by Olivia Miller | Apr 14, 2024 | Emergency Clinic

How Do I Know If I Need an X-Ray?

While playing at a favorite local park with your child, you decided to relive your youth. As the swing hung in midair for just a split second, you decided to dismount by jumping off. As soon as you landed, the excruciating pain in your foot made it clear that you had made a serious mistake. You knew immediately that your next stop was the emergency room for an examination and an x-ray.

In 1895, German physicist Wilhelm Conrad Röntgen sent radioactive rays which he did not yet fully understand through his wife’s hand revealing shadows of the bones beneath the skin. He called those unknown rays emitted by the machine “X-rays” and the name stuck. Within just five years his machine had become widely used and considered essential for clinical care, particularly for locating foreign objects in the body and identifying fractures.

Do I Need an X-ray?

As a diagnostic tool, x-rays provide invaluable insight to healthcare professionals because they can help identify issues that are not obvious, especially in the case of acute injury or illness. Being able to see beneath the skin provides invaluable insight leading to faster and more accurate care.

Symptoms for which your doctor might order an x-ray:

• Difficulty walking: A sprain will not show up on an X-ray, but an X-ray can tell your provider whether you have a fractured bone.
• Digestive issues: An x-ray done with a barium contrast can help your doctor identify what’s going on or help locate any swallowed, non-edible items, such as marbles, dice, and keys.
• Constant swelling: An X-ray can reveal if something is going on, like a bone fracture or fluid around a joint. It can also reveal changes to the soft tissue inside your body that might contribute to internal inflammation.
• Joint pain or stiffness: Arthritis shows up in x-rays and they allow your doctor to monitor the condition of your joints. The images can also reveal fluid buildup due to a joint injury.
• Lung issues: X-rays help diagnose chronic lung issues such as lung cancer or more acute conditions such as pneumonia. Changes to the heart affecting your respiration are also visible in an X-ray.

How do X-rays Work?

We now know that the rays Röntgen sent through his wife’s hand were high-energy electromagnetic waves. These invisible beams travel through the body and can be taken while you stand, sit, or lie down.

For the procedure, the X-ray tube points toward your body, sending the rays through it and to the film on the other side. Soft tissue like skin, fat and muscle allows the rays to pass through producing a dark gray area of the image. Denser tissue such as tumors or bones allows fewer rays to pass through creating a lighter gray or white area on the film. Identifying broken bones is easy because a dark line shows the break in the white of the bone. X-rays can help detect organ and skeletal injuries and abnormalities and some types of X-rays use iodine or barium to provide higher contrast and greater image detail.

There are three basic categories of x-ray:

1. Radiography: produces a still image x-ray and is the most used
2. Computed Tomography (CT) Scan: A person slides into a donut-shaped machine where a series of X-rays are taken from different angles and assembled by a computer producing a detailed 3D image. This type of x-ray produces 100 to 1,000 times more radiation than a chest x-ray.
3. Fluoroscopy: A continuous X-ray shows images of your organs and soft tissues producing an X-ray movie allowing doctors to see how your body moves. Usually done to examine the heart, intestines, kidneys, lungs, joints, muscles, and bones.

The most taken X-rays are of the chest, abdomen, bones, and mammograms of the breast tissue. Regular dental X-rays allow your dentist to evaluate the health of your teeth and gums and identify infections and cavities.

Are X-Ray’s Safe?

Although X-rays are standard and deemed safe for necessary use, it is wise to limit your exposure, when possible, by providing your doctor with previous x-ray images and letting them know when they were taken.

The average X-ray uses safe amounts of radiation for the average person, child, or baby. However, if there is a chance that you might be pregnant, tell your provider so they can prevent harm to the reproduction process of the fetal cells. Your provider may delay the procedure, act to shield the fetus from direct beam exposure or choose a different imaging option.

No amount of radiation is too much for a patient when an x-ray is considered necessary by their doctor. Likewise, having an x-ray taken without sound medical reasoning is inappropriate. Extremely low amounts of radiation absorbed during imaging produce no adverse effects, but it is recommended to reduce the doses as much as possible. The medical community follows a principle known as ALARA – As Low as Reasonably Achievable – to inform X-ray practices to reduce a person’s overall exposure to radiation. Several international organizations have established guidelines and recommendations based on scientific data and other organizations work to accredit X-ray facilities according to safety-related criteria. Reducing radiation exposure is important, but large radiation doses are useful in radiation oncology where they precisely target cancer cells stopping their growth and reproduction.

If your doctor needs assistance with or confirmation of a diagnosis because something in your body is hurting a great deal or is not functioning as it should, the odds are good that they will order an x-ray. Remember to follow the radiologists’ instructions carefully and remain as still as possible during the procedure to avoid a blurry image meaning that your x-ray will have to be redone meaning increased radiation exposure.