Keeping fit is part of Everyday life modern man. Running or Pilates, Karate or power training– everyone chooses the type of activity that suits them. Unfortunately, sports are sometimes unsafe and injuries occur, but any coach can confirm that you should not be afraid of them. Thanks to modern diagnostic methods, it is possible to detect almost any “problem” in the human body and begin timely treatment. One of the most effective ways diagnostics is radiology. Based on the analysis of the X-ray image, the doctor will quickly and with a high degree of accuracy detect the problem.
X-ray: what does it show and what does it look like?
More than a hundred years have passed since the discovery of X-rays, but X-ray diagnostics still remains not only convenient and relevant, but sometimes the only possible method of diagnosis. Thanks to this study, it is possible to diagnose bone fractures (X-rays for fractures are taken in frontal and lateral projections). The x-ray also clearly shows the pathology of the joints: arthritis, arthrosis, dislocations. In order to diagnose tuberculosis, fluorography is sometimes sufficient, but if the doctor has doubts when reading the image, he may prescribe an additional x-ray examination. X-rays are also used to diagnose diseases such as pneumonia, intestinal obstruction (the intestines are examined with contrast, the patient has to drink a barium sulfate suspension), neoplasms (both malignant and benign), aneurysms, spinal pathologies and some heart diseases. Also, thanks to this study, it is possible to determine the presence of a foreign body in the respiratory tract or stomach.
What is an x-ray? Probably each of us has seen it at least once in our lives - it is a black and white image of the internal structures of the body, reminiscent of an ordinary negative. The light areas of the image are characteristic of the denser parts of our body, and the dark areas are characteristic of soft organs and hollow structures, such as the lungs. Based on the nature of the brightening and darkening, the doctor makes a diagnosis.
Previously, images were projected only onto a special light-sensitive film, but with the development of digital radiography, it became possible to obtain images in digital format. That is why in Lately, this primarily concerns private clinics; the patient increasingly receives not a film image, but a disk or flash card with the results of the study.
How is the fluoroscopy procedure performed?
X-rays are not only painless, but also, contrary to popular belief, a safe procedure. The dose of radiation that a person receives during fluoroscopy is very small and completely harmless.
As a rule, preparation for x-rays is not required - you just need to follow the doctor’s instructions: wear a protective apron that covers reproductive organs, and do not move while the X-ray machine is taking a picture. However, in some cases, preparation is still needed: for example, when the patient needs to have an x-ray of the chest, spine or gastrointestinal tract. In order for the images to be as clear as possible, three days before the examination date the person will be asked to follow a special diet: exclude from the diet foods such as milk, brown bread, fresh cabbage, potatoes, beans and other foods that can cause flatulence. X-rays of the spine are performed only on an empty stomach, and the last meal can be no later than seven o'clock in the evening the day before the procedure.
How is an x-ray taken?
During the study, a person passes through the body ionizing radiation. Soft tissues transmit rays, while dense tissues block them. The rays passing through the patient's body are recorded by a detector. When using analog devices, the detector is a fluorescent screen or film onto which the image is directly projected. The screen can also play the role of a kind of amplifier of received signals. After converting the radiation into an image using a special optical system, the latter can be recorded by a television camera and shown on a monitor (indirect analogue method). In the case of digital equipment, the data is recorded by the receiver and immediately converted into binary code, displayed on the computer screen. A digital photograph can be recorded on magnetic media, disk, or the image can be displayed on film.
As a result of all these manipulations, a flat black and white image is obtained. anatomical structures. Based on the shadows and light areas in the image, the doctor “reads” it and then draws a conclusion about the condition of certain internal organs.
The most modern and safest method today is digital fluorography - during its implementation the patient receives a radiation dose one hundred times less than during radiography. The radiation dose will be only 0.015 mSv, at normal prophylactic dose in 1 mSv. However, the resolution of such a fluorograph is still inferior to digital radiography: on an X-ray of the lungs, the doctor will be able to see shadows measuring 2 mm, while a fluorographic study will show only shadows of at least 5 mm.
How to take an x-ray correctly and what determines the clarity of the image?
The clarity of an x-ray depends on several factors. These include the equipment on which the procedure is carried out and the correctness of the examination itself. So, for example, if the patient does not move while the image is being taken, the contours of the internal organs will be blurred and the doctor will not be able to clearly read the image.
If the doctor considers that one image is not enough to make an accurate diagnosis, he can prescribe additional x-ray examinations to the patient: take a photo of the desired organ in several projections: postero-anterior, anteroposterior, lateral or targeted.
For example, during a posteroanterior projection of the thoracic region or spine, the patient stands, his chin is fixed, and his breathing is held during the image. The anterior-posterior projection is done in the supine position and with a deep breath.
Lateral projection is often prescribed by a doctor if there is a suspicion of lung diseases. It is done as follows: the patient is asked to lie down with his hands behind his head. His left or right side is fixed, breathing is held, and then a deep breath is taken. Also, the lateral projection is often used in determining sports injuries: for example, sprains, joint damage. During the procedure, the person will need to bear weight on the affected leg.
This is interesting
At the beginning of the 20th century, a new trend arose: the fashion for x-rays. Every self-respecting fashionista simply had to have a photo of his own bones at home - arms, legs, skull. In large cities, so-called studios were opened en masse, where everyone could take a photo of any part of their body. Since the dangers of X-rays were unknown at that time, even pregnant women came to the studio to “photograph” their unborn child. The pictures were expensive, and those who did not have enough money were given the opportunity to simply “shine” in front of the screen - by the way, this is how the world learned about the deformations of the ribs caused by wearing a corset.
X-ray image evaluation
When interpreting an X-ray image, the doctor takes into account the fact that it is formed by a diverging beam of X-rays, so the dimensions of the structures in the image may not correspond to the actual ones. The diagnostician analyzes the entire spectrum of darkening, clearing and other radiological symptoms before giving the patient a conclusion.
At the first stage of decoding the image, its quality is assessed: focus, contrast and image clarity. The doctor then analyzes the shadow picture of the patient's organs. The doctor who referred the patient for an x-ray examination is responsible for deciphering the image.
As an example of deciphering an x-ray, we will give an example of assessing an image of a person’s lungs. The following criteria are analyzed:
- Asymmetrical body position, which is assessed by the location of the sternoclavicular joints.
- Additional shadows in the photo.
- The hardness or softness of the image.
- Accompanying illnesses, which may affect the photo.
- Complete coverage of the lungs in the image.
- The correct position of the shoulder blades in the image is outward, otherwise the image may be read incorrectly.
- Clarity of images of the anterior segments of the ribs. If the images are unclear, the patient was breathing or moving during the x-ray and the x-ray will have to be repeated.
- Contrast level. It is defined by the presence of shades of black and white. The doctor compares the areas of darkening and clearing - the light areas give the lung fields, the dark areas the anatomical structures.
The quality of the image assessment depends primarily on the professionalism of the doctor who takes it. An important factor in the analysis and subsequent conclusion is the illumination in which the image is read: insufficient lighting or too bright light prevents the doctor from giving a correct assessment of the image.
