X-ray • Risks, benefits & procedure of the examination

In medicine, the term X-ray refers to the examination of a specific region of the body using X-rays. This means, for example, that organs or bones can be examined if an illness is suspected or following treatment.

What is X-ray?

X-rays use X-rays to examine specific areas of the body. This takes advantage of the fact that different tissues absorb the X-rays to different extents.

The method is now a standard examination in diagnostics. It is quick and easy to carry out, inexpensive and versatile. Radiation exposure, which increases the risk of cancer and can damage germ cells (egg cells and sperm cells), should not be ignored.

The doctor should therefore consider whether the indication justifies an X-ray examination. It is recommended to keep an X-ray passport. This document is similar to a vaccination card – it records the X-ray examinations that have been carried out, including the date. Such an overview protects against too frequent X-rays.

The most important examinations at the doctor

When is an X-ray examination necessary?

In principle, any region of the body can be X-rayed, whereby the quality and significance of the respective image depends heavily on the density of the tissue examined. The correct alignment of the organ to be examined and the X-ray machine also plays an important role.

An examination using X-rays is mainly carried out in the context of medical diagnostics. If bone fractures, cancer, foreign bodies or inflammation are suspected, an X-ray examination can provide an initial indication or already enable a clear diagnosis.

Special X-ray procedures at a glance

Exemplary applications of X-ray diagnostics are:

  • X-ray of the bone system for the diagnosis of broken bones, wear and tear, inflammation and injury to joints, tendons or ligaments

  • X-ray examinations of the head to determine skull fractures and inflammation of the paranasal sinuses. In dentistry, the tooth status of the entire dentition is determined with X-rays, malpositions, inflammation of tooth roots as well as caries (also under fillings) and periodontitis can be diagnosed.

  • At the Thorax-Röntgen the organs of the chest cavity are x-rayed. In this way, for example, congenital heart defects, heart muscle inflammation, lung cancer or tuberculosis can be diagnosed. Pathological changes in the large blood vessels in the chest and vascular occlusions can also be detected. This special X-ray procedure is also called angiography.

  • One X-ray examination of the abdomen is ordered in the case of suspected chronic intestinal inflammation, tumors in the stomach and intestines as well as in the diagnosis of kidney and urinary tract diseases and the localization of large kidney stones.

  • X-ray of the female breast: Mammography is primarily used for the early detection of malignant breast cancer. Galactography examines the milk ducts in the breast.

  • Also the Computed Tomography is a special form of X-ray. Here, many individual sectional images are made.

  • Phlebography is an X-ray procedure that can be used to visualize deep veins. It is used, among other things, in the event of suspected thrombosis.

  • Bone density measurement is also based on X-rays.

This is how X-rays work

X-rays belong to the group of electromagnetic waves and are generated using an X-ray tube (high-vacuum electron tube). The radiation penetrates the tissue and is absorbed to varying degrees depending on the density of the tissue to be examined. The residual radiation that hits the X-ray film creates the greyscale image.

Digital X-ray

Today, however, classic X-ray films or plates are hardly ever used; instead, the images are often generated digitally. Advantages compared to conventional X-ray technology are lower X-ray radiation and the possibility of subsequent processing of the images obtained.

The radiation dose in an X-ray examination depends on the density of the region concerned and is achieved by adjusting the voltage in the X-ray tube. For example, a higher dose is required for mammography than for an X-ray examination of the ankle.

Preparation and procedure of the X-ray examination

Clothing, watches, jewelery and other metal objects must be removed before the X-ray. The X-ray system consists of an X-ray machine and a couch on which the patient lies or sits while the image is taken. Images of the jaw, spine or chest are often taken while standing.

To do this, the body part in question is placed on a plate, the X-ray film, and precisely aligned. The medical staff then leaves the room and triggers the recording from the adjoining room. Instructions can be given over loudspeakers. During the recording, which only lasts a fraction of a second, you should stand as still as possible and hold your breath so that the picture is not blurred.

X-ray of teeth

Recordings are often made in different planes, for example in the case of broken bones and joint injuries. The patient lies on their side to allow a picture of the inside or outside of the joint and on their back so that the X-ray can be taken from above.

In the event of an acute injury, care is taken to ensure that no further pain is caused to the person concerned. To protect against radiation, a lead apron is placed over the abdomen of the person concerned before admission, since X-rays cannot penetrate lead.

Use of contrast media in X-rays

An X-ray contrast examination enables regions to be clearly visualized that cannot be made sufficiently visible with a simple X-ray image because they are difficult to access.

For this purpose, the contrast medium is administered via a tablet or an injection and the X-ray examination is carried out after a certain period of time. The contrast agent changes the properties of the desired tissue and enables a high-contrast X-ray image. In this way, organs or blood vessels can be made clearly visible on the X-ray film.

X-ray risk radiation exposure

With each fluoroscopy, the patient is exposed to a certain amount of radiation. Depending on the part of the body, this radiation has different levels. As a rule, however, this value is below the radiation exposure to which humans are naturally exposed within a year. The amount of radiation in a fluoroscopy of the lungs is roughly that of a transatlantic flight.

X-rays should only be used sparingly in women of childbearing age and children, and should be avoided if possible during pregnancy. Because depending on the time and strength of the radiation, malformations of organs and growth disorders of the unborn child can occur.

Allergic reactions can occur when using contrast media. If an allergy to contrast media is known, the doctor treating you should be informed of this before the examination.

Alternative examination methods to X-ray

In some cases, an ultrasound (sonography), computed tomography (CT) or MRT (magnetic resonance imaging) can be performed as an alternative to the X-ray examination. However, these methods differ greatly in quality and possible applications. The alternative depends on the body region to be examined.

Ultrasound, for example, is primarily suitable for examinations of internal organs such as the kidneys and uterus. MRI is often used to examine joints. In any case, the doctor treating you must decide which method makes the most sense.

Source: Lifeline | Das Gesundheitsportal by www.lifeline.de.

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