RX Patient Tools
Use these quick guides before reading the article, or return to them when you need help preparing questions for a doctor.
An X-ray is a quick, painless, electromagnetic waves, invisible electromagnetic energy beam test that produces images of the structures inside your body particularly your bones to produce images of internal tissues, bones, and organs on film or digital media. X-ray beams pass through your body, and they are absorbed in different amounts depending on the density of the material they pass through.
X-rays are a type of electromagnetic radiation, just like visible light.
An x-ray machine sends individual x-ray particles through the body. The images are recorded on a computer or film.
- Structures that are dense (such as bone) will block most of the x-ray particles and will appear white.
- Metal and contrast media (special dye used to highlight areas of the body) will also appear white.
- Structures containing air will be black, and muscle, fat, and fluid will appear as shades of gray.
How the Test is Performed
The test is done in a hospital radiology department or in the health care provider’s office. How you are positioned depends on the type of x-ray being done. Several different x-ray views may be needed.
You need to stay still when you are having an x-ray. Motion can cause blurry images. You may be asked to hold your breath or not move for a second or two when the image is being taken.
The following are common types of x-rays:
- Abdominal x-ray
- Barium x-ray
- Bone x-ray
- Chest x-ray
- Dental x-ray
- Extremity x-ray
- Hand x-ray
- Joint x-ray
- Lumbosacral spine x-ray
- Neck x-ray
- Pelvis x-ray
- Sinus x-ray
- Skull x-ray
- Thoracic spine x-ray
- Upper GI and small bowel series
- X-ray of the skeleton
How to Prepare for the Test
Before the x-ray, tell your health care team if you are pregnant, may be pregnant, or if you have an IUD inserted.
You will need to remove all jewelry. Metal can cause unclear images. You may need to wear a hospital gown.
How the Test will Feel
X-rays are painless. Some body positions needed during an x-ray may be uncomfortable for a short time.
Risks
X-rays are monitored and regulated so you get the minimum amount of radiation exposure needed to produce the image.
For most x-rays, the risk of cancer or defects is very low. Most experts feel that the benefits of appropriate x-ray imaging greatly outweigh any risks.
Young children and babies in the womb are more sensitive to the risks of x-rays. Tell your provider if you think you might be pregnant.
Abdominal x-ray
Abdominal film; X-ray – abdomen; Flat plate; KUB x-rayAn abdominal x-ray is an imaging test to look at organs and structures in the abdomen. Organs include the spleen, stomach, and intestines.
When the test is done to look at the bladder and kidney structures, it is called a KUB (kidneys, ureters, bladder) x-ray.
How the Test is Performed
The test is done in a hospital radiology department. Or it may done in the health care provider’s office by an x-ray technologist.
You lie on your back on the x-ray table. The x-ray machine is positioned over your abdominal area. You hold your breath as the picture is taken so that the picture will not be blurry. You may be asked to change position to the side or to stand up for additional pictures.
Men will have a lead shield placed over the testes to protect against the radiation.
How to Prepare for the Test
Before having the x-ray, tell the provider the following:
- If you are pregnant or think you could be pregnant
- Have an IUD inserted
- Have had a barium contrast x-ray in the last 4 days
- If you have taken any medicines such as Pepto Bismol in the last 4 days (this type of medicine can interfere with the x-ray)
You wear a hospital gown during the x-ray procedure. You must remove all jewelry.
How the Test will Feel
There is no discomfort. The x-rays are taken as you lie on your back, side, and while standing.
Why the Test is Performed
Your provider may order this test to:
- Diagnose a pain in the abdomen or unexplained nausea
- Identify suspected problems in the urinary system, such as a kidney stone
- Identify blockage in the intestine
- Locate an object that has been swallowed
- Help diagnose diseases, such as tumors or other conditions
Normal Results
The x-ray will show normal structures for a person your age.
What Abnormal Results Mean
Abnormal findings include:
- Abdominal masses
- Buildup of fluid in the abdomen
- Certain types of gallstones
- Foreign object in the intestines
- Hole in the stomach or intestines
- Injury to the abdominal tissue
- Intestinal blockage
- Kidney stones
Risks
There is low radiation exposure. X-rays are monitored and regulated to provide the minimum amount of radiation exposure needed to produce the image. Most experts feel that the risk is low compared to the benefits.
