Bone X Rays

Definition

Bone x rays are a diagnostic test in which ionizing radiation passing through the bones being examined enables an image to be produced on film.

Purpose

Bone x rays are ordered to detect disease or injury to the bone such as broken bones, tumors, and other problems. They can determine bone density, texture, erosion, and changes in bone relationships. Bone x rays also evaluate the joints for diseases such as osteoarthritis.

Precautions

Precautions should be taken to protect patients from unnecessary exposure to radiation. Patients should be shielded with lead aprons as much as possible. Women of childbearing age who could be pregnant should not have x rays of their trunk or pelvic regions. The fetus is especially at risk during the first trimester of pregnancy. Women who are pregnant should not have x rays of their pelvic region, lumbar spine, and abdomen unless absolutely necessary. If other types of x rays are necessary, a lead apron should be used to shield the abdominal and pelvic regions.

Description

X rays are a common diagnostic test in which a form of energy called x-ray radiation penetrates the patient's body. In bone x rays, electrical current passes through an x-ray tube and produces a beam of ionizing radiation that passes through the bone(s) being examined. This produces a picture of the inside of the body on film. The physician reads the developed x ray on a wall-mounted light box.

Digital x rays are a new type of x ray in which conventional equipment is used to take the x ray but the image is produced via computer. In a digital x ray, the image is created on a reusable plate. After being read by a laser reader, the information is sent in digital form to a storage unit connected to a computer network from which the radiologist reads the image. An electronic report can then be sent to the patient's physician.

Problems with bones that x rays can detect result from injury or from disease caused by a malfunction in the patient's bone chemistry. Bone injuries, especially broken bones (fractures ), are common and can be accurately diagnosed by bone x rays. X rays are especially helpful in diagnosing simple and incomplete fractures that can't be detected during a physical examination. X rays can also be used to check for bone position in a fracture. Some bone diseases can be definitively diagnosed with bone x rays while others require additional tests.

Osteoporosis, a common bone disease, can be detected in bone x rays but other tests are then ordered to determine the extent of the disease. For osteomalacia and rickets, a blood test and x rays of the affected bone are usually definitive; in some cases a bone biopsy (microscopic analysis of a small amount of tissue) is also done. In a rare bone disease called Paget's disease, x rays may be used in conjunction with bone, blood, and urine tests to make a diagnosis. In another rare bone disease, fibrous dysplasia, bone x rays or a bone biopsy (microscopic analysis of a small amount of tissue) are used to confirm the diagnosis. Bone x rays are definitive in diagnosing osteogenesis imperfecta. For osteomyelitis, bone x rays are used in conjunction with a blood test, bone scan, or needle biopsy to make the diagnosis. For arthritis, x rays of the bone are occasionally used in conjunction with blood tests. For bone tumors, bone x rays are helpful but they may not be definitive.

KEY TERMS

Arthritis— A disease of the joints that arises from wear and tear, age and less often from inflammation.

Osteogenesis imperfecta— Also called brittle bones, this is a condition present at birth in which bones are abnormally fragile, brittle and break easily.

Osteomalacia— A disease in which bones gradually soften and bend.

Osteomyelitis— An infection of the bone marrow and the bone.

Osteoporosis— A disease that occurs primarily in post-menopausal women in which the amount of bone is reduced or skeletal tissue wastes away.

Paget's disease— A disease, whose cause is unknown, which is generally found in older people. Symptoms include bone pain, bowed legs, curves spine, and broken bones. Another name for this disease is osteitis deformans.

Bone x rays are performed by a technologist, and interpreted by a radiologist. They are taken in a physician's office, radiology department, outpatient clinic, or diagnostic clinic. Bone x rays generally take less than 10 minutes. There is no pain or discomfort associated with the test, but some people find it difficult to remain still. The results are often available in minutes.

During the test, the patient lies on a table. The technologist taking the x ray will check the patient's positioning and place the x-ray machine over the part of the body being examined. After asking the patient to remain motionless, he or she steps out of the area and presses a button to take the picture.

Preparation

The patient is asked to remove clothing, jewelry, and any other metal objects from the area being x rayed. If appropriate, a lead shield will be placed over other body parts to minimize exposure to radiation.

Aftercare

The patient can immediately resume normal activities.

Risks

The human body contains some natural radiation and is also exposed to radiation in the environment. There is a slight risk from exposure to radiation during bone x rays, however, the amount of radiation is small and the risk of harm is very low. If reproductive organs are exposed to radiation, genetic alterations may occur. Excessive or repeated doses of radiation can cause changes in other types of body tissue. No radiation remains in the body after the x ray.

