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X-ray
What are X-rays?
How do x-rays work?
What do we use them for?
What happens when we go digital?
Who must wear individual monitoring devices such as film/personal dosimetry badges?


What are X-rays?

X-rays are a very energetic form of electromagnetic radiation that can be used to take images of the human body.

X-rays are a form of electromagnetic radiation, just like visible light, infrared radiation, microwaves and radio waves. But compared to these other types of radiation, X-rays are more energetic.

An X-ray photon can be hundreds or thousands of times more energetic than a photon of visible light.

How do x-rays work?
An X-ray is a quick, painless test that produces images of the structures inside your body — particularly your bones. X-ray beams can pass through your body, but they are absorbed in different amounts depending on the density of the material they pass through. Dense materials, such as bone and metal, show up as white on X-rays. The air in your lungs shows up as black. Fat and muscle appear as varying shades of gray. For some types of X-ray tests, a contrast medium — such as iodine or barium — is introduced into your body to provide greater detail on the X-ray images.

X-ray technology is used to examine many parts of the body.

Bones and teeth

Fractures and infections. In most cases, fractures and infections in bones and teeth show up clearly on X-rays.Arthritis. X-rays of your joints can reveal evidence of arthritis. X-rays taken over the years can help your doctor determine if your arthritis is worsening.Dental decay. Dentists use X-rays to check for cavities in your teeth.Osteoporosis. Special types of X-ray tests can measure the density of your bones.Bone cancer. X-rays can also reveal tumors in your bones.Chest Lung infections or conditions. Evidence of problems such as pneumonia, tuberculosis or lung cancer can show up on chest X-rays.Breast cancer. Mammography is a special type of X-ray test used to examine breast tissue.Enlarged heart. One of the signs of congestive heart failure is an enlarged heart, which shows up clearly on X-rays. Blocked blood vessels. Injecting a contrast material that contains iodine can help highlight sections of your circulatory system so that they can be seen on X-rays. Abdomen Digestive tract problems. Barium, a contrast medium delivered in a drink or in an enema, can help reveal problems anywhere in your digestive system.Swallowed items. If your child has swallowed something like a key or a coin, an X-ray can show the location of that object.

Risks

Radiation exposure

Some people worry that X-rays aren't safe because radiation exposure can cause cell mutations that may lead to cancer. But the amount of radiation you're exposed to during an X-ray is so small that the risk of any damage to cells in your body is extremely low. However, if you're pregnant or suspect that you may be pregnant, tell your doctor before having an X-ray. Though the risk of most diagnostic X-rays to an unborn baby is small, your doctor may consider another imaging test, such as ultrasound.

Contrast medium

In some people, the injection of a contrast medium can cause side effects such as:

A feeling of warmth or flushing
A metallic taste in the mouth
Lightheadedness
Nausea
Itching
Hives
Rarely, severe reactions to a contrast medium occur, including:
Severe low blood pressure
Anaphylactic shock
Cardiac arrest

How you prepare

Different types of X-rays require different preparations. Ask your doctor or nurse to provide you with specific instructions.

What to wear

In general, you undress whatever part of your body needs examination. You may wear a gown to cover yourself during the exam, depending on which area is being X-rayed. You may also be asked to remove jewelry, eyeglasses and any metal objects that may obscure the X-ray image, because these objects can show up on an X-ray.

Contrast material

Before some types of X-rays you're given a liquid called contrast medium. Contrast mediums, such as barium and iodine, help outline a specific area of your body on the X-ray image. You may swallow the contrast medium, or receive it as an injection or an enema.

What you can expect

During the X-ray

X-rays may be performed at doctors' offices, dentists' offices, emergency rooms and hospitals — wherever an X-ray machine is available. The machine produces a tiny burst of radiation, at a safe level, that passes through your body and records an image on a specialized plate. You can't feel the X-ray passing through you. A technologist positions your body to obtain the necessary views. He or she may use pillows or sandbags to help you hold the proper position. During the X-ray exposure, you remain still and hold your breath to avoid moving, which can cause the image to blur.

An X-ray procedure may take only a few minutes for a bone X-ray, or more than an hour for more-involved procedures, such as those using a contrast medium.

Your child's X-ray

If a young child is having an X-ray, restraints or other immobilization techniques may be used to help keep him or her still. These will not harm your child and will prevent the need for a repeat procedure, which may be necessary if the child moves during the X-ray exposure. You may be allowed to remain with your child during the test. If you remain in the room during the X-ray exposure, you're typically asked to wear a lead apron to shield you from unnecessary exposure.

After the X-ray

After an X-ray, you generally can resume normal activities. Routine X-rays usually have no side effects. However, if you receive an injection of contrast medium before your X-rays, call your doctor if you experience pain, swelling or redness at the injection site. Ask your doctor about other signs and symptoms to watch for pertaining to your specific X-ray procedure

Results

X-rays are saved digitally on computers. Digital images can be viewed on-screen within minutes. A radiologist typically views and interprets the results and sends a report to your doctor, who then explains the results to you. In an emergency, your X-ray results can be made available to your doctor in minutes.

X-ray during pregnancy: Is it safe?

Is it safe to have an X-ray during pregnancy?

Yes — having an X-ray during pregnancy is generally considered safe. It's highly unlikely that a diagnostic X-ray during pregnancy will harm a developing baby.

Most X-ray exams — including those of the arms, legs, head, teeth or chest — won't expose your reproductive organs to radiation, and a leaded apron and collar can be worn to block any scattered radiation. The exception is abdominal X-rays, which expose your abdomen — and your baby — to radiation. High doses of radiation can cause changes in a baby's rapidly growing cells. In turn, it's possible that these changes could slightly increase a baby's risk of birth defects or certain cancers, such as leukemia, later in life. Remember, however, that the typical dose of radiation associated with a diagnostic X-ray — even one of the abdomen or pelvis — doesn't pose this risk.

Before having an X-ray, tell your health care provider if you are or might be pregnant. Depending on the circumstances, it might be possible to do an imaging study that doesn't involve radiation — such as ultrasound or magnetic resonance imaging. In addition, if you have a child who needs an X-ray, don't hold your child during the exam if you are or might be pregnant. Instead, ask another person to take your place. If you had a diagnostic X-ray before you knew you were pregnant, remember that any potential risk is exceedingly remote. If you had radiation treatment for a medical condition, the risks might be more significant. Share any concerns about radiation exposure with your health care provider. He or she might consult a medical radiation physicist to calculate your baby's radiation exposure.

What happens when we go digital?
When your facility goes digital, you will need to do the following:
Make sure all of your staff who are performing x-rays are trained and the training is documented. If you do a train-the-trainer type set-up, make sure this training is documented as well. Technique charts will need to be corrected to ensure they indicate you are using digital. Update your radiation manual. Ensure there is a copy of your digital software and digital sensor (or CR system) manual available for inspection. Resources need to be available on-site that allow for operator troubleshooting and outline QC requirements. Review the set-up, maintenance, and troubleshooting areas of these manuals in detail. If there is any routine maintenance of the digital system that may affect dose, you will need to perform these items and document them appropriately. Consider writing new procedures that outline what steps staff should take if they have a problem with the digital system (i.e. do not x-ray the patient further, contact you, contact doctor, call the x-ray service provider, etc).

Who must wear individual monitoring devices such as film/personal dosimetry badges?
If you are likely to receive 10% of 5 rem in one year or a facility doing fluoroscopy, you will need to wear them. Generally, most offices will not need to provide monitoring devices.