Pregnant women and children are more sensitive to the risks of the x-ray. Women should tell their provider if they are, or may be, pregnant.
Bone x-ray
X-ray – bone
A bone x-ray is an imaging test to look at the bones.
How the Test is Performed
The test is done in a hospital radiology department or in the health care provider’s office by an x-ray technician. For the test, you will position the bone to be x-rayed on the table. Pictures are then taken, and the bone is repositioned for different views.
How to Prepare for the Test
Tell the health care provider if you are pregnant. You must remove all jewelry for the x-ray.
How the Test will Feel
The x-rays are painless. Changing position for getting different views of the bone may be uncomfortable.
Why the Test is Performed
A bone x-ray is used to look for injuries or conditions affecting the bone.
What Abnormal Results Mean
Abnormal findings include:
- Fractures or broken bone
- Bone tumors
- Degenerative bone conditions
- Osteomyelitis (inflammation of the bone caused by an infection)
Additional conditions under which the test may be performed:
- Cystic fibrosis
- Multiple endocrine neoplasia (MEN) II
- Multiple myeloma
- Osgood-Schlatter disease
- Osteogenesis imperfecta
- Osteomalacia
- Paget’s disease
- Primary hyperparathyroidism
- Rickets
Risks
There is low radiation exposure. X-ray machines are set to provide the smallest amount of radiation exposure needed to produce the image. Most experts feel that the risk is low compared with the benefits.
Children and the fetuses of pregnant women are more sensitive to the risks of the x-ray. A protective shield may be worn over areas not being scanned.
Chest x-ray
Chest radiography; Serial chest x-ray; X-ray – chest
A chest x-ray is an x-ray of the chest, lungs, heart, large arteries, ribs, and diaphragm.
How the Test is Performed
You stand in front of the x-ray machine. You will be told to hold your breath when the x-ray is taken.
Two images are usually taken. You will first need to stand facing the machine, and then sideways.
How to Prepare for the Test
Tell the health care provider if you are pregnant. Chest x-rays are generally not done during the first 6 months of pregnancy.
How the Test will Feel
There is no discomfort. The film plate may feel cold.
Why the Test is Performed
Your doctor may order a chest x-ray if you have any of the following symptoms:
- A persistent cough
- Chest pain from a chest injury (with a possible rib fracture or lung complication) or from heart problems
- Coughing up blood
- Difficulty breathing
- Fever
It may also be done if you have signs of tuberculosis , lung cancer , or other chest or lung diseases .
A serial chest x-ray is one that is repeated. It may be done to monitor changes found on a past chest x-ray.
What Abnormal Results Mean
Abnormal results may be due to many things, including:
In the lungs:
- Collapsed lung
- Collection of fluid around the lung
- Lung tumor (noncancerous or cancerous)
- Malformation of the blood vessels
- Pneumonia
- Scarring of lung tissue
- Tuberculosis
In the heart:
- Problems with the size or shape of the heart
- Problems with the position and shape of the large arteries
- Evidence of heart failure
In the bones:
- Fractures or other problems of the ribs and spine
- Osteoporosis
Risks
There is low radiation exposure. X-rays are monitored and regulated to provide the minimum amount of radiation exposure needed to produce the image. Most experts feel that the benefits outweigh the risks. Pregnant women and children are more sensitive to the risks of x-rays.
Hand x-ray
X-ray – hand
This test is an x-ray of one or both hands.
How the Test is Performed
A hand x-ray is taken in a hospital radiology department or your health care provider’s office by an x-ray technician. You will be asked to place your hand on the x-ray table, and keep it very still as the picture is being taken. You may need to change the position of your hand, so more images can be taken.
How to Prepare for the Test
Tell the provider if you are pregnant or think you may be pregnant. Remove all jewelry from your hand and wrist.
How the Test will Feel
Generally, there is little or no discomfort associated with x-rays.
Why the Test is Performed
Hand x-ray is used to detect fractures , tumors, foreign objects, or degenerative conditions of the hand. Hand x-rays may also be done to find out a child’s “bone age.” This can help determine if a health problem is preventing the child from growing properly or how much growth is left.