Normal results

Normal bones show no fractures, dislocations, or other abnormalities.

Abnormal results

Results that indicate the presence of bone injury or disease differ in appearance according to the nature of the injury/disease. For example, fractures show up as clear breaks in the bones, while osteoporotic bone has the same shape as a normal bone on an x ray but is less dense. Even though a bone x ray may not show definite results, it often is the first imaging choice, to be followed up by another imaging technique such as magnetic resonance imaging (MRI). Bone x rays are still the easiest was to show a typical bone fracture and to check on healing of broken bones.

Resources

PERIODICALS

Frank, John. "Introduction to Imaging: Bone and Joint." Student BMJ (March 2004): 101-105.

Bone X Rays

Definition

Bone x rays are a diagnostic imaging test in which ionizing radiation passes through the bone. This enables an image of the bone to be produced either digitally or on film.

Purpose

Bone x rays are ordered to detect disease or injury to the bones, such as broken bones (fractures ), tumors, or other problems. They are often used to rule out a fracture vs soft-tissue injury. They can determine bone density, texture, erosion, and changes in bone relationship and anatomy. Bone x rays also evaluate the joints for diseases such as osteoarthritis.

Precautions

Precautions should be taken to protect patients from unnecessary exposure to radiation. Patients should be shielded with lead aprons as much as possible especially when undergoing numerous x rays over short periods of time. Women of childbearing age who could be pregnant should avoid x rays of their pelvic region, lumbar spine, and abdomen unless absolutely necessary. The fetus is especially at risk during the first trimester of pregnancy. If other types of x rays are necessary, a lead apron should be used to shield the abdominal and pelvic regions.

Description

X rays are a common diagnostic test in which a form of energy called ionizing radiation penetrates the patient's body. In bone x rays, electrical current passes through an x-ray tube and produces a beam of ionizing radiation that passes through the bone(s) being examined. This produces a picture of the inside of the body on film. The physician reads the developed film on a wall-mounted light box.

Alternatively, digital x rays are a new type of x ray in which conventional equipment is used to take the x ray but the image is produced via computer. In a digital x ray, the image is created on a reusable plate. After being read by a laser reader, the information is sent in digital form to a storage unit connected to a computer network from which the radiologist reads the image. An electronic report can then be sent to the patient's physician. In addition, these digital images can be reviewed by any radiologist that has access to the digital viewers anywhere in the world.

Bone x rays can detect injury or disease from many causes, including malfunctions in the patient's bone chemistry, bone breaks, and bone fractures. X rays are especially helpful in diagnosing simple and incomplete fractures that cannot be detected during a physical examination. X rays can also be used to check the position of the fracture site. Some bone diseases can be definitively diagnosed with bone x rays, while others may require additional tests.

Osteoporosis, a common bone disease, can be detected in bone x rays, but other tests are then ordered to determine the extent of the disease. For osteomalacia and rickets, a blood test and x rays of the affected bone are usually definitive; in some cases a bone biopsy (microscopic analysis of a small amount of tissue) is also done. In a rare bone disease called Paget's disease, x rays may be used in conjunction with bone, blood, and urine tests to make a diagnosis. In another rare bone disease, fibrous dysplasia, bone x rays or a bone biopsy (microscopic analysis of a small amount of tissue) are used to confirm the diagnosis. Bone x rays are definitive in diagnosing osteogenesis imperfecta. For osteomyelitis, bone x rays are used in conjunction with a blood test, bone scan, or needle biopsy to make the diagnosis. For arthritis, x rays of the bone commonly taken, and are occasionally combined with blood tests. In bone tumors, bone x rays are helpful but they are not always definitive.

Bone x rays are performed by a radiographer (technologist), and interpreted by a radiologist. They are taken in a physician's office, radiology unit, outpatient clinic, or diagnostic clinic. Bone x rays generally take a few minutes to complete. There is little or no discomfort associated with the test, but some people find it difficult to remain still or in the positions required for the image. The results are often available in minutes.

During the test, the patient lies on a table or sits on a stool (for most upper extremities). The technologist taking the x ray will check the patient's positioning and place the x-ray machine over the part of the body being examined. After asking the patient to remain motionless, he or she steps out of the area and sets appropriate technical factors to create the proper exposure, and takes the x ray.

Preparation

The patient is asked to remove clothing, jewelry, and any other metal objects from the area being x rayed. If appropriate, a lead shield will be placed over other body parts to minimize exposure to radiation.

Aftercare

The patient can immediately resume normal activities.

