X-ray diagnostics is an imaging technique used to diagnose diseases. Various imaging methods are employed in this process. X-rays can visualize bones, tendons, muscles, blood vessels, and internal organs. Conrad Röntgen discovered it in 1895. Since then, it has continued to evolve. Today, it is commonly used in nearly all areas of medicine.
X-rays can penetrate matter. This property makes them useful for producing images. Just like light, X-rays can darken photographic material (this effect was what led to their discovery). However, they also cause changes in living organisms. This undesirable effect makes radiation protection necessary.
The affected body part must be uncovered. The patient must also not wear any metal objects on their body, as they cause artifacts on the X-ray image.
A lead apron protects radiation-sensitive organs; a member of the practice staff will help the patient put it on.
In a separate room, the staff member takes an image, which takes only a fraction of a second. The exam is completely painless.
The patient must not move during the procedure. The staff member often takes several images from different angles. Afterward, the specialist (usually a radiologist) carefully examines the images and looks for any abnormal areas.
An X-ray examination is a type of imaging procedure that uses X-rays to create an image of a specific area of the body @ Gorodenkoff /AdobeStock
A radiologist specializes in diagnostic imaging. In addition to their general medical training, they have completed several years of specialized training.
They examine patients referred to them by primary care physicians and other specialists. Their practice is equipped with state-of-the-art MRI and X-ray technology.
Radiology practices also conduct screening programs, such as regular breast cancer screening (mammography). If hospitalized patients require an X-ray examination, it is performed in the hospital’s radiology department.
Mammography is a specialized X-ray examination of the breast @ RFBSIP /AdobeStock
Electromagnetic waves pass through the body during X-ray imaging. This allows the rays to strike the X-ray film.
As the radiation passes through matter, it loses energy. This allows structures to be depicted in shades ranging from black to white, depending on their composition.
Bones have the highest density of all body tissues and therefore attenuate the radiation the most. They appear as white structures on the image.
Transparent, soft tissues as well as air-filled organs such as the lungs and stomach appear nearly black and are difficult to distinguish. This is where X-ray examinations using contrast agents come into play.
The following techniques are used:
X-rays are the most common conventional diagnostic technique. They show dense structures as bright and less dense structures, such as fatty tissue, as dark.
Fluoroscopy is used in examinations that show movement. It is commonly used in examinations of the esophagus and the gastrointestinal tract.
Angiography is also one of these diagnostic methods. It is also used for treatment, such as to widen a narrowed blood vessel.
Angiography refers to the visualization of blood vessels using imaging techniques @ utah51 /AdobeStock
Computed tomography is a cross-sectional imaging technique. To produce cross-sectional images free of overlap, experts take a large number of individual images.
Digital volume tomography (DVT) and tomosynthesis mammography are also cross-sectional imaging techniques that are increasingly used today. DVT is particularly common in dental diagnostics.
Digital X-ray differs from analog X-ray in both image generation and display. Traditional analog technology poses health risks to staff due to the chemicals required for film development.
As a result, traditional X-ray archives take up a great deal of space. Digital technology allows images to be stored on much smaller media and is more environmentally friendly. A computer is required to view the images. The workflow in the practice can proceed without interruption.
The key advantage of digital X-rays is that radiation exposure for the patient is lower. Digital X-ray systems build upon existing X-ray equipment.
In addition, an X-ray detector or a CR reader is used. This keeps the investment costs manageable for the dentist.
X-ray technology has revolutionized medicine. The range of applications for X-ray examinations is very broad. Nevertheless, patients are exposed to radiation.
X-ray diagnostics should therefore only be used when the therapeutic benefit justifies the radiation risk.
X-ray examinations are used in the following cases:
The hand consists of many bones connected to one another by joints @ Mathias Weil /AdobeStockMany conditions can only be definitively diagnosed through X-rays. In cases of accidents (bone fractures) or suspected cancer, X-rays are essential.
In some procedures, doctors inject a water-soluble contrast agent into the bloodstream. Patients should drink plenty of fluids after an exam involving contrast agents so that the body can flush it out.
Risks arise from radiation exposure and from the contrast agent. The contrast agent rarely causes allergic reactions. Today’s X-ray technology uses a lower radiation dose than it did 10 years ago. As a result, the radiation exposure for patients is low.
Nevertheless, pregnant women should only undergo X-rays in exceptional cases and with special protective measures. This is because the unborn child is particularly vulnerable to damage from X-ray radiation. The examining physicians are required to ask patients whether they are pregnant.
X-ray examinations are harmful to everyone. The extent of the harm always depends on the dose. The insidious nature of radiation exposure lies in the fact that it does not cause any acute side effects. Damage caused by radiation often does not become apparent until years or decades later.
Since 2007, the number of CT scans has risen by 40%. This has increased the average radiation exposure of German citizens. The average effective radiation dose per resident from medical examinations was approximately 1.6 millisieverts (mSv) in 2015.
For all other X-ray procedures, however, the average per-capita radiation dose has decreased noticeably. Because the technology is so easy to use, many physicians tend to order X-rays more frequently than necessary. Patients should be as critical as possible when considering X-ray examinations.
It should also be noted that critically ill patients often undergo radiological examinations. However, the risk of death is higher due to the cancer itself than from the long-term effects of radiation exposure.
