X-rays

A radiograph, commonly known as an X-ray is a quick and painless test. It uses radiation to take pictures of the inside of your body. X-rays can be used to help diagnose and treat medical conditions. It’s often the first test to be used if you have symptoms that need urgent investigation.

About X-rays

In an X-ray, a machine sends beams of radiation (called X-rays) through the part of your body being tested. The beams are picked up by a detector, which converts them into a black and white image.

X-rays are absorbed differently by different parts of your body. Dense (very solid) structures, such as your bones and teeth, absorb X-rays and appear white or light grey on the image. Less dense structures such as your air-filled lungs absorb fewer X-rays so show up dark grey or black.

Uses of X-rays

X-rays can be used to take images of almost any part of your body. Doctors will use the images to help diagnose a condition.

X-rays are very common and widely available. This means an X-ray is often one of the first tests you’ll have to investigate problems. You often need other tests afterwards to confirm a diagnosis.

X-rays can help in the investigation and diagnosis of the following problems and conditions.

• Chest X-rays can help find heart problems, including heart failure.
• Chest X-rays can also help identify lung conditions, such as pneumonia, fluid on your lungs, and lung cancer.
• Problems affecting your bones and joints. These can include broken bones (fractures), joint dislocation, infection, and arthritis.
• Teeth decay and infections. Dentists use X-ray images to help them to find and treat dental problems.
• An X-ray can show up any blockage in your intestines (bowel obstruction).

Doctors can also use X-rays to locate objects that you may have swallowed, such as fishbones. They can also use them to check the position of medical devices, such as a catheter or needle. X-rays can also provide ‘real-time’ images to help guide medical procedures.

Special X-ray techniques

There are other, more specialised tests that use X-ray. These include the following.

• Fluoroscopy. This is when X-rays are used to look at moving structures in real time. It’s often used in combination with a contrast agent. Examples include barium test to look at your food pipe, an angiogram, which can show up your blood vessels, and a urogram, to show your urinary tract.
• DEXA (dual-energy X-ray absorptiometry) scans. These use a low dose of X-ray to look at the strength of your bones. They can check for a condition called osteoporosis, which is when your bones start to become weaker.
• Mammogram. This is a special type of X-ray to examine your breasts, and check for signs of breast cancer.
• CT (computed tomography) scans. This is an advance technique where the X-ray machine and detector rotate rapidly around you while you lie down. The scan is more detailed and can help diagnose complex problems such as cancers. It uses a higher radiation dose than an X-ray.
Contrast studies. These use a contrast (dye) to show up certain structures in your body, and create more detailed images.

Your doctor will explain why you need an X-ray and the benefits and any risks involved. If you have any questions, ask your doctor.

Preparation for X-ray

You usually have an X-ray as an outpatient procedure in the radiology or imaging department of a hospital or health clinic. A health professional called a radiographer will usually carry out the X-ray.

Sometimes it may be a practitioner or operator who is trained to perform X-rays. A dentist can carry out a dental X-ray at a dental practice.

You don’t usually need any special preparation before an X-ray. You can eat and drink normally beforehand, and continue taking your usual medications.

If you are pregnant or might be pregnant, you should tell the doctor or hospital staff before your X-ray. They can then consider whether to cancel the test or go ahead. There are times where the benefit of having the X-ray can outweigh the risk of radiation. The hospital will take measures to keep radiation risk to the baby as low as possible, for example by placing a lead apron over your tummy, or by changing the angle in which the X-ray is taken.

Depending on which part of your body is being tested, you may need to change into a hospital gown before your X-ray. You may be asked to remove any jewellery too. You may want to consider wearing clothes that will be easy to remove and leaving jewellery at home.

Having an X-ray

X-rays can be carried out in different ways, depending on the part of your body being X-rayed. If you’re having a chest X-ray, you may need to stand up, against an X-ray machine. For other types of X-ray, you may need to lie or sit down on an X-ray table or couch. The operator will help you to get into the right position.

When they are ready to take the X-ray, the operator will stand behind a screen, cover, or in a different room. They’ll still be able to see and hear you at all times. They may need to take more than one X-ray, or X-rays at different angles or in different positions. During the X-ray itself, you’ll need to keep still. Sometimes you’ll be asked to take a deep breath and hold it for a few seconds. You won’t feel anything while you’re having the X-ray.

Aftercare following X-ray

You’ll usually be able to go home or back to work straight after your X-ray.

Your X-ray images will usually be sent off to be examined by a radiologist. This is a doctor who specialises in examining medical images and producing reports. Sometimes another health professional, like a radiographer, might examine your X-ray images. A report will be sent to your GP, or the doctor who requested your X-ray. They will let you know when they have your results.

The time it takes to get your results can vary. Before you go home, you can ask the X-ray operator or reception staff how long it’s likely to take to get your results.

If you want a copy of your report, contact the radiology department to see if they can provide it to you.

Risks of X-rays

There is always some level of risk with any medical test or procedure. But X-rays are generally considered to be very safe and the potential risks are very low.

Having an X-ray involves being exposed to radiation. Any exposure to radiation carries a risk of developing cancer. Simple X-rays use a very low dose. It’s about the same as you’d receive from natural radiation in the atmosphere over a few days. Your doctor will only recommend an X-ray when it’s really necessary. This means the benefits of having it should outweigh any potential risks. Ask your doctor if you have any questions or concerns about this.

Children and X-rays

Children, especially younger children, are at greater risk from radiation. Your doctor will only recommend a child has an X-ray if it’s really necessary.

If your child has an X-ray, you can usually stay with them to help look after them and keep them calm. You might be asked to wear protective clothing, such as an apron, to protect your body from unnecessary radiation. You may not be able to do this if you’re pregnant, as you will also be exposed to X-ray radiation.

Pregnancy and X-rays

Unborn babies are at greater risk from the effects of X-rays than adults. So if you’re pregnant, your doctor will usually only recommend an X-ray if there’s an urgent medical reason and there’s no safe alternative. If you think you could be pregnant, tell your doctor or the X-ray operator before your appointment. They will consider if the benefits outweigh the risks and advise you whether or not you should go ahead with the test.