Complications

The human body contains some natural radiation and is also exposed to radiation in the environment. There is a slight risk from exposure to radiation during bone x rays, however, the amount of radiation is small and the risk of harm is very low. If reproductive organs are exposed to radiation, genetic alterations may occur. Excessive or repeated doses of radiation can cause changes in other types of body tissue. In addition, the radiology professional is continually monitored for his/her occupational exposure. This data is reviewed by a physicist monthly. If the exposure level exceeds the safety level, the technologist or radiologist is removed from that area temporarily while the exposure data and radiation safety measures are evaluated.

Results

Normal bones show no fractures, dislocations, or other abnormalities. Results indicating the presence of bone injury or disease differ in appearance according to the nature of the injury/disease. For example, fractures show up as clear breaks in the bones, while osteoporotic bone has the same shape as a normal bone on an x ray but is less dense.

Health care team roles

The radiology professional most likely in contact with the patient having bone x rays is the radiologic technologist. He or she should take a moment to explain the procedure that the patient will have, especially if this patient has had an injury. The patient's fear of pain can be profound, and because the technologist must touch and/or move the patient, care should be taken to calm the fears of the patient. In addition, the technologist must protect him- or herself from exposure to the patients bodily fluids, and unneccesary radiation where possible.

Training

A technologist must complete a 24-month radiologic technology program, that consists of didactic (classroom) and clinical education and rotations. The student radiographer will rotate through all areas of radiology. Upon completion, they will take a national registry exam given by the American Registry of Radiologic Technology (ARRT) that will encompass areas of physics, radiation safety, exposure factors, positioning, anatomy and physiology, and chemistry. The technologist that performs bone x rays is a highly trained professional and must comply with continuing education yearly.

KEY TERMS

Arthritis— A disease of the joints that arises from wear and tear, age and less often from inflammation.

Osteogenesis imperfecta— Also called brittle bones, this is a condition present at birth in which bones are abnormally fragile and brittle; they break easily.

Osteomalacia— A disease in which bones gradually soften and bend.

Osteomyelitis— An infection of the bone marrow and the bone.

Osteoporosis— A disease which occurs primarily in post-menopausal women in which the amount of bone is reduced or skeletal tissue wastes away.

Paget's disease— A disease, whose cause is unknown, which is generally found in older people. Symptoms include bone pain, bowed legs, curves spine, and broken bones. Another name for this disease is osteitis deformans.

Radiographer— A person who takes x rays. Must be registered with the American Registry of Radiologic Technology (ARRT).

Resources

BOOKS

Fischbach, Frances, ed. "X-ray Studies." In A Manual of Laboratory and Diagnostic Tests. Philadelphia, New York: Lippincott, 1996.

Tierney, Jr., Lawrence M., Stephen J. McPhee, and Maxine Papadakis, eds. "Tumors and Tumor-Like Lesions of the Bone." In Current Medical Diagnosis and Treatment, 36th ed. Stamford, CT: Appleton & Lange, 1997, 796.

PERIODICALS

"FDA Approves Bone Density Measurement Device." Women's Health Weekly, (23 March 1998): 13.

OTHER

Thriveonline. "Bone Fracture," and "Osteporosis: Improved Detection and Treatment." (1998). 〈http://www.thriveonline.com/health/Library〉 (15 April 1998).

Bone X Rays

Definition
Purpose
Description
Preparation
Aftercare
Risks
Normal results

Definition

Bone X rays are a diagnostic imaging test in which ionizing radiation passing through the bones enables an image to be produced on film. An x ray (radiograph) can produce an image of a bone from various and multiple angles. A physician may view an x-ray film to help diagnose fractures in patients and then consider treatment options based on the findings. An x ray may be taken of many bones in the body including the hand, foot, wrist, spine, rib cage, spine, and ankle.

Purpose

Bone x rays are ordered to detect bone disease or injury, such as in the case of broken bones, tumors, and other problems. They can determine bone density, texture, erosion, and changes in bone relationships. Bone x rays also evaluate the joints for such diseases as arthritis. In addition, x rays may be taken to see if a joint has been dislocated, to guide a surgeon during an orthopedic surgical procedure such as a total joint replacement operation, to visualize foreign objects, or to check bone alignment before and after cast application or repair via screw and plate orthopedic procedures.

