Do you also have difficulty lifting your shoulder, experience severe pain when using your arm, or have shoulder pain that keeps you awake at night? Sometimes, your shoulder can hurt while playing sports, riding a bike, or even after a slip or fall. When you go to see a doctor at a time like this, he or she may tell you to "bring me a shoulder X-ray." Some people get a little scared when they hear the word "X-ray." Many questions come to mind, such as "What will happen with this?", "Isn't radiation good for the body?", "Will this hurt?" But this is actually not as scary as you think. Today, we will talk about this Shoulder X-ray in a very simple way, in a way that you can understand.
Simply put, what is a shoulder X-ray?
A shoulder X-ray is a picture of the bones inside your shoulder. It's like taking a photo, but it allows you to see the bones inside clearly through the skin and muscles. Doctors sometimes call it a "radiograph."
Imagine that an X-ray machine is a special camera. This camera sends electromagnetic waves, or radiation, that are invisible to our eyes through the body. When these waves pass through the body and hit a special film (X-ray film) or a digital sensor on the other side, an image is formed.
Your bones are very thick, so it is difficult for these radiation waves to pass through them. That is why they appear white on the X-ray picture. But because these waves pass through soft tissues like muscles and tendons easily, they appear gray or black on the picture. This is how the doctor can clearly see the shape and position of the bones in your shoulder, and whether there are any cracks or fractures.
The doctor usually asks you to turn your shoulder from side to side and take several pictures. The reason for this is that even a subtle crack that is invisible when viewed from one side can be clearly seen when viewed from another angle.
Sometimes, if an X-ray alone cannot accurately diagnose the disease, your doctor may refer you for other tests that can take more detailed images.
- CT (Computed Tomography) scan: This can take much clearer, cross-sectional images than X-rays.
- MRI (Magnetic Resonance Imaging) scan: In addition to bones, this can provide very clear information about soft tissues such as muscles, tendons, and cartilage.
- Ultrasound scan: This can also provide a better understanding of soft tissues.
How can an X-ray show the shape of our shoulder?
The shoulder joint is the joint that allows the most movement of any joint in our body. This is because it is a ball-and-socket joint. An X-ray of a normal, healthy shoulder should clearly show the major bones that make up this joint. These are the bones that the doctor will be looking at.
| Bone Name | Simply introduced |
|---|---|
| Arm bone (Humerus) | Your upper arm, that is, the longest bone from the elbow to the shoulder. The ball-like part at the top of this makes up the shoulder joint. |
| Scapula | The triangular flat bone on the upper back. This is where the ball of the arm bone fits (socket). |
| Acromion | The bony prominence that protrudes forward from the scapula and forms the upper part of the shoulder. |
| Clavicle | This is what we call the "scapula bone" in our language. It is connected to the acromion. |
| Coracoid process | This is also a bony part shaped like a hook that protrudes forward from the shoulder blade. |
The doctor carefully examines the size, shape, and how each bone is connected to the other. Things like fractures, calcifications, or some bone tumors can be clearly seen on an X-ray.
But remember, the soft tissues that are essential to the functioning of the shoulder, such as cartilage, tendons, nerves, and muscles, cannot be seen on an X-ray. However, by looking at the arrangement and shape of the bones, the doctor can get some idea of the damage to these soft tissues. For example, if the distance between two bones has decreased, it can be assumed that the cartilage between them has worn away.
When do you need a shoulder X-ray?
If you have pain in your shoulder, or if you have difficulty lifting or rotating your arm, the first test your doctor will order is an X-ray. This is a painless, noninvasive test that can be easily performed at any hospital in Sri Lanka.
Below are some of the main reasons why your doctor may ask you to get a shoulder X-ray.
| Diagnosable condition | A simple explanation of what is seen on an X-ray |
|---|---|
| Arthritis | Symptoms include joint swelling, decreased spacing between bones, and the formation of small bone spurs on the bones. |
| Shoulder fractures | After a fall or accident, you can clearly see the marks, cracks, or complete fractures in the bones. |
| Dislocated shoulder | The ball-like part of the arm bone can be seen protruding from the socket in the shoulder bone. |
| Bursitis / Calcific tendinitis | You may sometimes see white spots caused by calcium deposits in the soft tissues around the joint. |
| Bone cancer / Benign tumors | Changes such as abnormal bone growth, changes in thickness, or bone loss can be detected. |
| Joint misalignment (alignment problems) | You can see if the bones that make up the joint are not connected to each other correctly or if there is any change in their position. |
Who takes the X-ray? Who reads the report?