What Abnormal Results Mean
Abnormal results may include:
- Fractures
- Bone tumors
- Degenerative bone conditions
- Osteomyelitis (inflammation of the bone caused by an infection)
Risks
There is low radiation exposure. X-rays are monitored and regulated to provide the minimum amount of radiation exposure needed to produce the image. Most experts feel that the risk is low compared with the benefits. Pregnant women and children are more sensitive to the risks of x-rays.
Skull x-ray
X-ray – head; X-ray – skull; Skull radiography; Head x-ray
A skull x-ray is a picture of the bones surrounding the brain, including the facial bones, the nose, and the sinuses.
How the Test is Performed
You lie on the x-ray table or sit in a chair. Your head may be placed in different positions.
How to Prepare for the Test
Tell the health care provider if you are pregnant or think you are pregnant. Remove all jewelry.
How the Test will Feel
There is little or no discomfort during an x-ray. If there is a head injury , positioning the head may be uncomfortable.
Why the Test is Performed
Your doctor may order this x-ray if you have injured your skull. You may also have this x-ray if you have symptoms or signs of a structural problem inside the skull, such as a tumor or bleeding.
A skull x-ray is also used to evaluate an unusually shaped child’s head.
Other conditions for which the test may be performed include:
- Teeth are not aligned properly ( malocclusion of teeth )
- Infection of the mastoid bone ( mastoiditis )
- Occupational hearing loss
- Middle ear infection ( otitis media )
- Abnormal bone growth in the middle ear that causes hearing loss ( otosclerosis )
- Pituitary tumor
- Sinus infection ( sinusitis )
Sometimes skull x-rays are used to screen for foreign bodies that may interfere with other tests, such as an MRI scan .
A CT scan of the head is usually preferred to a skull x-ray to evaluate most head injuries or brain disorders. Skull x-rays are rarely used as the main test to diagnose such conditions.
What Abnormal Results Mean
Abnormal results may be due to:
- Fracture
- Tumor
- Breakdown ( erosion ) or calcium loss of the bone
- Movement of the soft tissues inside the skull
A skull x-ray may detect increased intracranial pressure and unusual skull structures that are present at birth (congenital).
Risks
There is low radiation exposure. X-rays are monitored and regulated to provide the minimum amount of radiation exposure needed to produce the image. Most experts feel that the risk is low compared with the benefits. Pregnant women and children are more sensitive to the risks associated with x-rays.
Joint x-ray
X-ray – joint; Arthrography; Arthrogram
This test is an x-ray of a knee, shoulder, hip, wrist, ankle, or other joint.
How the Test is Performed
The test is done in a hospital radiology department or in the health care provider’s office. The x-ray technologist will help you position the joint to be x-rayed on the table. Once in place, pictures are taken. The joint may be moved into other positions for more images.
How to Prepare for the Test
Tell the health care provider if you are pregnant. Remove all jewelry before the x-ray.
How the Test will Feel
The x-ray is painless. It may be uncomfortable to move the joint into different positions.
Why the Test is Performed
The x-ray is used to detect fractures , tumors, or degenerative conditions of the joint.
What Abnormal Results Mean
The x-ray may show:
- Arthritis
- Fractures
- Bone tumors
- Degenerative bone conditions
- Osteomyelitis (inflammation of the bone caused by an infection)
The test may also be performed to find out more about the following conditions:
- Acute gouty arthritis (gout)
- Adult-Onset Still’s disease
- Caplan syndrome
- Chondromalacia patellae
- Chronic gouty arthritis
- Congenital dislocation of the hip
- Fungal arthritis
- Non-gonococcal (septic) bacterial arthritis
- Osteoarthritis
- Pseudogout
- Psoriatic arthritis
- Reiter syndrome
- Rheumatoid arthritis
- Runner’s knee
- Tuberculous arthritis
Risks
There is low radiation exposure. X-ray machines are set to provide the smallest amount of radiation exposure needed to produce the image. Most experts feel that the risk is low compared with the benefits. Children and the fetuses of pregnant women are more sensitive to the risks of the x-ray. A protective shield may be worn over areas not being scanned.
Lumbosacral spine x-ray
X-ray – lumbosacral spine; X-ray – lower spine
A lumbosacral spine x-ray is a picture of the small bones (vertebrae) in the lower part of the spine. This area includes the lumbar region and the sacrum, the area that connects the spine to the pelvis.
