Radiography was invented over a century ago, but it has still been used in almost all medical fields. It is a non-invasive method of examination that allows timely detection of abnormal conditions in neurology, gastroenterology, gynecology, urology, traumatology, and so on. The procedure does not involve any unpleasant sensations and has minimal contraindications.
What is radiography?
Radiography is a particularly popular method of examination. It consists in passing X-ray beams through a human body and recording the resulting image on film. The result is achieved due to the fact that tissues absorb X-rays in different ways depending on their density, which gets clearly visible on the picture.
For a long time, radiography was used for suspected musculoskeletal system disorders. It is also instrumental in examining the thorax organs. At the same time, hollow organs can also be studied using X-rays. In the latter case, contrast agents are applied for better visualization. Besides, X-ray imaging formed the basis for developing such an advanced examination procedure as computed tomography is based on X-ray imaging.
The imaging technology is as follows. An X-ray tube generates radiation. It is directed at the problem area. The rays pass through the tissue, their attenuation degree varying depending on the organ or structure density. The result is registered by the X-ray sensitive film. The obtained picture shows an image with varying intensity degrees.
During the examination, X-rays pass through all layers, so the resulting image will be aggregate, i.e., featuring shadows. For this reason, X-rays are taken to examine heterogeneous masses.
Modern tools allow X-rays to be taken both on film and on cassette. Electronic matrices are also used, which allow saving the results in a digital format.
To obtain comprehensive information, X-ray is performed in two views, because only a flat image is possible. The procedure implies a certain amount of radiation exposure. However, it should be noted that the latest systems produce a minimum volume of X-rays, which makes it possible to stay within the permissible limits of background radiation.
What are the indications for radiography
There are several types of radiography, each of them indicated for particular conditions. However, there are some general reasons to perform the exam, which include the need to:
- confirm a preliminary diagnosis of internal organ and soft tissue disorders;
- detect a current condition, like a fracture or hemorrhage;
- evaluate effectiveness of the ongoing treatment;
- guide an endoscopic procedure or surgery.
On the whole, radiography is recommended to diagnose and evaluate therapy effect in disorders of the bone system, internal organs, tumors, as well as dental diseases, etc.
Contraindications to radiography
There are no absolute contraindications to X-ray examinations. Whenever possible, it should be avoided during pregnancy and under the age of 16, but if the exam is definitely indicated for a particular condition and there is no alternative, x-rays imaging is performed regardless of pregnancy. The same applies to children.
The technology allows to obtain images of any organs and tissues. Accordingly, there is a great variety of examination types. The most appropriate one is chosen by the attending physician. The procedure itself is carried out by radiologists. They also explain how one should prepare oneself for the study and what one may feel during the examination, as well as what results may be expected.
Currently, radiography is used in health care to study the following organs:
- Lungs. The result is a 2-view image of the entire chest. It makes it possible to identify abnormal foci. It is especially informative in the presence of inflammatory processes, foreign bodies, and a high risk of lung metastases.
- Heart. A 2-view X-ray is conducted. A contrast agent may be applied. Indications include heart and vessel diseases, congenital and acquired defects, as well as blood circulation disorders.
- Spine. The indications are suspected fractures, curvatures, deformities, and degenerative processes.
- Stomach and duodenum. The examination of internal organs is performed with or without contrast. The application area comprises purulent processes, perforations, foreign bodies, peristalsis disorders.
- Gallbladder. A contrast medium is always administered. The images may be taken at certain intervals to assess the function of the organ.
- Colon. The study is used to detect polyps, foreign bodies, tumors, and inflammations.
- Abdominal cavity. A common reason is to find the cause of pains. The study is conducted with or without contrast.
- Bones and joints. X-rays can diagnose fractures, injuries, acute and secondary conditions. The view mode depends on the examination purpose.
- Teeth. The aim is to identify abnormalities of the jaw, the teeth roots, teething disorders, and injuries in dentistry and maxillofacial surgery.