Distribution of study results to the patient
The timing for issuing X-ray images is not regulated. Each clinic, public or private, sets them individually. But, as a rule, they are ready on the same day. The patient receives images and an X-ray examination report - a conclusion made by the doctor. In the protocol, doctors try not to use highly specialized terms such as “clearance”, “darkening”, “superposition of structures” and others. The protocol is certified by a personal signature, and in some clinics – by the doctor’s seal, and is a legal document.
Despite the fact that only a doctor can read an X-ray, many patients try to do it themselves, based on descriptions of X-rays they see on the Internet. This is wrong, since each image is individual, and, in addition, making an independent diagnosis turns out to be incorrect in almost one hundred percent of cases. Trust your doctor on this matter!
Where can I take an x-ray?
A high-quality x-ray or fluorography can be done in almost any modern clinic– both public and private. Before visiting a medical facility, pay attention to the level and novelty of the equipment - not only the result of the X-ray examination, but also the dose of radiation exposure that you will receive during the X-ray depends on them.
We recommend that you pay attention to an independent laboratory operating in Russia since 1995. Branches of the laboratory are represented in many large Russian cities, as well as in Ukraine, Belarus and Kazakhstan. All departments are equipped with the latest technology. Thanks to the latest equipment and highly qualified doctors, X-ray examinations of all organs are carried out in INVITRO clinics quickly and efficiently.
Tuesday, 04/10/2018
Editorial opinion
The radiation exposure that a patient receives during an X-ray examination directly depends on the quality of the equipment in the clinic. For example, in Europe, the radiation dose for one person during a lung examination over the course of a year does not exceed 0.6 mSv. In Russia this figure is higher – 1.5 mSv. To protect yourself, doctors recommend conducting examinations in clinics with modern equipment.
Review
Of all the radiation diagnostic methods, only three: x-rays (including fluorography), scintigraphy and computed tomography, are potentially associated with dangerous radiation - ionizing radiation. X-rays are capable of splitting molecules into their component parts, so their action can destroy the membranes of living cells, as well as damage the nucleic acids DNA and RNA. Thus, the harmful effects of hard X-ray radiation are associated with cell destruction and death, as well as damage to the genetic code and mutations. In ordinary cells, mutations over time can cause cancerous degeneration, and in germ cells they increase the likelihood of deformities in the future generation.
The harmful effects of such types of diagnostics as MRI and ultrasound have not been proven. Magnetic resonance imaging is based on the emission of electromagnetic waves, and ultrasound studies are based on the emission of mechanical vibrations. Neither is associated with ionizing radiation.
Ionizing radiation is especially dangerous for body tissues that are intensively renewed or growing. Therefore, the first people to suffer from radiation are:
- bone marrow, where the formation of immune cells and blood occurs,
- skin and mucous membranes, including the gastrointestinal tract,
- fetal tissue in a pregnant woman.
Children of all ages are especially sensitive to radiation, since their metabolic rate and cell division rate are much higher than those of adults. Children are constantly growing, which makes them vulnerable to radiation.
At the same time, X-ray diagnostic methods: fluorography, radiography, fluoroscopy, scintigraphy and computed tomography are widely used in medicine. Some of us expose ourselves to the rays of an X-ray machine on our own initiative: so as not to miss something important and to detect an invisible disease at a very early stage. But most often the doctor sends you for radiation diagnostics. For example, you come to the clinic to get a referral for a wellness massage or a certificate for the pool, and the therapist sends you for fluorography. The question is, why this risk? Is it possible to somehow measure the “harmfulness” of X-rays and compare it with the need for such research?
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Accounting for radiation doses
By law, every diagnostic test related to X-ray irradiation, must be recorded in the dose load recording sheet, which is filled out by the radiologist and pasted into your outpatient card. If you are examined in a hospital, then the doctor should transfer these figures to the extract.
In practice, few people comply with this law. At best, you will be able to find the dose you were exposed to in the study report. At worst, you will never know how much energy you received with invisible rays. However, you have every right to demand from the radiologist information about how much the “effective dose of radiation” was - this is the name of the indicator by which harm from x-rays is assessed. The effective radiation dose is measured in milli- or microsieverts - abbreviated as mSv or µSv.
Previously, radiation doses were estimated using special tables that contained average figures. Now every modern X-ray machine or computed tomograph has a built-in dosimeter, which immediately after the examination shows the number of sieverts you received.
The radiation dose depends on many factors: the area of the body that was irradiated, the hardness of the X-rays, the distance to the beam tube and, finally, technical characteristics the device itself on which the study was carried out. The effective dose received when examining the same area of the body, e.g. chest, can change two or more times, so after the fact it will be possible to calculate how much radiation you received only approximately. It’s better to find out right away without leaving your office.
Which examination is the most dangerous?
To compare the “harmfulness” of different types of x-ray diagnostics, you can use average indicators effective doses given in the table. This is data from methodological recommendations No. 0100/1659-07-26, approved by Rospotrebnadzor in 2007. Every year the technology is improved and the dose load during research can be gradually reduced. Perhaps in clinics equipped with the latest devices, you will receive a lower dose of radiation.
| Part of the body,
organ | Dose mSv/procedure | |
|---|---|---|
| film | digital | |
| Fluorograms | ||
| Rib cage | 0,5 | 0,05 |
| Limbs | 0,01 | 0,01 |
| Cervical spine | 0,3 | 0,03 |
| Thoracic region spine | 0,4 | 0,04 |
| 1,0 | 0,1 | |
| Pelvic organs, hip | 2,5 | 0,3 |
| Ribs and sternum | 1,3 | 0,1 |
| Radiographs | ||
| Rib cage | 0,3 | 0,03 |
| Limbs | 0,01 | 0,01 |
| Cervical spine | 0,2 | 0,03 |
| Thoracic spine | 0,5 | 0,06 |
| Lumbar spine | 0,7 | 0,08 |
| Pelvic organs, hip | 0,9 | 0,1 |
| Ribs and sternum | 0,8 | 0,1 |
| Esophagus, stomach | 0,8 | 0,1 |
| Intestines | 1,6 | 0,2 |
| Head | 0,1 | 0,04 |
| Teeth, jaw | 0,04 | 0,02 |
| Kidneys | 0,6 | 0,1 |
| Breast | 0,1 | 0,05 |
| X-ray | ||
| Rib cage | 3,3 | |
| Gastrointestinal tract | 20 | |
| Esophagus, stomach | 3,5 | |
| Intestines | 12 | |
| Computed tomography (CT) | ||
| Rib cage | 11 | |
| Limbs | 0,1 | |
| Cervical spine | 5,0 | |
| Thoracic spine | 5,0 | |
| Lumbar spine | 5,4 | |
| Pelvic organs, hip | 9,5 | |
| Gastrointestinal tract | 14 | |
| Head | 2,0 | |
| Teeth, jaw | 0,05 | |
Obviously, the highest radiation dose can be obtained during fluoroscopy and computed tomography. In the first case, this is due to the duration of the study. Fluoroscopy usually takes a few minutes, and an x-ray is taken in a fraction of a second. Therefore, during dynamic research you are exposed to more radiation. Computed tomography involves a series of images: the more slices, the higher the load, this is the price to pay for the high quality of the resulting image. The radiation dose during scintigraphy is even higher, since radioactive elements are introduced into the body. You can read more about the differences between fluorography, radiography and other radiation research methods.
