Have you ever had to take an X-ray? Let's find out!

We've all heard of X-rays. Maybe you've had to get one too. They're used to check if a child has broken an arm or leg after a fall, or when you go to the dentist, or to find the cause of some illnesses. So, what exactly is this, how does it work, and what can it treat? Let's talk about it today.

What is an X-ray?

Simply put, an X-ray is a special type of radiation used to take pictures of things inside our bodies. It's like taking a picture with a camera, but this one takes a picture of the inside of our bodies. Most of the time, when we think of an X-ray, we think of something that's done to look for broken bones or problems with our teeth. However, these X-ray images help doctors diagnose many different injuries, diseases, and other health conditions.

When we usually say 'X-ray', we mean a 'plain radiograph' that takes only one picture. However, there are many other tests that use X-ray radiation. For example, in a CT scan, these X-ray radiation is used to take many pictures, which are then combined by a computer to create a three-dimensional (3D) image. However, today we are mainly talking about those ordinary, single-picture X-rays.

What kind of X-ray is done with 'contrast material'?

Some X-rays use something called a 'contrast material'. Some people call it a 'contrast agent' or a 'dye'. This helps certain things in our bodies, such as blood vessels, to show up clearly on the X-ray image. Remember, sometimes things inside our bodies can be too delicate for an X-ray to pick up, and that's when this 'contrast material' comes in handy.

This 'contrast material' can come as a liquid, a capsule, or a tablet. Your doctor will give you this before the X-ray. Depending on the type of X-ray being done, you may be given this 'contrast material' in one of the following ways:

• Drink orally.
• By IV (an injection into a vein) or by injection into your cerebrospinal fluid.
• By inserting it into your rectum (enema).

When do we need an X-ray?

Your doctor may order an X-ray for these reasons:

• Check for a broken bone (fracture): This is the most common cause. Even a minor fall can break an arm or leg.
• Find the cause of your symptoms, such as pain and swelling: Sometimes, an X-ray can help find the root cause of pain that is not clear.
• Check for lung infection: A chest X-ray is taken for things like a persistent cough and wheezing.
• Check for foreign objects: This is useful in cases where young children may accidentally swallow small objects, such as small toys.
• Check for structural problems in the bones, joints, or soft tissues.
• Plan treatments and see how successful they are: For example, see the condition before and after surgery.

What does an X-ray show?

X-ray images can reveal things like:

• Joint inflammation such as arthritis.
• Broken bones.
• Bone changes or abnormalities.
• If you have herniated discs in your spine.
• Infections, for example pneumonia.
• Kidney stones.
• Scoliosis and other curvatures of the spine.
• Tooth cavities.
• Some types of tumors.

But it's important to remember this too. Some abnormalities can be seen on an X-ray, but not always. That is, even if there are kidney stones or tumors, they may not be visible on an X-ray. That is why doctors sometimes recommend further tests (e.g. CT scan, MRI).

Can an X-ray show cancer?

X-rays can sometimes show signs of cancer. However, they are not the primary method doctors use to detect many types of cancer or to confirm that it is cancer. This is because tumors in our organs can be very small, or they can be hidden by things like ribs on a chest X-ray, or they can be mixed with normal tissue and not be seen clearly. So if cancer is suspected, doctors usually do further tests, such as a biopsy.

What types of X-rays are there?

There are several types of X-rays used to take pictures of different parts of our bodies. Some of the most commonly used types are:

• Abdominal X-ray: This helps doctors see parts of our digestive system and detect things like kidney stones and bladder stones. Imagine if you had a stomach ache, you might be asked to take an X-ray like this.
• Bone X-ray: This may be done if your doctor suspects you have a broken bone, a dislocated joint, or a condition like arthritis. It can also check for bone cancer or infection.
• Chest X-ray: Your doctor may order this if you have symptoms like chest pain, shortness of breath, or a cough. This is important for detecting things like pneumonia and tuberculosis (TB).
• Dental X-ray: A dentist will often take these X-rays to check for problems with your teeth and gums.
• Head X-ray: This can help to check for skull fractures from a head injury, or conditions such as craniosynostosis that affect the way the bones of the skull form.
• Spine X-ray: A doctor can use this to look for spinal fractures, slipped discs, and other problems with the spine.

In addition to these regular X-rays, there are other medical imaging techniques that use a series of X-rays and are processed by a computer to create detailed images. Examples include:

• Bone density (DXA) scan.
• CT scan (CT scan - computed tomography).
• Fluoroscopy.
• Mammogram.

How does an X-ray work?

X-rays work by sending beams of radiation through our bodies and creating an image on a nearby X-ray detector. We can neither see nor feel these radiation beams.

As these beams pass through the body, bones, soft tissues, and other objects absorb radiation differently. Dense objects, such as bones, absorb radiation well, so they appear bright white on the image. On the other hand, soft tissues, such as organs and lungs, do not absorb radiation as well, so they appear in different shades of gray on the X-ray. Areas with air (such as the lungs) appear black.

A radiologist will look at this image, note if there is anything unusual or of concern, and write a report for the doctor who ordered the X-ray.

How should we prepare before an X-ray?

How you prepare will depend on the type of X-ray you are having. Your doctor may ask you to do things like:

• Avoid using lotions, creams, or perfumes. These can create shadows on the X-ray and cause inaccurate results.
• Remove metal objects such as earrings, necklaces, hairpins, and hearing aids. Metal can interfere with the X-ray, making the images unclear and giving incorrect results.
• For some X-rays, especially if contrast material is used, you may be asked to stop eating and drinking for a few hours beforehand.
• Come dressed in comfortable clothing, or wear a gown provided by the hospital before the X-ray.