Description

X rays are the result of the collision between electrons and a protons. German physicist Wilhelm Conrad Röntgen (1845–1923), discovered what he called X-radiation, in 1895. This form of radiation was noted to have properties allowing transparency and fluorescence that absorbed visible light and contrasting shadows. Experiments with this new form of radiation revealed the distinction between bone and soft tissues in the body, such as in the hand. Rontgen’s first x ray was of his wife’s hand, which showed bones, soft tissue, and metal from the ring she was wearing. His discovery of x rays heralded a significant and valuable diagnostic tool used in the field of medicine. Röntgen was awarded the Nobel Prize for Physics in 1901 for his discovery. He was the first recipient to be honored in this category. This Nobel Laureate was honored “in recognition of the extraordinary services he has rendered by the discovery of the remarkable rays subsequently named after him.”

X rays are a common diagnostic test in which a form of energy called x ray radiation penetrates the patient’s body. In bone x rays, electrical current passes through an x-ray tube and produces a beam of ionizing radiation that passes through the bone(s) being examined. This produces a picture of the inside of the body on film. The doctor reads the developed x ray on a wall-mounted light box or on a computer monitor.

Digital x rays are a new type of exam in which conventional equipment is used to take the x-ray picture, but the image is produced via computer. In a digital x ray, the image is created on a reusable plate. After being read by a laser reader, the information is sent in digital form to a storage unit that is connected to a computer network. The radiologist reads the x ray from there. An electronic report can then be sent to the patient’s doctor. Electronic reports can also be generated with non-digital x-ray exams.

X rays can detect problems with bones that result from injury or disease caused by malfunction in the patient’s bone chemistry. Bone injuries, especially broken bones (fractures), are common and can be accurately diagnosed by evaluation of bone x rays. X rays are especially helpful in diagnosing simple and incomplete fractures, which cannot be detected during a physical examination. X rays can also be used to check for bone position and alignment in a fracture. Some bone diseases can be definitively diagnosed with bone x rays, while others require additional, more sophisticated imaging tests.

Osteoporosis, a common bone disease, can be detected in bone x rays, but other tests, such as bone densitometry, may need to be ordered to determine the extent of the disease. In some cases, a bone biopsy (microscopic analysis of a small amount of tissue) is also done. For arthritis, a common ailment, x rays of the bone are occasionally used in conjunction with blood tests. In bone tumors, bone x rays can be helpful, but they may not be definitive when used alone.

Bone x rays are taken by a technologist or radiologist and interpreted by a radiologist. They are taken in a doctor’s office, in a hospital, or in an outpatient clinic. Bone x rays generally take less than 10 minutes to complete. There is no pain or discomfort associated with the test, but some people find it difficult to remain still throughout the procedure.

During the test, the patient lies on a table. The technician taking the x ray checks the patient’s position and places the x-ray machine over the part of the body being scanned. After asking the patient to remain still, the technician steps out of the area and presses a button to take the picture.

Preparation

The patient is asked to remove clothing, jewelry, and any other metal objects from the part of the body being x rayed. If appropriate, a lead shield is placed over another part of the body to minimize exposure to the radiation that is being used.

Aftercare

The patient can immediately resume normal activities once the technician has checked that the x rays have processed well and that none need to be repeated. This takes just a few minutes.

Risks

The human body contains some natural radiation and is also exposed to radiation in the environment. There is a slight risk from exposure to radiation during bone x rays; however, the amount of radiation is small and the risk of harm is very low. If reproductive organs are to be exposed to large amounts of radiation, genetic alterations could occur in a developing fetus. Excessive or repeated doses of radiation can cause changes in other types of body tissue. No radiation remains in the body after the x ray.

KEY TERMS

Arthritis— A disease of the joints that arises from wear and tear, age, and, less often, from inflammation.

Bone densitometry— A test to measure bone density.

Ionizing radiation— Energy from radio, ultraviolet, or x rays, that produces charged particles in the recipient matter.

Osteoporosis— A disease which occurs primarily in postmenopausal women in which the amount of bone is reduced or skeletal tissue wastes away.

Normal results

Normal bones show no fractures, dislocations, or other abnormalities.

Results that indicate the presence of bone injury or disease differ in appearance, according to the nature of he injury or disease. For example, fractures show up as clear breaks in the bones, while osteoporotic bone has the same shape as normal bone on an x ray, but s less dense.

Resources

BOOKS

Dutton, Mark. Orthopaedic Examination, Evaluation, and Intervention. New York: McGraw-Hill, 2004.

Fishback, Francis Talaska, ed. A Manual of Laboratory and Diagnostic Tests. 5th ed. Philadelphia: Lippincott, 2003.

Perry, Clayton R., and John Elstrom. The Handbook of Fractures, 2nd ed. New York: McGraw-Hill, 1999.

Skinner, Harry. Current Diagnosis & Treatment in Orthopedics. New York: McGraw-Hill, 2006.