- Uterus and fallopian tubes. The method consists in injecting a contrasting substance into the uterine cavity and tubes. It enables to estimate their patency.
- Mammary glands. It is one of the procedures in breast screening.
Getting ready for the test
In most cases no complex preparatory procedures are needed on behalf of the patient. This is especially true for injuries, fractures, and other emergency conditions. There are a large number of specific examination types, some of them requiring certain prior actions to avoid errors.
Getting ready to a chest exam involves:
- Telling your doctor about any existing medical conditions.
- Informing about the possibility of pregnancy.
- Removing jewelry and clothing above the waist prior to examination.
For stomach and duodenum screening, you should come to your appointment with a radiologist on an empty stomach. You should take your last meal 8-10 hours before, so it is better to plan the examination in the morning. Within the previous three days you should reconsider your diet, avoiding meals that cause increased flatulence. Stick to non-fatty and boiled food. It is especially important to clean your bowel. Before the procedure, remove clothing, jewelry, and removable dentures.
Irrigoscopy is a radiological examination of the colon. It allows you to evaluate its general status, peristalsis, and detect abnormal lesions.
- Correcting your diet three days before the procedure. Please avoid fatty and fried foods, legumes, cabbage, bread, fruit and juice.
- Taking activated charcoal in a dosage based on body weight for three days.
- Use a laxative according to your doctor’s prescription to cleanse your bowel.
- Staging a purging enema. The first should be done in the evening before the procedure, and the second in the morning.
- Do not take any medications the day before the examination. Only medications to normalize blood sugar levels should be taken.
- Complete refusal of food and water 8 hours before the procedure.
You should come to the examination on an empty stomach. It is important to inform your doctor that you may be pregnant.
Urography also requires preparation. During the procedure, a contrasting substance is used, which is injected intravenously. As part of the preparation, you should refuse to eat foods that increase flatulence, take activated charcoal for 3 days, and completely avoid taking food during 8 hours before the procedure.
If necessary, the doctor may prescribe a laxative. In addition, it is important to give up taking medications if possible. The bladder should be emptied before the examination.
Examination of a particular anatomical area is performed using specific equipment. It can be both large-sized units and compact devices. It is especially important to organize the room for the examination. The examination itself is performed in one room, while the doctor and the nurse are in an adjacent office. The commands, for example, "do not move", "do not breathe" are given on a speakerphone.
The examination can be performed lying down or standing up, depending on the diagnostic area. It is important that the patient can remain motionless in the selected position.
A common examination can be performed at any time of the day, especially in an emergency situation. When contrast radiography is planned, it is important to make an appointment in the morning. The procedure is performed on an empty stomach.
The duration of the examination is a few minutes. In some cases, it is necessary to take several pictures, which increases the duration of the procedure. Additional time is needed to describe the findings.
Evaluation and interpretations of study results
Image clarity depends on the current intensity and voltage in the tube of the device, as well as on the duration of its operation. These parameters are determined individually based on the organ being examined and the goals set. To facilitate the adjustment process, each device has tables of average values, which are already adjusted based on the mass-dimensional data of the patient.
The procedure outcome is one picture or several images. In each particular case a certain description order is applied. It is important to specify the area of examination, the tissue status, size, borders, relation to adjacent organs, presence or absence of inclusions and voids, integrity, and so on. At the end, a preliminary diagnosis is made based on the results. The patient is then referred to the attending physician, who will combine all the information to make a final diagnosis.
A second opinion provides a chance to consult with a doctor at a European clinic without visiting the country. In each case, we select a specialist who has the greatest experience in diagnosing and treating the disease. To obtain a review, it is necessary to provide all available data - a file with your study, existing or presumed diagnosis, clinical data and complaints.
- Principles of conventional radiography and fluoroscopy, R L Perry, 1993.
- Conventional radiography in musculoskeletal imaging, Jordan B Renner, 2009.
- Digital radiography, J S Mattoon, 2006.