of the body, there is no need to prepare for the examination. The X-ray examination itself is based on the correct positioning of the x-rayed part of the body, it may be necessary to inhale and hold your breath for a while, such as for an x-ray of the lungs. The examination is painless and takes a very short time.
Also read: “Lungs – what do they give us and what do they get sick with?”
Arrangements for X-ray photos
The X-ray examination is performed in various positions, depending on the target area of the body to be imaged – the chest or spine X-ray will be performed standing, or even a sitting skull X-ray. In the case of a patient in a very poor health condition, the examination is performed lying down.
The following markings help in the proper interpretation of X-ray images:
- PA, or posterior-anterior – a posterior-anterior arrangement, i.e. one in which X-rays penetrate the patient’s body through the back,
- AP, or anterior-posterior – anterior-posterior position, i.e. similarly penetrating from the thoracic side.
X-ray – harmfulness
X-rays are not indifferent to our health, so we shouldn’t make x-rays too often. The measure of the irradiation of our tissues is a unit called sievert (Sv). Typically, the dose taken after a single x-ray is a thousandths of a sievert, which is a very small amount. High doses increase the risk of DNA damage and cancer formation.
Siwert (Sv) is a derived unit of the SI system that relates to the amount of radiation energy absorbed by the body in relation to the biological effects of that radiation. Sievert is a large entity. One Sv when exposed to X-rays is the value at which an acute radiation syndrome can occur. It differs from grays (Gy) in that it does not determine the amount of radiation applied to the body. The unit is named after the Swedish physicist Rolf Maximilian Sievert.
Opinions on the dose limits are divided and the norms are very different according to the different organizations around the world. The rule is not to expose yourself without the necessary necessity. When taking an X-ray, the person performing the examination gives a protective apron, which should cover the pelvis in order to protect the reproductive organs. However, it is absolutely contraindicated to perform x-rays in pregnant women due to the risk of harmful effects of X-rays on the fetus.
Also read: “Tests that every pregnant woman should do”
X-ray in pregnancy – effects
Until recently, X-rays in pregnant women were considered absolutely harmful. However, X-ray imaging technology has developed to such an extent that, in justified cases and with special precautions, X-rays can be performed in pregnant women. Over the years, X-ray devices have been modernized to give a precise image while emitting the lowest possible dose of X-rays.
For a long time, there was no definition of a dose that was safe for the mother and the fetus, and if it was established, it oscillated at a very low level. Only many years of research have shown that the X-ray safety thresholds are much higher than it was claimed even 40 years ago – not 0,15 cGY (centigrade), but as much as 10-15 cGY, i.e. about 100 times more.
However, X-ray should be preceded by examinations and a thorough assessment of whether the X-ray is necessary during pregnancy. It is also necessary to use an X-ray apron in the pelvic area to protect the fetus from radiation. X-ray examinations in pregnant women that have the least impact on the fetus include those performed farthest from the pelvis, i.e. head or jaw examination, and the risky X-rays of the spine or pelvic X-ray.
What if an X-ray is done in the 2nd week of pregnancy or at any other stage of pregnancy and she is not yet aware of her condition? There are special procedures that are handled by the National Center for Radiological Protection. The potential dose of X-ray radiation received by the body and the risk of fetal malformations are assessed. The largest one exists in the phase of organogenesis (the formation and initial development of organs in the fetus), i.e. in the 3rd to 9th week of pregnancy.
The dangers of performing an X-ray during pregnancy without special precautions are:
- high risk of miscarriage or fetal death inside the uterus due to significant malformations of individual organs,
- the occurrence of severe mental underdevelopment of a child (the nervous system is most sensitive to X-ray radiation),
- risk of initiating neoplastic changes that will develop in the first 20 years of a child’s life.
How to avoid the risks of a possible pregnancy during X-ray examination in sexually active women of reproductive age?
- Perform the test in the 1st phase of the menstrual cycle (after menstruation and before ovulation) to make sure that you have not fertilized.
- Be careful with performing X-ray examinations when planning offspring.
- Choose, if possible, medical facilities with the most modern equipment that uses the lowest possible dose of X-rays during the examination.
- Consult a gynecologist.
When it comes to pregnancy planning and X-ray, the studies show no correlation. The radiation does not survive in the body, so it is not necessary to wait any period from the examination to start trying for a descendant.
X-ray in children
X-ray examinations are associated with the diagnosis of adults. However, it is often advisable to carry out an X-ray examination in an infant, and even in a newborn child. The most common indications for its implementation are:
- diagnosis of birth defects,
- perinatal injuries, such as fractures of the skull or limbs (mainly the humerus and the femur),
- respiratory system abnormalities, incl. a syndrome of breathing disorders resulting from insufficient maturity of the child’s lungs, meconium aspiration syndrome, which occurs when meconium accumulates in the vocal cords of the child, bronchopulmonary dysplasia,
- congenital defects of the heart and other organs, dysraphic defects such as meningeal hernia.
In larger children, X-ray will be needed for fractures or even swallowing small objects. In general, however, in children, regardless of age, the test may be recommended for infections, including pneumonia and sepsis.
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