To reduce potential harm from radiology studies, there are remedies. These are heavy lead aprons, collars and plates that a doctor or laboratory assistant must provide you with before making a diagnosis. You can also reduce the risk of an X-ray or CT scan by spacing the studies as far apart as possible. The effects of radiation can accumulate and the body needs to be given time to recover. Trying to get a whole body scan done in one day is unwise.
How to remove radiation after an x-ray?
Ordinary X-rays are the effect on the body of gamma radiation, that is, high-energy electromagnetic oscillations. As soon as the device is turned off, the exposure stops; the radiation itself does not accumulate or collect in the body, so there is no need to remove anything. But during scintigraphy, radioactive elements are introduced into the body, which are the emitters of waves. After the procedure, it is usually recommended to drink more fluids to help get rid of the radiation faster.
What is the acceptable radiation dose for medical research?
How many times can you do fluorography, x-rays or CT scans without causing harm to your health? It is believed that all these studies are safe. On the other hand, they are not performed on pregnant women and children. How to figure out what is truth and what is a myth?
It turns out that the permissible dose of radiation for humans during medical diagnostics does not exist even in official documents of the Ministry of Health. The number of sieverts is subject to strict recording only for X-ray room workers, who are exposed to radiation day after day in company with patients, despite all protective measures. For them, the average annual load should not exceed 20 mSv; in some years, the radiation dose may be 50 mSv, as an exception. But even exceeding this threshold does not mean that the doctor will begin to glow in the dark or will grow horns due to mutations. No, 20–50 mSv is only the limit beyond which the risk of harmful effects of radiation on humans increases. The dangers of average annual doses less than this value could not be confirmed over many years of observations and research. At the same time, it is purely theoretically known that children and pregnant women are more vulnerable to x-rays. Therefore, they are advised to avoid radiation just in case; all studies related to X-ray radiation are carried out only for health reasons.
Dangerous dose of radiation
The dose beyond which radiation sickness begins - damage to the body under the influence of radiation - ranges from 3 Sv for humans. It is more than 100 times higher than the permissible annual average for radiologists, and it is simply impossible for an ordinary person to obtain it during medical diagnostics.
There is an order from the Ministry of Health that introduces restrictions on the radiation dose for healthy people during medical examinations - this is 1 mSv per year. This usually includes such types of diagnostics as fluorography and mammography. In addition, it is said that it is prohibited to resort to x-ray diagnostics for prevention in pregnant women and children, and fluoroscopy and scintigraphy cannot be used as a preventive study, as they are the most “heavy” in terms of radiation exposure.
Quantity x-rays and tomograms must be limited by the principle of strict reasonableness. That is, research is necessary only in cases where refusing it would cause more harm than the procedure itself. For example, if you have pneumonia, you may need to take a chest x-ray every 7-10 days until complete recovery to monitor the effect of antibiotics. If we are talking about a complex fracture, then the study can be repeated even more often to ensure the correct comparison of bone fragments and the formation of callus, etc.
Are there any benefits from radiation?
It is known that in the room a person is exposed to natural background radiation. This is, first of all, the energy of the sun, as well as radiation from the bowels of the earth, architectural buildings and other objects. Complete exclusion of the effect of ionizing radiation on living organisms leads to a slowdown in cell division and early aging. Conversely, small doses of radiation have a restorative and healing effect. This is the basis for the effect of the famous spa procedure - radon baths.
On average, a person receives about 2–3 mSv of natural radiation per year. For comparison, with digital fluorography you will receive a dose equivalent to natural radiation for 7-8 days a year. And, for example, flying on an airplane gives an average of 0.002 mSv per hour, and even the work of a scanner in the control zone is 0.001 mSv in one pass, which is equivalent to the dose for 2 days of normal life under the sun.
All site materials have been checked by doctors. However, even the most reliable article does not allow us to take into account all the features of the disease in a particular person. Therefore, the information posted on our website cannot replace a visit to the doctor, but only complements it. The articles have been prepared for informational purposes and are advisory in nature. If symptoms appear, please consult a doctor.
Radiography is a common diagnostic procedure that is used as a screening for certain diseases, and is also indispensable for confirming and clarifying the diagnosis. The fact that x-rays do not have the best effect on the body became known several years after its introduction into medical practice. Since then, radiation machines have undergone significant changes, making X-rays less dangerous. Nevertheless, there are still risks of negative consequences.
This material will discuss the main questions regarding whether x-rays are harmful and what dangers are hidden behind them. Readers will learn how often X-rays can be taken without harm to health, and what can be done to reduce the likelihood of consequences.
To understand why x-rays are dangerous, it is important to know the essence and nature of this type of radiation. This type of ray belongs to the category of X-ray radiation, and the wavelength of such radiation is in the range between gamma and ultraviolet rays. Like other types of waves, x-rays have a certain energy potential - ionizing properties. When passing through tissue, an X-ray leaves a kind of trace: the structure of atoms and molecules changes due to a change in their “charge”.
Important! Even in small concentrations, X-rays always affect the body, and its effects have a cumulative effect - the longer contact with ionizing radiation continues, the greater the harm of X-rays.
When one-time exposure to large doses of this type of rays occurs, a person develops acute symptoms of X-ray exposure - radiation sickness. Internal organs are damaged (primarily the central nervous system and the hematopoietic system), a semblance of burns appears on the body, and multiple organ internal bleeding begins. Death can occur within the first hours after receiving a lethal dose. Regularly receiving non-life-threatening doses leads to chronic diseases.
The negative effects of X-rays are not limited to the body of the person exposed to the rays. Most dangerous consequences For an organism, genetic changes are considered that can be inherited. This is due to the fact that the gonads and reproductive cells - sperm and eggs - are most exposed to harmful effects. The damage to their DNA structure fully demonstrates how harmful X-rays are for humanity as a whole.
How much radiation does a person receive during research?
Having realized how harmful x-rays are to humans, doctors had the opportunity to calculate what a safe dose of radiation should be. In medical practice, this concept is known as recommended radiation exposure.
In modern devices, the radiation dose from X-rays does not harm health, since its indicators are hundreds of times lower than the lethal dose, which is 1 Sv. It is this dose of radiation for a person that is fraught with the development of radiation sickness. It poses a danger in terms of long-term consequences and leads to various diseases of internal organs and systems. As for the concept of a lethal dose of radiation for humans, it implies a higher dose load:
- over 4 Sv - leads to death 1-2 months after exposure due to damage bone marrow and dysfunction of the hematopoietic system;
- over 10 Sv - leads to death 1-2 weeks after irradiation due to large-scale hemorrhages in the internal organs;
- over 100 Sv - causes enormous harm, causing death several hours (maximum 48 hours) after irradiation due to cessation of the functioning of the central nervous system.