A shoulder X-ray is taken by a Radiologic Technologist, who we commonly call an "X-ray tech." These people have received special training in how to operate the X-ray machine.
After your X-rays are taken, a radiologist will examine the images and prepare a report containing a diagnosis. He or she will be able to identify even the subtle changes in the images and tell you exactly what is wrong with your shoulder.
The report prepared by this specialist is usually sent to the doctor who recommended you have the X-ray. Your doctor will then review the report, explain the findings to you, and decide what further treatment you need.
Do you need to prepare before an X-ray?
No. There is nothing special you need to do before getting a shoulder X-ray. You don't need to restrict your diet or stop taking any medications. However, there are a few things you should definitely be aware of.
- Removing metal jewelry: You should remove all metal jewelry, such as your necklaces, earrings, and hairpins. Metal cannot pass through X-rays. They can show up as large white spots on the image and obscure important parts of the bone underneath.
- Clothing: You will be asked to remove your clothing from the waist up and put on a special hospital gown provided by the hospital.
- Pregnancy: This is the most important thing . If you are pregnant or have even the slightest suspicion that you are pregnant, be sure to inform the doctor and the technician taking the X-ray before having the X-ray. Pregnant women, especially in the early months, are generally not exposed to X-rays unless absolutely necessary.
What happens when you get an X-ray? Does it hurt?
Not at all. You won't feel any pain when you get an X-ray. The entire process only takes a few minutes. It usually goes something like this:
1. First, you will be asked to go to a separate room to change. There, you will need to remove your clothes from the waist down and put on a hospital gown.
2. Then you will be taken to the X-ray room.
3. The technician (X-ray tech) will ask you to stand or sit in a chair. Then, your shoulder will be positioned properly for the X-ray machine.
4. You will be instructed to remain still for a few seconds before the picture is taken. If you move, the picture may become blurry.
5. Sometimes, you may be asked to "hold your breath for a moment" to get a clear picture.
6. Turn your shoulders from side to side in this way, taking several pictures from different angles.
After taking the X-ray...
After the images are taken, the technician will check them to make sure they are clear. If any of the images are blurry, they may need to be retaken. If everything is OK, you can go back to the changing room, put on your clothes and jewelry, and go about your business as usual.
Are there any risks with X-rays? Should you be afraid of radiation?
This is a question that many people have. Yes, during an X-ray, your body is exposed to a very small amount of radiation. It is true that exposure to high levels of radiation over a long period of time can cause risks such as cancer.
However, modern X-ray machines emit a very low dose of radiation , similar to the amount of radiation your body naturally receives from the environment when you spend a few days in the sun.
Simply put, the benefits of getting an X-ray to accurately diagnose your condition far outweigh the risks of this small amount of radiation. So don't be unnecessarily afraid of this.
Young children and babies growing in the womb are more sensitive to radiation, so in such cases, doctors consider taking X-rays with the lowest possible dose or other alternative tests.
When will I receive the report?
If your X-ray was taken urgently, for example in the ETU (Emergency Treatment Unit) after an accident, you may get the results within a few minutes or an hour or two. A regular X-ray taken in an outpatient department may take a few days to get the report. The doctor who ordered the X-ray will call you when the results are available.
When do you need to talk to the doctor again?
Talk to your doctor in these situations:
- What if it's been about a week since the X-ray was taken and you haven't heard anything about the report?
- If you develop new symptoms, such as increasing pain in your shoulder.
A shoulder X-ray is a very safe and effective way to diagnose many shoulder conditions. If your doctor tells you to have this test, ask if you have any questions about why. It is a quick, painless test that can provide valuable information about your health.
Take-Home Message
- A shoulder X-ray is a painless, very simple test that takes pictures of the bones of your shoulder.
- This is very useful for diagnosing problems like fractures, dislocations, and arthritis.
- No special preparation is required before the X-ray, but don't forget to remove all metal jewelry from your body.
- If you are pregnant or suspect you are pregnant, be sure to inform the doctor and technician.
- The amount of radiation emitted by modern X-ray machines is very low , so the risk is negligible when compared to the diagnostic benefits.
- Once you receive the X-ray report, discuss it and future treatment with your doctor .
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