X-Ray

What are X-Rays?

X-rays are very short wavelengths of electromagnetic radiation that can penetrate matter to produce an image of bones and internal organs. X-ray images are tools used by physicians and practitioners to confirm a diagnosis or a clinical finding such as extremity fracture or pneumonia.

Most x-ray examinations consist of at least two views of a body part at right angles to one another. X-ray dye or contrast mediums are used in some examinations to make certain structures, such as the kidneys or bowel, appear visible on an x-ray image. Other imaging techniques or procedures such as nuclear medicine, ultrasound, MRI, CT, or PET (position emission tomography) may be necessary to view anatomy or to determine a diagnosis.

Due to potential radiation exposure only patients are permitted in the x-ray room. Supportive partners including parents are asked to remain outside the x-ray room during filming. Patients with small children are encouraged to make prior arrangements for their supervision during the x-ray examination.

Remember to inform the technologist there is a possibility that you could be pregnant prior to any x-ray examination.

X-Ray Exam Descriptions

General X-ray

General x-ray includes evaluation of the chest, spine, skull, extremities, hips and pelvis and abdomen. General x-ray is often used to evaluate suspected fracture, or other indications of injury or abnormality.

Chest x-rays may be used to detect pneumonia, TB and enlargement of the heart. Abdominal x-rays can reveal the size and shape of abdominal structures and/or the presence of fluid or air in the abdomen. Spinal x-rays may be used to evaluate scoliosis (curvature of the spine). Extremity films may indicate fracture or locality of foreign bodies.

Esophagram (Barium Swallow)

Esophagram examinations are generally used to evaluate symptoms related to difficulty or pain while swallowing, reflux from the stomach or throat stricture. This procedure allows for examination of the esophagus (food pipe) from the throat to the stomach.

Upper GI

Upper GI examinations are generally used to evaluate the stomach for indications of peptic ulcer, hiatal hernia or stomach cancer.

Small Bowel Series

Small bowel series examination is generally used to evaluate the small bowel for symptoms of malabsorption, GI bleeding or indications of bowel obstruction.

This exam is performed after drinking 12 to 24 oz of barium liquid. This procedure may take up to several hours with images taken at different, timed intervals. The radiologist monitors the progression of the barium through the small bowel. The amount of time varies with each individual. Patients should plan for this variable length of time.

Arthogram

Arthogram examination, developed in the 1920's, used to evaluate unexplained or post traumatic joint pain, has been largely replaced by non-invasive and more accurate MRI joint / extremities. Arthograms have been commonly used to evaluate the shoulder, knee or wrist, but might also be used to evaluate the elbow or ankle.

An arthrogram examination involves the injection of x-ray contrast (dye) into a joint to improve soft tissue visualization on x-ray film. Though reactions to the contrast material are uncommon, patients may experience a tingling sensation or pressure in the joint as the contrast is injected. The exam will require patients to assume different positions as films are taken.

Hysterosalpingogram

Hysterosalpingogram allows the uterus and fallopian tubes to be visualized on x-rays. The procedure is performed to evaluate narrowing of the fallopian tubes, scarring of the uterine lining and congenitally malformed uterus as a possible cause of infertility.

For procedure, the patient is positioned as for routine pelvic exam and a speculum is inserted. A small tube is inserted (vaginally) through the cervix into the uterus. A contrast media (clear dye) is injected into the uterus. Under fluoroscopic x-ray, the uterus and fallopian tubes are illuminated and visualized as they fill with contrast. X-ray images are obtained. A cramping sensation during and after the procedure is common.

If proximal tubal occlusion (obstruction of a fallopian tube near its juncture / joining with the uterus) is confirmed by hysterosalpingogram procedure, fallopian tube recanalization* may be recommended to open blocked fallopian tubes.

X-Ray Preparations

Most x-ray examinations take only a few minutes to complete. The patient is asked to remove any jewelry and/or clothing that may interfere with imaging the area of concern. It is helpful to bring any relevant prior films with you or information (date and location) of other examinations, which might be obtained. It is best to compare old films with new ones if they are available.

General X-Ray

No special preparation is required.

Esophagram (Barium Swallow)

For examination, the patient is required to drink a barium sulfate liquid. As the radiologist observes the progress of the barium through the esophagus, fluoroscopic x-ray images are taken by the technologist.

If the stomach will also be evaluated, a patient should follow preparation for an upper GI examination. Otherwise, no preparation is required.

Upper GI

The examination requires a patient to drink 12 to 24 oz of barium liquid with an empty stomach. A small amount of effervescent granules are sometimes given with the barium. Under fluoroscopic x-ray, the radiologist monitors the progression of the barium through the esophagus, stomach and the first section of the small bowel.

How to prepare:

• Step 1: 12:00 Midnight or 8 hours before your exam, take nothing by mouth until after the exam. A good exam requires an empty stomach.
• Step 2: Two hours before your exam, do not smoke or chew gum. This stimulates saliva production, causing fluid to collect in the stomach. Plan for at least 1 hour to complete your exam.
• Step 3: After your exam, drink extra fluids and use a mild laxative or stool softener at your discretion to prevent constipation.

Small Bowel Series

This exam is performed after drinking 12 to 24 oz of barium liquid. Follow 3 steps above.

Arthogram

No preparation is usually required for arthogram examinations

After the exam:

• Patient may experience some swelling or discomfort after the test. Rest the joint for 12 hours.
• Creaking noises may be heard in the joint for a day or two.
• Apply ice to the joint for swelling and take a mild analgesic such as Tylenol, Motrin, Advil or Aleve for pain.
• Report persistent symptoms to the clinic or depHysterosalpingogramartment where the procedure was performed.
• Hysterosalpingogram can be performed 3 to 5 days after the menstrual period.
• No other preparation is required.
• Tylenol, Motrin, Aleve or other non-aspirin (ibuprofen) pain reliever are recommended to relieve post procedural cramping.