Experts note that even modern x-rays are harmful if x-rays are taken too often. In this case, the ability of radiation to accumulate after the next procedure is affected.
Calculation of permissible radiation dose
According to WHO recommendations, the average annual X-ray dose for an adult should not exceed 0.5 Sv or 500 mSv per year. This level of radiation exposure is two times lower than that which provokes radiation sickness. However, in most cases, doctors ensure that the permissible dose received through X-rays per year is 10 times lower, that is, 50 mSv per year. This is due to the fact that per person and without medical procedures background radiation influences daily: solar, emanating from devices, etc. It does not cause direct harm to health, but also tends to accumulate.
Important! The permissible dose for children is 2-3 times lower than for adults, since it causes more harm to the growing body.
In order to correctly calculate the permissible number of rays for an individual patient, the background in the place of his permanent residence, other environmental factors and lifestyle are taken into account. For example, for people who frequently fly on airplanes, the amount of radiation exposure during X-ray examinations can be reduced, since in upper layers the atmosphere is more irradiated than at the surface of the earth.
To determine how often a particular test can be done, the permissible annual dose of 50 mSv is written down throughout the year in the medical record. If at the beginning of the term it was necessary to frequently make diagnostics and the limit was exhausted, the adult will not be given an x-ray until the end of the billing period.
Received radiation doses for different types of x-rays
In modern facilities, radiation doses to patients are not much higher than background radiation. This made x-rays safer for repeated use. Even when taking a series of repeated images, the total X-ray exposure does not exceed 50% of the recommended annual load and is not harmful, but the final figures depend on the type of study.
Different procedures are characterized by different radiation exposure to the human body:
- analogue fluorography (an outdated option for diagnosing lung diseases) - up to 0.2 mSv;
- digital fluorography - up to 0.06 mSv (in devices latest generation up to 0.002 mSv);
- X-ray of the neck and cervical spine - up to 0.1 mSv;
- head examination - up to 0.4 mSv;
- image of the abdominal organs - up to 0.4 mSv;
- detailed radiography (includes X-rays of different parts of the body and joints) - up to 0.03 mSv;
- intraoral (dental) radiography - up to 0.1 mSv.
The greatest radiation exposure to the human body occurs during fluoroscopy of internal organs. Despite the insignificant radiation power indicators, they reach impressive figures due to the long duration of the procedure. On average, up to 3.5 mSv of radiation is transmitted to an adult in one session. Computed tomography has even greater indicators, in which the patient receives a dose of up to 11 mSv. Although such amounts of radiation are not harmful, such tests are not often done.
Is digital x-ray harmful?
Unlike the outdated analog X-ray, digital has less radiation exposure and causes less harm, but allows you to obtain higher-quality images. Considering that the radiation dose on digital X-rays is several times lower, specialists have the opportunity to do studies more often.
Good to know! Even when taking a series of images or repeated studies using digital installations, the resulting radiation dose is 2-3 times lower, so their harm is minimal.
When using a digital camera, photographs can be taken a second time within 24 hours. This may be necessary when you receive a blurry picture or find indistinguishable details in it. However, even here, radiologists take into account the potential harm of radiation, and try not to do diagnostics often, especially for children.
How many times a year can you take an x-ray without harming your health?
To calculate how often an x-ray can be taken without harm to the body, it is necessary to take into account a number of factors. The main attention is paid to the total values of exposure per unit time. Do it too often x-rays harmful, especially if large areas of the body are exposed to rays. In addition, when calculating the period between studies, experts take into account the index of susceptibility of various tissues to radiation. The most pronounced harm is observed with irradiation of the brain and endocrine glands, including the gonads, so it is not recommended to diagnose them more than once a year.
Fluorography and x-rays of the abdominal cavity can be done 2 times a year. The average time between such diagnostic procedures can be reduced to 45 days. This is necessary so that the organs have time to partially recover after exposure to radiation. X-rays of peripheral parts of the body (limbs and joints) can be done more frequently - up to 6 times a year. However, here too the potential harm to health should be taken into account. You can do no more than three such procedures per month.
How long after can I do it again?
In some cases, patients need repeat x-rays:
- to clarify the diagnosis after fluorography;
- to track dynamics during treatment;
- to monitor the effectiveness of therapy;
- to clarify pathologies when receiving a low-quality image.
Only a specialist can determine the frequency of x-rays. This takes into account the ratio of the radiation load created by the device with the area of radiation exposure and individual harm to tissues. For example, when diagnosing a fracture of the hand, the image can be repeated after two days, while fluoroscopy of the intestine can be performed at intervals of at least two months. X-rays that affect the endocrine glands (neck, hip joints in women, etc.) are allowed no more than twice a year.
Important! An exception is for cancer patients who need regular monitoring of tumor dynamics. They can undergo up to 4 procedures per month, regardless of the area of study.
What will happen if you do it often?
There are different situations in medicine: some patients have to take x-rays 2 times in a row to establish an accurate clinical picture. At the same time, patients often worry whether it is dangerous to do x-rays so often. Experts say that if there are unconditional indications and it is impossible to use other diagnostic methods, an x-ray taken 2 times a day does not cause significant harm to the human body.
In situations where photographs need to be taken frequently, clinic staff use minimal dosages and try to protect the patient’s body from radiation as much as possible. This to a certain extent reduces the risk of receiving the maximum permissible doses of radiation. If the total exposure indicators approach the maximum acceptable standards, the doctor may refuse to take a photo. But this rule also has exceptions: if the patient’s life is in danger due to the lack of important data, X-rays will often be taken even if the total dose did not significantly exceed the recommended values.
The main harm, which determined the rule why x-rays should not be taken frequently, is the gradual change in the functions of internal organs and systems. If the patient receives doses of radiation regularly, there is a risk of changes in the blood picture: leukopenia, erythrocytopenia, thrombocytopenia. Main sign their appearance - excessive fatigue, weakness, bleeding gums, severe bleeding even from small wounds. Such conditions require special therapy and radical abolition of x-rays.
Does X-ray affect potency in men?
Among the male population, the effect of x-rays on potency is of particular importance. The question is about what harm the procedure does to male body, interests male patients much more than the potential harm of x-rays for other areas of health. Radiologists reassure us that the radiation in modern installations is not enough to radically worsen the functioning of the reproductive system. Moreover, during each procedure, a man’s intimate organs are protected with a special lead apron in order to 100% eliminate the possibility of irradiation of the gonads.
Good to know! The male part of the population can have X-rays done as many times a year as women.
The only situation where x-rays can harm potency is the consequences of acute radiation sickness, that is, more than 1 Sv in one session, which is completely excluded if you do regular x-rays. In this case, deterioration of erectile function will be a secondary symptom. It will arise over time due to dysfunction of the gonads and general deterioration well-being.
How to reduce stress and precautions
To reduce the harm from x-rays, you can do examinations no more often than your doctor recommends. In this case, preference should be given to medical institutions, in which the latest generation devices are installed. They allow you to take health-safe images more frequently than older analogue X-ray machines.