How the Test is Performed
The test is done in a hospital x-ray department or your health care provider’s office by an x-ray technician. You will be asked to lie on the x-ray table in different positions. If the x-ray is being done to diagnose an injury, care will be taken to prevent further injury.
The x-ray machine will be placed over the lower part of your spine. You will be asked to hold your breath as the picture is taken so that the image will not be blurry. Usually, 3 to 5 pictures are taken.
How to Prepare for the Test
Tell the provider if you are pregnant. Take off all jewelry.
How the Test will Feel
There is rarely any discomfort when having an x-ray, although the table may be cold.
Why the Test is Performed
Often, a provider will treat a person with low back pain for 4 to 8 weeks before ordering an x-ray.
The most common reason for lumbosacral spine x-ray is to look for the cause of low back pain that:
- Occurs after injury
- Is severe
- Does not go away after 4 to 8 weeks
- Is present in an older person
What Abnormal Results Mean
Lumbosacral spine x-rays may show:
- Abnormal curves of the spine
- Abnormal wear on the cartilage and bones of the lower spine, such as bone spurs and narrowing of the joints between the vertebrae
- Cancer (although cancer often cannot be seen on this type of x-ray)
- Fractures
- Signs of thinning bones ( osteoporosis )
- Spondylolisthesis , in which a bone (vertebra) in the lower part of the spine slips out of the proper position onto the bone below it
Though some of these findings may be seen on an x-ray, they are not always the cause of back pain.
Many problems in the spine cannot be diagnosed using a lumbosacral x-ray, including:
- Sciatica
- Slipped or herniated disc
- Spinal stenosis – narrowing of the spinal column
Risks
There is low radiation exposure. X-ray machines are checked often to make sure they are as safe as possible. Most experts feel that the risk is low compared with the benefits.
Pregnant women should not be exposed to radiation, if at all possible. Care should be taken before children receive x-rays.
Considerations
There are some back problems that an x-ray will not find. That is because they involve the muscles, nerves, and other soft tissues. A lumbosacral spine CT or lumbosacral spine MRI are better options for soft tissue problems.
Neck x-ray
X-ray – neck; Cervical spine x-ray; Lateral neck x-ray
A neck x-ray is an imaging test to look at cervical vertebrae. These are the 7 bones of the spine in the neck.
How the Test is Performed
This test is done in a hospital radiology department. It may also be done in the health care provider’s office by an x-ray technologist.
You will lie on the x-ray table.
You will be asked to change positions so that more images can be taken. Usually 2, or up to 7 different images may be needed.
How to Prepare for the Test
Tell the health care provider if you are or think you may be pregnant. Remove all jewelry.
How the Test will Feel
When the x-rays are taken, there is no discomfort. If the x-rays are done to check for injury, there may be discomfort as your neck is being positioned. Care will be taken to prevent further injury.
Why the Test is Performed
The x-ray is used to evaluate neck injuries and numbness, pain, or weakness that does not go away. A neck x-ray can also be used to help see if air passages are blocked by swelling in the neck or something stuck in the airway.
Other tests, such as MRI , may be used to look for disk or nerve problems.
What Abnormal Results Mean
A neck x-ray can detect:
- Bone joint that is out of position (dislocation)
- Breathing in a foreign object
- Broken bone (fracture)
- Disk problems (disks are the cushion-like tissue that separate the vertebrae)
- Extra bone growths (bone spurs) on the neck bones (for example, due to osteoarthritis)
- Infection that causes swelling of the vocal cords (croup)
- Inflammation of the tissue that covers the windpipe (epiglottitis)
- Problem with the curve of the upper spine, such as kyphosis
- Thinning of the bone ( osteoporosis )
- Wearing away of the neck vertebrae or cartilage
Risks
There is low radiation exposure. X-rays are monitored so that the lowest amount of radiation is used to produce the image.
Pregnant women and children are more sensitive to the risks of x-rays.
Pelvis x-ray
X-ray – pelvis
A pelvis x-ray is a picture of the bones around both the hips. The pelvis connects the legs to the body.
How the Test is Performed
The test is done in a radiology department or in the health care provider’s office by an x-ray technician.
You will lie down on the table. The pictures are then taken. You will change your body to other positions to provide different views.