The most important thing is to tell your doctor about your health history, any allergies you have, and the medications you are taking.

In particular, if you are pregnant, think you may be pregnant, or are breastfeeding, you should definitely tell your doctor before having an X-ray.

If you are having an X-ray with contrast material, tell your doctor if you have a kidney condition.

What happens when you take an X-ray?

The exact procedure will depend on the type of X-ray you have. Typically, when taking an X-ray, the technologist or doctor will do the following:

• (If necessary) A contrast medium is given by injection, enema, or oral route. Sometimes, when the dye is injected into a vein, you may feel a slight burning or stinging sensation. Some people may experience a metallic taste in their mouth. These side effects go away within a few minutes and are nothing to worry about.
• You will be asked to sit in a chair, stand, or lie down on a table.
• In the past, you would sometimes be covered with a thick lead shield/apron to protect yourself from unwanted radiation. But new research suggests that this is not necessary with the machines used today, as the radiation only reaches where it is needed.
• A part of the X-ray machine (like a camera) is placed near the part of the body that needs to be imaged.
• They will move your body or limbs into different positions and ask you to stay still. Sometimes they will ask you to hold your breath for a few seconds to prevent the images from blurring.

Sometimes young children don't stay still long enough to get a clear picture. In that case, the doctor may suggest using a special device (restraint or immobilizer) to keep the child still while the X-ray is taken. These devices don't hurt or harm the child. They just keep the child calm and reduce the number of times the pictures have to be taken.

What happens after an X-ray is taken?

In most cases, there are no restrictions on what you can do after an X-ray. You can go about your daily activities as usual. However, if you were given contrast medium, your doctor may give you some special instructions. For example, you may be told to drink plenty of water afterwards. This will help the dye to leave your body more quickly.

Are there any risks or side effects of X-rays?

X-rays are generally very safe, low-risk tests. Some people may experience side effects from the contrast dye. Some of these include:

• Nausea or vomiting.
• Stomach cramps or diarrhea.
• Headaches.

There is a very small risk of having an allergic reaction to contrast material. People with allergies or asthma are at a slightly higher risk of having an allergic reaction to contrast dye. Therefore, talk to your doctor about the risk of having this type of reaction. If you experience any unusual symptoms after having an X-ray with contrast, call your doctor right away.

Some people may be concerned because X-rays use radiation (which is said to cause cancer and other health problems in the long term). However, when you get a plain X-ray, you are only exposed to a very small amount of radiation . That is, it is not much more than the amount of radiation you are naturally exposed to in your daily life (background radiation). For example:

• A chest X-ray exposes you to about 10 days' worth of natural radiation.
• A dental X-ray exposes you to about a day's worth of natural radiation.

A doctor will only recommend an X-ray if they feel that the benefits far outweigh the very small risks.

X-rays in pregnancy

Although the amount of radiation an adult is exposed to from an X-ray is usually not harmful, it can be harmful to an unborn baby (fetus). Therefore, if you are pregnant, or if you have any suspicion that you may be pregnant, you should definitely tell your doctor or technician before having an X-ray. Your doctor may then decide to do another imaging test that does not involve radiation, such as an MRI (magnetic resonance imaging) or an ultrasound scan. Only if absolutely necessary, an X-ray can be done to minimize the risk to the baby.

What are the results of an X-ray?

A radiologist is a doctor who specializes in diagnosing diseases by looking at images such as X-rays and CT scans. He or she will look at your X-rays, record the findings, and write a report. He or she may also recommend further testing if necessary. Your doctor will receive both the images and the radiologist’s notes. He or she will review the images, read the report, and let you know if there is anything to be concerned about.

How long does it take to get X-ray results?

The results of a bone X-ray, especially in an emergency, are often ready quickly . However, the time it takes for a radiologist to review them and provide a report can vary from hospital to hospital and from time to time. The doctor may tell you the results immediately after taking the X-ray, or they may show them in your electronic health records (this system is not yet available in Sri Lanka, but it is available in some places).

Other types of X-rays (for example, a GI test with contrast) can take longer, perhaps a day or two, to get results. It's a good idea to talk to your doctor about when you can expect to get your results.

If the results are abnormal, what do you do next?

Your doctor will tell you if you need follow-up imaging or other tests. Not all abnormal findings are dangerous. In fact, many things that are found by chance are benign. That is, they may not cause any major concern. However, if you have any questions or concerns about the X-ray results, don't be afraid to talk to your doctor and clarify them.

When should I call a doctor?

If you were given contrast material before an X-ray, call your doctor immediately if you experience any of these symptoms:

• Skin rash, hives, or severe itching.
• Headaches (if more severe than usual).
• Nausea or vomiting (if it doesn't stop).
• Trouble breathing or shortness of breath, if you feel a tightness in the chest.
• If you feel like your face, lips, or throat is swelling.

These symptoms may appear up to a day or two after the X-ray. It is important to seek medical advice immediately as these may be signs of an allergic reaction.

Finally, the most important things to remember

X-rays are one of the oldest and most reliable medical techniques. Although they have been around for nearly 130 years, they are still very important because they are being used in more advanced ways thanks to new research. X-ray images are much clearer than before, and the amount of radiation used is much less. Therefore, there is no need to be unnecessarily afraid of getting an X-ray.

X-rays allow doctors to quickly see if there is anything wrong with your body. This means you can quickly find out if there is anything that needs to be treated or further tested. If you have any questions about having an X-ray or the results, don't be afraid to ask your doctor, okay?

` X-ray, X-ray, radiation, diagnosis, fracture, contrast material, medical tests