To reduce the harmfulness of x-rays, clinics use special precautions. Most often they are expressed in limiting the area of exposure to radiation using special reflective devices: hats, sleeves, aprons and diapers made of lead rubber. They cover parts of the body that do not require diagnosis.
In order for the radiography to take place safely, the patient should follow the specialist’s recommendations for behavior during the procedure. Even minor disturbances (careless movement, uneven breathing, etc.) often lead to cloudy images, so doctors have to do a repeat session, that is, additionally irradiate the patient.
To track the total radiation exposure for each person, a special X-ray passport has been created, in which you need to make notes about the timing of the procedures and the doses received. Often the patient does not have access to them, so if it is necessary to do x-ray diagnostics in private clinics, you can take an extract from such a card. This will help reduce the likelihood of harm to health due to overexposure.
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X-ray diagnostic method. Types of X-ray examination of bones
X-ray of bones is one of the most common studies conducted in modern medical practice. Most people are familiar with this procedure, since the possibilities for using this method are very extensive. List of indications for x-ray bone disease includes a large number of diseases. Injuries and fractures of the limbs alone require repeated x-rays. X-rays of bones are performed using various equipment, and there are also a variety of methods this study. The use of the type of x-ray examination depends on the specific clinical situation, the age of the patient, the underlying disease and associated factors. Radiation diagnostic methods are indispensable in the diagnosis of diseases of the skeletal system and play main role in making a diagnosis.
There are the following types of x-ray examination of bones:
- film radiography;
- digital radiography;
- X-ray densitometry;
- x-ray of bones using contrast agents and some other methods.
What is an X-ray?
X-ray is a type of electromagnetic radiation. This type of electromagnetic energy was discovered in 1895. Electromagnetic radiation also includes sunlight, as well as light from any artificial lighting. X-rays are used not only in medicine, but are also found in ordinary nature. About 1% of the Sun's radiation reaches the Earth in the form of X-rays, which forms the natural background radiation.The artificial production of X-rays became possible thanks to Wilhelm Conrad Roentgen, after whom they are named. He was also the first to discover the possibility of using them in medicine to “transilluminate” internal organs, primarily bones. Subsequently, this technology developed, new ways of using X-ray radiation appeared, and the radiation dose was reduced.
One of negative properties X-ray radiation is its ability to cause ionization in the substances through which it passes. Because of this, X-ray radiation is called ionizing radiation. In large doses, x-rays can lead to radiation sickness. The first decades after the discovery of X-rays this feature was unknown, which led to illness in both doctors and patients. However, today the dose of X-ray radiation is carefully controlled and we can say with confidence that the harm from X-ray radiation can be neglected.
The principle of obtaining an x-ray
Three components are required to produce an x-ray. The first of these is an X-ray source. The source of X-ray radiation is an X-ray tube. In it, under the influence of an electric current, certain substances interact and energy is released, most of which is released in the form of heat, and a small part in the form of x-rays. X-ray tubes are part of all X-ray machines and require significant cooling.The second component for obtaining an image is the object under study. Depending on its density, partial absorption of X-rays occurs. Due to the difference in the tissues of the human body, X-ray radiation of varying power penetrates outside the body, which leaves different spots on the image. Where the X-ray radiation was absorbed to a greater extent, shadows remain, and where it passed almost unchanged, clearings are formed.
The third component for obtaining an x-ray is the x-ray receiver. It can be film or digital ( X-ray sensor). The most commonly used receiver today is X-ray film. It is treated with a special emulsion containing silver, which changes when X-rays hit it. The highlight areas in the image have a dark tint, and the shadows have a white tint. Healthy bones have high density and leave a uniform shadow on the image.
Digital and film X-ray of bones
The first X-ray research techniques involved the use of a photosensitive screen or film as a receiving element. Today, X-ray film is the most commonly used X-ray detector. However, in the coming decades, digital radiography will completely replace film radiography, as it has a number of undeniable advantages. In digital radiography, the receiving element is sensors that are sensitive to x-ray radiation.Digital radiography has the following advantages Compared to film radiography:
- the ability to reduce the radiation dose due to more high sensitivity digital sensors;
- increasing the accuracy and resolution of the image;
- simplicity and speed of taking an image, no need to process photosensitive film;
- ease of storing and processing information;
- the ability to quickly transfer information.
X-ray of bones with contrast agent
X-rays of the limb bones can be performed using contrast agents. Unlike other body tissues, bones have a high natural contrast. Therefore, contrast agents are used to clarify formations adjacent to bones - soft tissues, joints, blood vessels. These X-ray techniques are not used very often, but in some clinical situations they are irreplaceable.There are the following radiopaque techniques for examining bones:
- Fistulography. This technique involves filling the fistula tracts with contrast agents ( iodolipol, barium sulfate). Fistulas form in bones due to inflammatory diseases such as osteomyelitis. After the study, the substance is removed from the fistula tract using a syringe.
- Pneumography. This study involves the introduction of gas ( air, oxygen, nitrous oxide) with a volume of about 300 cubic centimeters in soft fabrics. Pneumography is performed, as a rule, for traumatic injuries combined with crushing of soft tissues and comminuted fractures.
- Arthrography. This method involves filling the joint cavity with a liquid X-ray contrast agent. The volume of contrast agent depends on the volume of the joint cavity. Most often, arthrography is performed on knee joint. This technique allows you to assess the condition of the articular surfaces of the bones included in the joint.
- Angiography of bones. This type of study involves the introduction of a contrast agent into the vascular bed. The study of bone vessels is used for tumor formations, to clarify the characteristics of its growth and blood supply. In malignant tumors, the diameter and arrangement of blood vessels are uneven, and the number of vessels is usually greater than in healthy tissues.
X-ray and computed tomography ( CT) bones
Computed tomography is an x-ray method that has increased accuracy and information content. Today, computed tomography is the most best method studies of the skeletal system. With the help of CT, you can obtain a three-dimensional image of any bone in the body or sections through any bone in all possible projections. The method is accurate, but at the same time it creates a high radiation dose.The advantages of CT over standard radiography are:
- high resolution and accuracy of the method;
- the ability to obtain any projection, while x-rays are usually performed in no more than 2 - 3 projections;
- the possibility of three-dimensional reconstruction of the body part being studied;
- absence of distortion, correspondence of linear dimensions;
- possibility of simultaneous examination of bones, soft tissues and blood vessels;
- the ability to conduct surveys in real time.
X-ray of bones and magnetic resonance imaging ( MRI)
Magnetic resonance imaging ( MRI) is a relatively new diagnostic method. MRI allows you to obtain an accurate image of the internal structures of the body in all possible planes. Using computer modeling tools, MRI makes it possible to perform three-dimensional reconstruction of human organs and tissues. The main advantage of MRI is complete absence radiation exposure.The operating principle of a magnetic resonance imaging scanner is to impart a magnetic impulse to the atoms that make up the human body. After this, the energy released by the atoms when returning to their original state is read out. One of the limitations of this method is the impossibility of use if there are metal implants or pacemakers in the body.