How to Prepare for the Test
Tell the provider if you are pregnant. Remove all jewelry. You will wear a hospital gown.
How the Test will Feel
The x-rays are painless. Changing position may cause discomfort.
Why the Test is Performed
The x-ray is used to look for:
- Fractures
- Tumors
- Degenerative conditions of bones in the hips, pelvis, and upper legs
What Abnormal Results Mean
Abnormal results may suggest:
- Pelvic fractures
- Arthritis of the hip joint
- Tumors of the bones of the pelvis
- Sacroiliitis (inflammation of the area where the sacrum joins the ilium bone)
- Ankylosing spondylitis (abnormal stiffness of the spine and joint)
Risks
Children and the fetuses of pregnant women are more sensitive to the risks of the x-ray. A protective shield may be worn over areas not being scanned.
Sinus x-ray
Paranasal sinus radiography; X-ray – sinuses
A sinus x-ray is an imaging test to look at the sinuses. These are the air-filled spaces in the front of the skull.
How the Test is Performed
A sinus x-ray is taken in a hospital radiology department. Or the x-ray may be taken in the health care provider’s office. You are asked to sit in a chair so that any fluid in the sinuses can be seen in the x-ray images. The technologist may place your head in different positions as the images are taken.
How to Prepare for the Test
Tell your doctor if you are or think you are pregnant. You will be asked to remove all jewelry.
How the Test will Feel
There is little or no discomfort with a sinus x-ray.
Why the Test is Performed
The sinuses are located behind the forehead, nasal bones, cheeks, and eyes. When the sinus openings become blocked or too much mucus builds up, bacteria and other germs can grow. This can lead to an infection and inflammation of the sinuses called sinusitis .
A sinus x-ray is ordered when you have any of the following:
- Symptoms of sinusitis
- Other sinus disorders, such as a deviated septum (crooked or bent septum, the structure that separates the nostrils)
- Symptoms of another infection of that area of the head
These days, a sinus x-ray is not often ordered. This is because a CT scan of the sinuses shows more detail.
What Abnormal Results Mean
The x-ray may detect an infection, blockages, bleeding or tumors.
Risks
There is low radiation exposure. X-rays are monitored and regulated so that the lowest amount of radiation is used to produce the image.
Pregnant women and children are more sensitive to the risks of x-rays.
X-ray – skeleton
Skeletal survey
A skeletal x-ray is an imaging test used to look at the bones. It is used to detect fractures , tumors, or conditions that cause wearing away (degeneration) of the bone.
How the Test is Performed
The test is done in a hospital radiology department or in the health care provider’s office by an x-ray technologist.
You will lie on a table or stand in front of the x-ray machine, depending on the bone that is injured. You may be asked to change position so that different x-ray views can be taken.
The x-ray particles pass through the body. A computer or special film records the images.
Structures that are dense (such as bone) will block most of the x-ray particles. These areas will appear white. Metal and contrast media (special dye used to highlight areas of the body) will also appear white. Structures containing air will be black. Muscle, fat, and fluid will appear as shades of gray.
How to Prepare for the Test
Tell the health care provider if you are pregnant. You must remove all jewelry before the x-ray.
How the Test will Feel
The x-rays are painless. Changing positions and moving the injured area for different x-ray views may be uncomfortable. If the whole skeleton is being imaged, the test usually takes 1 hour or more.
Why the Test is Performed
This test is used to look for:
- Fractures or broken bone
- Cancer that has spread to other areas of the body
- Osteomyelitis (inflammation of the bone caused by an infection)
- Bone damage due to trauma (such as an auto accident) or degenerative conditions
- Abnormalities in the soft tissue around the bone
What Abnormal Results Mean
Abnormal findings include:
- Fractures
- Bone tumors
- Degenerative bone conditions
- Osteomyelitis
Risks
There is low radiation exposure. X-rays machines are set to provide the smallest amount of radiation exposure needed to produce the image. Most experts feel that the risk is low compared with the benefits.
Children and the fetuses of pregnant women are more sensitive to the risks of the x-ray. A protective shield may be worn over areas not being scanned.
