In 1895 W.C. Roentgen invented roentgenograms, which today are simply referred to as x-rays or radiographs. Although x-rays have evolved over the years, the principle remains the same - except - today's techniques utilize only a fraction of the x-ray dose required in the early days of radiology.
Truly, x-ray technology is the 'workhorse' of fundamental diagnostic imaging. Testing is fast, easy, and painless. Radiographs are produced by means of a source that radiates x-rays through a particular body part (e.g. spine). As the x-rays pass through the body they are weakened by the many types and levels of tissue encountered. That is why bony structures appear more prominently (e.g. whiter) than soft tissue - bone is denser and absorbs a greater amount of radiation. The energy is directed into a film cassette that has been placed into a receptacle under/behind the targeted body part. The film is exposed and developed in much the same manner as a photograph.
AP (Anterior/Posterior) X-Ray of
Lumbar (L1) Burst Fracture
Lateral X-Ray of L1 Burst Fracture
X-rays are performed in many types of medical facilities such as a hospital, imaging center, or physician's office. If previous imaging studies (x-rays, CT scans, MRIs) pertinent to the diagnosis are available, those should be presented to the radiologist the day of the study.
There are certain questions the x-ray technician will ask the patient - some of these questions are listed below and should be discussed with the referring physician prior to the day of the test:
- Are you pregnant?
- Are you allergic to contrast agents (e.g. iodine, IVP)?
- Do you wear permanent eyeliner?
- Do you have a pacemaker, artificial hip/knee, or other metal implants?
Patient preparation depends on the type of x-ray the referring physician has ordered. Some x-rays require an injection of a contrast medium to enhance the images. The patient will be made aware of the type of test and whether any form of preparation is required.
The patient will be instructed to remove any metal objects (e.g. jewelry, hearing aids, hairpins) and change into a gown. Next, the radiology technician positions the patient properly on the table. In some cases, the technician will drape or have the patient wear a lead apron. The apron shields and protects other body parts from radiation.
It is important the patient remain still. The technician leaves the room to enter the adjacent control room. During the imaging process, the patient will be asked to hold their breath for several seconds. When the test is done, the patient is instructed to dress and wait while the images are reviewed. In some cases, additional x-rays are required.
A radiologist, a doctor whose specialty is diagnostic imaging, carefully examines the x-rays and prepares a report for the referring physician documenting the findings.
Figure 3: X-Ray of 13 Year Old Female with Scoliosis
Figure 4: X-Ray of Thoracic (T11-T12) Fracture