When performing an MRI, the energy of hydrogen atoms is usually measured. Hydrogen in the human body is most often found in water compounds. Bones contain much less water than other tissues of the body, so when examining bones, MRI provides less accurate results than when examining other areas of the body. In this respect, MRI is inferior to CT, but still exceeds conventional radiography in accuracy.
MRI is best method diagnosis of bone tumors, as well as metastases of bone tumors in distant areas. One of the serious disadvantages of this method is the high cost and time-consuming research ( 30 minutes or more). All this time, the patient must remain stationary in the magnetic resonance imaging scanner. This device looks like a tunnel of a closed structure, which is why some people experience discomfort.
X-ray and bone densitometry
The study of the structure of bone tissue is carried out in a number of diseases, as well as during the aging of the body. Most often, a study of bone structure is carried out for a disease such as osteoporosis. A decrease in the mineral content of bones leads to their fragility, the risk of fractures, deformations and damage to neighboring structures.An X-ray allows you to evaluate the structure of the bones only subjectively. Densitometry is used to determine quantitative parameters of bone density and mineral content. The procedure is quick and painless. While the patient lies motionless on the couch, the doctor examines certain areas of the skeleton using a special sensor. The most important are densitometry data of the femoral head and vertebrae.
There are the following types of bone densitometry:
- quantitative ultrasound densitometry;
- X-ray absorptiometry;
- quantitative magnetic resonance imaging;
- quantitative computed tomography.
Densitometry is indicated in the following cases:
- osteoporosis;
- mature age ( over 40 – 50 years old);
- menopause in women;
- frequent bone fractures;
- diseases of the spine ( osteochondrosis, scoliosis);
- any bone damage;
- sedentary lifestyle ( physical inactivity).
Indications and contraindications for x-rays of skeletal bones
X-ray of skeletal bones has an extensive list of indications. Different diseases may be specific to different ages, but bone injuries or tumors can occur at any age. For diagnosing diseases of the skeletal system, x-rays are the most informative method. The X-ray method also has some contraindications, which, however, are relative. However, be aware that bone x-rays can be dangerous and harmful if used too frequently. Indications for bone x-ray
X-ray examination is an extremely common and informative test for skeletal bones. Bones are not available for direct examination, but X-rays can provide almost all the necessary information about the condition of the bones, their shape, size and structure. However, due to the release of ionizing radiation, x-rays of bones cannot be performed too often and for any reason. The indications for bone x-rays are determined quite accurately and are based on the complaints and symptoms of the patients’ diseases.X-ray of bones is indicated in the following cases:
- traumatic bone injuries with severe pain, deformation of soft tissues and bones;
- dislocations and other joint injuries;
- abnormalities of bone development in children;
- children's growth retardation;
- limited mobility in joints;
- pain at rest or with movement of any part of the body;
- an increase in bone volume, if a tumor is suspected;
- preparation for surgical treatment;
- assessment of the quality of treatment provided ( fractures, transplantations, etc.).
X-ray of bones in most cases makes it possible to differentiate between the listed diseases, due to the fact that each of them has reliable radiological signs. In difficult cases, especially before surgery, the use of computed tomography is indicated. Doctors prefer to use this study because it is the most informative and has the least amount of distortion compared to anatomical dimensions bones.
Contraindications for X-ray examination
Contraindications to x-ray examination are associated with the presence of the ionizing effect of x-ray radiation. At the same time, all contraindications to the study are relative, since they can be neglected in in case of emergency, such as skeletal bone fractures. However, if possible, you should limit the number of x-ray examinations and not carry them out unnecessarily.Relative contraindications for x-ray examination include:
- the presence of metal implants in the body;
- acute or chronic mental illness;
- serious condition of the patient ( massive blood loss, unconsciousness, pneumothorax);
- first trimester of pregnancy;
- childhood ( up to 18 years old).
- allergic reactions to components of contrast agents;
- endocrine disorders ( thyroid diseases);
- severe liver and kidney diseases;
Radiation doses for various x-ray examination methods
Modern radiation diagnostics adheres to strict safety standards. X-ray radiation is measured using special dosimeters, and X-ray installations undergo special certification for compliance with radiological exposure standards. Radiation doses are not the same for different research methods, as well as for different anatomical areas. The unit of measurement for radiation dose is milliSievert ( mSv).Radiation doses for various bone x-ray methods
As can be seen from the above data, computed tomography carries the greatest x-ray load. At the same time, computed tomography is the most informative method for studying bones today. We can also conclude that digital radiography has a great advantage over film radiography, since the x-ray load is reduced by 5 to 10 times.
How often can an x-ray be taken?
X-ray radiation poses a certain danger to the human body. It is for this reason that all the radiation that was received from medical purpose, must be reflected in the patient's medical record. Such records must be maintained in order to comply with annual standards limiting the possible number of x-ray examinations. Thanks to the use of digital radiography, their quantity is sufficient to solve almost any medical problem.The annual ionizing radiation that the human body receives from the environment ( natural background), ranges from 1 to 2 mSv. The maximum permissible dose of X-ray radiation is 5 mSv per year or 1 mSv for each of 5 years. In most cases, these values are not exceeded, since the radiation dose for a single examination is several times less.
The number of X-ray examinations that can be performed in a year depends on the type of examination and the anatomical area. On average, 1 computed tomography scan or 10 to 20 digital x-rays are allowed. However, there is no reliable data on the impact of radiation doses of 10–20 mSv annually. All we can say with certainty is that to some extent they increase the risk of certain mutations and cellular disorders.
What organs and tissues suffer from ionizing radiation from X-ray machines?
The ability to cause ionization is one of the properties of X-ray radiation. Ionizing radiation can lead to spontaneous decay of atoms, cellular mutations, and failure of cell reproduction. That is why x-ray examination, which is a source of ionizing radiation, requires normalization and establishment of threshold values of radiation doses.Ionizing radiation has the greatest impact on the following organs and tissues:
- bone marrow, hematopoietic organs;
- lens of the eye;
- endocrine glands;
- genitals;
- skin and mucous membranes;
- fetus of a pregnant woman;
- all organs of the child's body.
Is it possible to do bone x-rays for pregnant and breastfeeding mothers?
Any X-ray examination is not recommended for pregnant women. According to the World Health Organization, a dose of 100 mSv almost inevitably causes fetal developmental disorders or mutations leading to cancer. The first trimester of pregnancy is of greatest importance, since during this period the most active development of fetal tissue and organ formation occurs. If necessary, all X-ray examinations are transferred to the second and third trimester of pregnancy. Studies conducted on humans have shown that x-rays taken after 25 weeks of pregnancy do not lead to abnormalities in the baby.For nursing mothers, there are no restrictions in taking x-rays, since the ionizing effect does not affect the composition of breast milk. Complete research in this area has not been conducted, so in any case, doctors recommend that nursing mothers express the first portion of milk while breastfeeding. This will help you be on the safe side and maintain confidence in your child’s health.