Thoracic spine x-ray
Vertebral radiography; X-ray – spine; Thoracic x-ray; Spine x-ray; Thoracic spine films; Back films
A thoracic spine x-ray is an x-ray of the twelve chest (thoracic) bones (vertebrae). The vertebrae are separated by flat pads of cartilage called disks that provide a cushion between the bones.
How the Test is Performed
The test is done in a hospital radiology department or in the health care provider’s office. You will lie on the x-ray table in different positions. If the x-ray is checking for an injury, care will be taken to prevent further injury.
The x-ray machine will be moved over the thoracic area of the spine. You will hold your breath as the picture is taken, so that the picture will not be blurry. Usually 2 or 3 x-ray views are needed.
How to Prepare for the Test
Tell the provider if you are pregnant. Remove all jewelry.
How the Test will Feel
The test causes no discomfort. The table may be cold.
Why the Test is Performed
The x-ray helps evaluate:
- Bone injuries
- Cartilage loss
- Diseases of the bone
- Tumors of the bone
What Abnormal Results Mean
The test can detect:
- Bone spurs
- Deformities of the spine
- Disk narrowing
- Dislocations
- Fractures
- Thinning of the bone ( osteoporosis )
- Wearing away (degeneration) of the vertebrae
Risks
There is low radiation exposure. X-rays are monitored and regulated to provide the minimum amount of radiation exposure needed to produce the image. Most experts feel that the risk is low compared with the benefits.
Pregnant women and children are more sensitive to the risks of x-rays.
Considerations
The x-ray will not detect problems in the muscles, nerves, and other soft tissues, because these problems cannot be seen well on an x-ray.
Dental x-rays
X-ray – teeth; Radiograph – dental; Bitewings; Periapical film; Panoramic film; Digital image
Dental x-rays are a type of image of the teeth and mouth. X-rays are a form of high energy electromagnetic radiation. The x-rays penetrate the body to form an image on film.
Structures that are dense (such as silver fillings or metal restoration) will block most of the light energy from the x-ray. They will appear white on developed film. Structures that contain air will be black on the film. Teeth, tissue, and fluid will appear as shades of gray.
How the Test is Performed
The test is performed in the dentist’s office. There are many types of dental x-rays. Some of them are:
- Bitewing. Shows the crown portions of the top and bottom teeth together when the person bites on a paper tab.
- Periapical. Shows 1 or 2 complete teeth from crown to root.
- Palatal (also called occlusal ). Captures all the upper or lower teeth in one shot while the film rests on the biting surface of the teeth.
- Panoramic. Requires a special machine that rotates around the head. The x-ray captures all of the jaws and teeth in one shot. It is used to plan treatment for dental implants, check for impacted wisdom teeth, and detect jaw problems. A panoramic x-ray is not the best method for detecting cavities, unless the decay is very advanced and deep.
Many dentists are also taking x-rays using digital technology. These images runs through a computer. The amount of radiation given off during the procedure is less than traditional methods. Other types of dental x-rays can create a 3-D picture of the jaw. Cone beam computerized tomography (CBCT) may be used before dental surgery, especially when many implants are being placed.
How to Prepare for the Test
There is no special preparation. A lead apron may be placed over your body. Tell your dentist if you might be pregnant.
How the Test will Feel
The x-ray itself causes no discomfort. Biting on the piece of film makes some people gag. Slow, deep breathing through the nose usually relieves this feeling.
Why the Test is Performed
Dental x-rays help diagnose disease and injury of the teeth and gums.
Normal Results
Normal x-rays show a normal number, structure, and position of the teeth and jaw bones. There are no cavities or other problems.
What Abnormal Results Mean
Dental x-rays may be used to identify the following:
- The number, size, and position of teeth
- Unemerged or impacted teeth
- The presence and extent of tooth decay (called cavities, or dental caries)
- Bone damage (such as from gum disease called periodontitis )
- Abscessed teeth
- Fractured jaw
- Problems in the way the upper and lower teeth fit togethher ( malocclusion )
- Other abnormalities of the teeth and jaw bones
Risks
There is very low radiation exposure from dental x-rays. However, no one should receive more radiation than necessary. A lead apron can be used to cover the body and reduce radiation exposure. Pregnant women should not have x-rays taken unless absolutely necessary.
Considerations
Dental x-rays can reveal dental cavities before they are visible, even to the dentist. Many dentists will take yearly bitewings to look for early development of cavities.
