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Bone X Rays

 
Medical Encyclopedia: 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.

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 x ray. 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 which 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 ammount 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. In bone tumors, bone x rays are helpful but they may not be definitive.

Bone x rays are performed by a technician or radiologist, 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 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 technician 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.

— Lori De Milto



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Surgery Encyclopedia: 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

 
Medical Test: Bone X-rays
Top

General information

Where It's DoneWho Does ItHow Long It TakesDiscomfort/Pain
Hospital, doctor's office, or commercial X-ray facility.Radiologist or X-ray technician.5-10 minutes.You may have to assume uncomfortable positions, such as flexing and extending your neck for skull X-rays.

Results Ready WhenSpecial EquipmentRisks/ComplicationsAverage Cost
Immediately.X-ray machine (portable or stationary).Risks associated with exposure to radiation, particularly during pregnancy.$-$$

Other names

Plain X-rays of bones, scoliosis series (if spine curvature is evaluated), and skeletal survey.

Purpose
  • To detect bone fractures.
  • To detect bone cancer and cancer metastases to the bone.
  • To diagnose infectious diseases of the bones.
  • To diagnose different types of arthritis.
  • To determine bone age in children.
  • To evaluate intervertebral disc spaces in the lower spine.
  • To evaluate abnormal curvature of the spine or other deformities.
  • To detect congenital skull deformities.
  • To detect injuries in a battered child.
How it works

X-rays (electromagnetic energy emitted by an X-ray tube) are absorbed by the body tissue. When the tissue is exposed to special photographic film, various types of tissue show up as shadows, as dark gray areas, or as white opaque areas.

Preparation
  • You remove all clothing and jewelry and don a hospital gown.
  • For skull X-rays, you will have to remove hairpins, glass eyes, contact lenses, glasses, and dentures.
Test procedure
  • The technician places you against the X-ray machine in a position dependent on which bones are to be examined. For example, for an X-ray of the upper spine in the absence of injury, you will stand with your side to the X-ray machine while dropping your shoulders as much as possible. You may have to hold heavy weights in your arms to help you lower the shoulders.
  • You must remain perfectly still during the X-ray picture, which takes only a few seconds.
  • The X-ray picture may be taken from different angles or of different parts of your skeleton. The number of views depends on the purpose of the test. A single X-ray is sufficient to determine bone age.
After the test
  • You get dressed and are free to leave.
  • The film is processed in a developing machine and X-ray pictures are produced.
Factors affecting results
  • Metal jewelry.
  • Movement during the test.
Interpretation
  • The X-ray films are analyzed for abnormalities. In arthritis, the loss of cartilage produces a narrowed space between bones. The pattern of joint space narrowing can help distinguish among types of arthritis. Bone spurs and erosions (characteristic indentations of the bone) also help diagnose arthritis.
  • Infectious diseases, such as osteomyelitis and septic arthritis, produce bone changes that appear on X-rays within several weeks, but a bone scan is a better test for picking up early signs of bone and joint infection.
  • The age of the bones, which can be determined by comparing an X-ray of the hand and wrist with a standard X-ray from a child of the same age and gender, helps assess the physical development of the child. A bone that is too mature for a child's age may signal precocious puberty, while immature bones may be due to delayed development. The doctor can also assess the mineral content of the child's bones and scars resulting from interrupted growth that may have been caused by past illnesses or other mishaps.
Advantages
  • It's simple, quick, and noninvasive.
  • It's also inexpensive and widely available.
Disadvantages
  • It involves exposure to radiation (although minimal).
  • It's less sensitive than a bone scan in detecting bone destruction.
 
 

 

Copyrights:

Medical Encyclopedia. © 2006 through a partnership of Answers Corporation. All rights reserved.  Read more
Surgery Encyclopedia. Gale Encyclopedia of Surgery. Copyright © 2005 by The Gale Group, Inc. All rights reserved.  Read more
Medical Test. The Patient's Guide to Medical Tests by Faculty Members at The Yale University of Medicine and G.S. Sharpe Communications, Inc. Copyright © 1997 by Yale University of Medicine and G.S. Sharpe Communications, Inc. Published by Houghton Mifflin Company. All rights reserved.  Read more