X-ray examination of bones for children
X-ray examination for children is considered undesirable, since it is in childhood the body is most susceptible negative influence ionizing radiation. It should be noted that it is in childhood that the largest number of injuries occur, which lead to the need to perform an x-ray examination. This is why children are given x-rays, but various protective devices are used to protect developing organs from radiation.X-ray examination is also required in case of growth retardation in children. In this case, x-rays are taken as many times as required, since the treatment plan includes x-ray examinations after a certain period of time ( usually 6 months). Rickets, congenital skeletal anomalies, tumors and tumor-like diseases - all these diseases require radiology diagnostics and cannot be replaced by other methods.
Preparing for a bone x-ray
Research preparation is at the core of any successful research. Both the quality of diagnosis and the result of treatment depend on this. Preparing for an x-ray examination is a fairly simple undertaking and usually does not pose any difficulties. Only in some cases, such as x-rays of the pelvis or spine, does the x-ray require special preparation. There are some features of preparing for x-rays of children. Parents should help doctors and properly psychologically prepare their children for the study. It is difficult for children to remain motionless for a long time; they are also often afraid of doctors, people “in white coats.” Thanks to cooperation between parents and doctors, good diagnosis and quality treatment of childhood diseases can be achieved.
How to get a referral for a bone x-ray? Where is X-ray examination performed?
Bone x-rays can be performed today in almost any center that provides medical care. Although X-ray equipment is widely available today, X-ray examinations are performed only on the direction of a physician. This is due to the fact that x-rays are harmful to human health to a certain extent and have some contraindications.Bone x-rays are performed at the direction of doctors of various specialties. Most often it is performed urgently when providing first aid in trauma departments and emergency hospitals. In this case, the referral is issued by the on-duty traumatologist, orthopedist or surgeon. Bone x-rays can also be performed on the direction of family doctors, dentists, endocrinologists, oncologists and other doctors.
X-rays of bones are performed in various medical centers, clinics, and hospitals. For this purpose, they are equipped with special X-ray rooms, which have everything necessary for this type of research. X-ray diagnostics are carried out by radiologists with special knowledge in this field.
What does an X-ray room look like? What's in it?
X-ray room - a place where X-rays are taken various parts human body. The X-ray room must meet high standards of radiation protection. In the decoration of walls, windows and doors, special materials are used that have a lead equivalent, which characterizes their ability to block ionizing radiation. In addition, it contains dosimeters-radiometers and personal protective equipment against radiation, such as aprons, collars, gloves, skirts and other elements.The X-ray room must have good lighting, primarily artificial, since the windows are small and natural light is not enough for high-quality work. The main equipment of the office is an X-ray unit. X-ray machines come in different forms as they are designed for different purposes. Large medical centers have all types of X-ray machines, but the simultaneous operation of several of them is prohibited.
A modern X-ray room contains the following types of X-ray units:
- stationary x-ray machine ( allows you to perform radiography, fluoroscopy, linear tomography);
- ward mobile X-ray unit;
- orthopantomograph ( installation for performing x-rays of jaws and teeth);
- digital radiovisiograph.
Additional equipment for X-ray rooms includes:
- computer for processing and storing digital images;
- equipment for developing film photographs;
- film drying cabinets;
- Consumables ( film, photo reagents);
- negatoscopes ( bright screens for viewing pictures);
- tables and chairs;
- cabinets for storing documentation;
- bactericidal lamps ( quartz) for disinfection of premises.
Preparing for a bone x-ray
Tissues of the human body, differing in different densities and chemical compositions, absorb x-ray radiation differently and, as a result, have a characteristic x-ray image. Bones have a high density and very good natural contrast, so X-rays of most bones can be performed without special preparation.If a person needs an x-ray examination of most of the bones, then it is enough to come to the x-ray room on time. There are no restrictions on food intake, liquids, or smoking before the X-ray examination. It is recommended not to take any metal items with you, especially jewelry, as they will need to be removed before performing the test. Any metal objects interfere with the X-ray image.
The process of obtaining an x-ray does not take much time. However, in order for the image to be of high quality, it is very important for the patient to remain still while it is being taken. This is especially true for young children who can be restless. X-rays are performed for children in the presence of parents. For children less than 2 years old, x-rays are performed in a lying position; it is possible to use a special fixation that secures the child’s position on the x-ray table.
One of the serious advantages of x-rays is the ability to use them in emergency situations ( injuries, falls, traffic accidents) without any preparation. There is no loss in image quality. If the patient is not transportable or is in serious condition, then it is possible to perform an x-ray directly in the room where the patient is located.
Preparation for x-rays of the pelvic bones, lumbar and sacral spine
X-ray of the pelvic bones, lumbar and sacral spine is one of the few types of x-rays that requires special preparation. It is explained by its anatomical proximity to the intestines. Intestinal gases reduce the sharpness and contrast of an x-ray image, which is why special preparation is carried out to cleanse the intestines before this procedure.Preparing for x-rays of the pelvic bones and lumbar region The spine includes the following main elements:
- cleansing the intestines with laxatives and enemas;
- following a diet that reduces the formation of gases in the intestines;
- conducting the study on an empty stomach.
Bone x-ray techniques
X-ray examination is designed to examine all the bones of the skeleton. Naturally, for the study of most bones there are special methods for obtaining x-rays. The principle of obtaining images remains the same in all cases. It involves placing the body part being examined between the X-ray tube and the radiation receiver, so that the X-ray beams pass at right angles to the bone being examined and to the cassette of X-ray film or sensors. The positions that the components of an X-ray installation occupy relative to the human body are called placements. Over the years of practice, a large number of X-ray installations have been developed. The quality of X-ray images depends on the accuracy of their observance. Sometimes the patient has to take a forced position to carry out these instructions, but the x-ray examination is performed very quickly.
Styling usually involves taking pictures in two mutually perpendicular projections - frontal and lateral. Sometimes the study is supplemented with an oblique projection, which helps to get rid of the overlap of some parts of the skeleton with each other. In case of severe injury, some styling may become impossible. In this case, an x-ray is performed in the position that causes the least discomfort to the patient and which will not lead to displacement of the fragments and aggravation of the injury.
Methodology for studying the bones of the extremities ( arms and legs)
X-ray examination of the tubular bones of the skeleton is the most common x-ray examination. These bones make up the bulk of the bones; the skeleton of the arms and legs is made entirely of tubular bones. The X-ray technique should be familiar to anyone who has suffered injuries to their arms or legs at least once in their life. The examination takes no more than 10 minutes and does not cause pain or discomfort.Tubular bones can be examined in two perpendicular projections. The main principle of any X-ray image is the location of the object under study between the emitter and the X-ray sensitive film. The only condition for a high-quality image is that the patient remains motionless during the examination.
Before the examination, the limb section is exposed, all metal objects are removed from it, and the examination area is located in the center of the cassette with X-ray film. The limb should “lie” freely on the film cassette. The X-ray beam is directed to the center of the cassette perpendicular to its plane. The image is taken in such a way that adjacent joints are also included in the x-ray. Otherwise, it is difficult to distinguish between the upper and lower ends of the tubular bone. In addition, the large coverage area helps prevent damage to joints or adjacent bones.
Typically, each bone is examined in frontal and lateral projections. Sometimes photographs are taken together with functional tests. They involve flexion and extension of a joint or loading a limb. Sometimes, due to injury or the inability to change the position of a limb, special projections have to be used. The main condition is to maintain the perpendicularity of the cassette and the X-ray emitter.