Tierney, Lawrence M., Jr., Stephen J. McPhee, Maxine A. Papadakis. “Tumors and Tumor-Like Lesions of the Bone: Current Medical Diagnosis and Treatment.” In Current Medical Diagnosis & Treatment, 36th ed. Stamford, CT: Appleton & Lange, 1996.

OTHER

RadiologyInfo. http://www.radiologyinfo.org.

ORGANIZATIONS

Radiological Society of North America, 820 Jorie Blvd., Oak Brook, IL, 60523-2251, (630) 571-2670, http://www.rsna.org.

Lori De Milto

Lee A. Shratter, M.D.

Laura Jean Cataldo, R.N., Ed.D.

Bone x rays

Definition

Bone x rays are a diagnostic imaging test in which ionizing radiation passing through the bones enables an image to be produced on film.

Purpose

Bone x rays are ordered to detect bone disease or injury, such as in the case of broken bones, tumors, and other problems. They can determine bone density, texture, erosion, and changes in bone relationships. Bone x rays also evaluate the joints for such diseases as arthritis.

Description

X rays are a common diagnostic test in which a form of energy called x-ray radiation penetrates the patient's body. In bone x rays, electrical current passes through an x-ray tube and produces a beam of ionizing radiation that passes through the bone(s) being examined. This produces a picture of the inside of the body on film. The doctor reads the developed x ray on a wall-mounted light box or on a computer monitor.

Digital x rays are a new type of exam in which conventional equipment is used to take the x-ray picture, but the image is produced via computer. In a digital x ray, the image is created on a reusable plate. After being read by a laser reader, the information is sent in digital form to a storage unit that is connected to a computer network. The radiologist reads the x ray from there. An electronic report can then be sent to the patient's doctor. Electronic reports can also be generated with non-digital x-ray exams.

X rays can detect problems with bones that result from injury or disease caused by malfunction in the patient's bone chemistry. Bone injuries, especially broken bones (fractures), are common and can be accurately diagnosed by evaluation of bone x rays. X rays are especially helpful in diagnosing simple and incomplete fractures, which cannot be detected during a physical examination . X rays can also be used to check for bone position and alignment in a fracture. Some bone diseases can be definitively diagnosed with bone x rays, while others require additional, more sophisticated imaging tests.

Osteoporosis, a common bone disease, can be detected in bone x rays, but other tests, such as bone densitometry, may need to be ordered to determine the extent of the disease. In some cases, a bone biopsy (microscopic analysis of a small amount of tissue) is also done. For arthritis, a common ailment, x rays of the bone are occasionally used in conjunction with blood tests. In bone tumors, bone x rays can be helpful, but they may not be definitive when used alone.

Bone x rays are taken by a technologist or radiologist and interpreted by a radiologist. They are taken in a doctor's office, in a hospital, or in an outpatient clinic. Bone x rays generally take less than 10 minutes to complete. There is no pain or discomfort associated with the test, but some people find it difficult to remain still throughout the procedure.

During the test, the patient lies on a table. The technician taking the x ray checks the patient's position and places the x-ray machine over the part of the body being scanned. After asking the patient to remain still, the technician steps out of the area and presses a button to take the picture.

Preparation

The patient is asked to remove clothing, jewelry, and any other metal objects from the part of the body being x rayed. If appropriate, a lead shield is placed over another part of the body to minimize exposure to the radiation that is being used.

Aftercare

The patient can immediately resume normal activities once the technician has checked that the x-rays have processed well and that none need to be repeated. This takes just a few minutes.

Risks

The human body contains some natural radiation and is also exposed to radiation in the environment. There is a slight risk from exposure to radiation during bone x rays; however, the amount of radiation is small and the risk of harm is very low. If reproductive organs are to be exposed to large amounts of radiation, genetic alterations could occur in the developing fetus. Excessive or repeated doses of radiation can cause changes in other types of body tissue. No radiation remains in the body after the x ray.

Normal results

Normal bones show no fractures, dislocations, or other abnormalities.

Results that indicate the presence of bone injury or disease differ in appearance, according to the nature of the injury or disease. For example, fractures show up as clear breaks in the bones, while osteoporotic bone has the same shape as normal bone on an x ray, but is less dense.

Resources

books

A Manual of Laboratory and Diagnostic Tests. 5th ed. Ed. Francis Fishback. Philadelphia: Lippincott, 1996.

"Tumors and Tumor-Like Lesions of the Bone." In Current Medical Diagnosis and Treatment, 1996. 35th ed. Ed. Stephen McPhee, et al. Stamford: Appleton & Lange, 1995.

Lori De Milto Lee A. Shratter, MD