Technique for X-ray examination of skull bones
X-ray examination of the skull is usually performed in two mutually perpendicular projections - lateral ( in profile) and straight ( in frontal view). X-rays of the skull bones are prescribed for head injuries, endocrine disorders, and to diagnose deviations from indicators of age-related bone development in children.X-ray of the skull bones in a direct anterior projection provides general information about the condition of the bones and the connections between them. It can be performed in a standing or lying position. Typically, the patient lies on the X-ray table on his stomach, with a cushion placed under his forehead. The patient remains motionless for several minutes while the X-ray tube is aimed at the back of the head and the image is taken.
X-ray of the skull bones in a lateral projection is used to study the bones of the base of the skull, the bones of the nose, but is less informative for other bones of the facial skeleton. To perform an x-ray in a lateral projection, the patient is placed on the x-ray table on his back, a cassette with film is placed on the left or right side of the patient’s head parallel to the axis of the body. The X-ray tube is directed perpendicular to the cassette on the opposite side, 1 cm above the ear-pupillary line.
Sometimes doctors use x-rays of the skull bones in the so-called axial projection. It corresponds to the vertical axis of the human body. This placement has a parietal and chin direction, depending on which side the X-ray tube is located on. It is informative for studying the base of the skull, as well as some bones of the facial skeleton. Its advantage is that it avoids much of the overlap of bones on each other that is characteristic of the direct projection.
X-ray of the skull in axial projection consists of the following steps:
- the patient removes metal objects from himself, outerwear;
- the patient takes a horizontal position on the X-ray table, lying on his stomach;
- the head is positioned in such a way that the chin protrudes forward as much as possible, and only the chin and the front surface of the neck touch the table;
- There is a cassette with X-ray film under the chin;
- the x-ray tube is directed perpendicular to the plane of the table, towards the crown area, the distance between the cassette and the tube should be 100 cm;
- after this, a picture is taken with the chin direction of the X-ray tube in a standing position;
- the patient throws his head back so that the crown of his head touches the support platform, ( raised x-ray table), and the chin was as high as possible;
- The X-ray tube is directed perpendicular to the front surface of the neck, the distance between the cassette and the X-ray tube is also 1 meter.
X-ray techniques of the temporal bone according to Stenvers, according to Schuller, according to Mayer
The temporal bone is one of the main bones that forms the skull. The temporal bone contains a large number of formations to which muscles are attached, as well as holes and canals through which nerves pass. Due to the abundance of bone formations in the facial area, X-ray examination of the temporal bone is difficult. That is why various positions have been proposed for obtaining special X-ray images of the temporal bone.Currently, three projections of x-ray examination of the temporal bone are used:
- Mayer's technique ( axial projection). Used to study the condition of the middle ear, pyramid of the temporal bone and mastoid process. Mayer's X-ray is performed in the supine position. The head is turned at an angle of 45 degrees to the horizontal plane, and a cassette with X-ray film is placed under the ear being examined. The X-ray tube is directed through the frontal bone of the opposite side, it should be aimed exactly at the center of the external auditory opening of the side being examined.
- Method according to Schuller ( oblique projection). With this projection, the condition of the temporomandibular joint, mastoid process, and the pyramid of the temporal bone is assessed. X-rays are performed lying on your side. The patient's head is turned to the side, and a cassette with X-ray film is placed between the ear of the side being examined and the couch. The X-ray tube is located at a slight angle to the vertical and directed towards the foot end of the table. The X-ray tube is centered on the auricle of the side being examined.
- Stenvers method ( transverse projection). A transverse view allows you to assess the condition inner ear, as well as the pyramids of the temporal bone. The patient lies on his stomach, his head is turned at an angle of 45 degrees to the line of symmetry of the body. The cassette is placed in a transverse position, the X-ray tube is beveled at an angle to the head end of the table, and the beam is directed to the center of the cassette. All three techniques use an X-ray tube in a narrow tube.
X-ray placement of zygomatic bones in tangential projection
For examination zygomatic bone The so-called tangential projection is used. It is characterized by the fact that X-rays propagate tangentially ( tangentially) in relation to the edge of the zygomatic bone. This placement is used to identify fractures of the zygomatic bone, the outer edge of the orbit, and the maxillary sinus.The X-ray technique of the zygomatic bone includes the following steps:
- the patient takes off his outer clothing, jewelry, metal prostheses;
- the patient takes a horizontal position on his stomach on the X-ray table;
- the patient's head is rotated at an angle of 60 degrees and placed on a cassette containing X-ray film measuring 13 x 18 cm;
- the side of the face being examined is on top, the X-ray tube is positioned strictly vertically, however, due to the tilt of the head, the X-ray rays pass tangentially to the surface of the zygomatic bone;
- During the study, 2–3 photographs are taken with slight turns of the head.
Technique for x-ray examination of the pelvic bones. Projections in which x-rays of the pelvic bones are performed
X-ray of the pelvis is the main examination for injuries, tumors, and other diseases of the bones in this area. An X-ray of the pelvic bones takes no more than 10 minutes, but there is a wide variety of methods for this study. Most often, a survey x-ray of the pelvic bones is performed in the posterior projection.The sequence of performing a survey x-ray of the pelvic bones in the posterior projection includes the following steps:
- the patient enters the X-ray room, removes metal jewelry and clothing, except for underwear;
- the patient lies on the X-ray table on his back and maintains this position throughout the procedure;
- arms should be crossed on the chest, and a cushion should be placed under the knees;
- the legs should be slightly spread, the feet should be fixed in the established position using tape or sandbags;
- a film cassette measuring 35 x 43 cm is located transversely;
- the X-ray emitter is directed perpendicular to the cassette, between the superior anterior iliac crest and the symphysis pubis;
- The minimum distance between the emitter and the film is one meter.
The posterior oblique view is used to examine the sacroiliac joint. It is performed by raising the side being examined by 25 - 30 degrees. In this case, the cassette must be positioned strictly horizontally. The X-ray beam is directed perpendicular to the cassette, the distance from the beam to the anterior iliac spine is about 3 centimeters. When the patient is positioned in this way, the x-ray image clearly shows the connection between the sacrum and the iliac bones.
Determining the age of the skeleton using X-rays of the hand in children
Bone age accurately indicates the biological maturity of the body. Indicators of bone age are the points of ossification and fusion of individual parts of bones ( synostoses). Based on bone age, it is possible to accurately determine the final height of children and determine whether they are behind or ahead in development. Bone age is determined by radiographs. After radiographs have been taken, the results obtained are compared with the standards using special tables.The most revealing way to determine the age of the skeleton is an x-ray of the hand. The convenience of this anatomical area is explained by the fact that ossification points appear in the hand with a fairly high frequency, which allows regular examination and monitoring of growth rates. Bone age determination is mainly used to diagnose endocrine disorders such as growth hormone deficiency ( somatotropin).
Comparison of the child’s age and the appearance of ossification points on an x-ray of the hand
Ossification points |
