X-ray
 What Is X-ray?
General X-ray
Arthrogram
Hysterosalpingogram
What Will My X-Ray Exam Be Like and How Should I Prepare?
These specialized procedures are performed in local hospitals.
Ask your healthcare provider about scheduling these exams.
Esophagram (Barium Swallow)
Upper GI
Small Bowel Series
Colon X-ray (Barium Enema)
Kidney X-ray (IVP, Intravenous Pyelogram)
What Is X-ray?
X-rays are very short wavelengths of electromagnetic radiation
that can penetrate matter to produce an image of bones and internal
organs. Physicians and practitioners use x-ray images to confirm
a diagnosis or a clinical finding such as extremity fracture or
pneumonia.
When x-rays pass through a patient, the various parts of the body
absorb the x-ray beam in different ways. Dense tissues in the body,
such as bones, appear white, and less dense tissues, such as muscles
and organs, appear in shades of gray. X-rays that pass only through
air appear black.
X-ray dye or contrast mediums can be 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.
General X-ray
General x-ray includes evaluation of the chest, spine, skull, extremities,
hips, 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
as well as 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
Arthrogram (fluoroscopy)
Arthrography examination, developed in the 1920's, is used to evaluate
unexplained or post-traumatic joint pain. It has largely been replaced
by non-invasive and more accurate MRI imaging. Arthrograms are
commonly used to evaluate the shoulder, knee or wrist, but may
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.
No preparation is usually required for arthrogram examination.
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 department where the
procedure was performed.
Hysterosalpingogram
Hysterosalpingogram allows the uterus and fallopian tubes to
be better 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 the same 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. It is
common
to feel a cramping sensation during and after the procedure.
If proximal tubal occlusion (obstruction of a fallopian tube)
is confirmed by hysterosalpingogram procedure, fallopian
tube recanalization may be recommended to open blocked fallopian tubes.
How to prepare
- Hysterosalpingogram must be performed 3 to 5 days after the
menstrual period.
- No sexual intercourse from the first day of menstrual cycle until
after this exam.
- No other preparation is required.
- Tylenol, Motrin, Aleve or other non-aspirin (ibuprofen) pain reliever
are recommended to relieve post procedural cramping.
What Will
My X-ray Examination Be Like and How Should I Prepare?
General x-ray examinations (i.e. chest and extremity exams)
are available on a walk-in basis.
Specialty x-ray exams require a scheduled appointment.
To avoid delay or rescheduling of your x-ray examination, check-in 10
minutes prior to your scheduled appointment and follow
any preparation instructions carefully.
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 examination.
Most x-ray examinations take only a few minutes to
complete. The patient is asked to remove any jewelry
and clothing that may interfere with the x-rays. A gown will be provided as needed.
Patients should expect to be placed in various positions and to
hold still. Patient motion, positioning and body mass may affect the
diagnostic usefulness of general x-rays.
It is helpful to bring any relevant prior films or
information (date and location) of other imaging exams, which might
be obtained. It is best to compare old films with new ones if
they are available.
Patients should expect to wait a few minutes while
their films are reviewed for diagnostic quality.
The radiologist interprets (analyze) the x-rays and dictates the report.
The report is forwarded to the referring doctor or healthcare provider, who
then shares the results and treatment options with the patient.
If test results do not correlate with clinical findings or if symptoms
persist despite a negative x-ray result, examination
with other imaging techniques may be recommended.
Remember to inform the technologist prior to
the exam if there is a possibility that you could be
pregnant.
These specialized procedures are performed in local hospitals. Ask your
healthcare provider about scheduling these exams and how to prepare.
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
Also called: stomach x-ray
Upper GI examinations are generally used to evaluate the stomach for indications
of peptic ulcer, hiatal hernia or stomach cancer.
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.
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.
Colon X-ray (Barium Enema)
Barium enema is an x-ray procedure used to evaluate the colon (large intestine).
The presence of blood in stool, constipation, diarrhea, unexplained abdominal
pain, weight loss, family history of colon cancer and/or polyps are among
the reasons for this exam.
A barium enema procedure involves the introduction of barium fluid and/or
air into the colon via a rectal tube, which is inserted by a trained technologist.
Barium enables the colon to be visualized by a radiologist on a fluoroscopic
screen and on x-ray images. Sometimes air is introduced following the barium
fluid. An accurate examination depends on a clean and empty colon (free
of fecal matter). Barium enema or colon x-ray requires a two day diet preparation
and laxative medication. Patients should inform the technologist at the
time of schedule if they are pregnant or diabetic. If you are diabetic,
ask for special diet and meditative instructions.
To flush out the barium and prevent constipation, patients are encouraged
to drink extra fluids following a barium enema exam. A mild stool softener
(laxative medication) may also be recommended.
Kidney X-ray (IVP, Intravenous Pyelogram)
Kidney x-rays (IVP examinations) are performed to evaluate the kidneys,
ureters (the tubes that connect each kidney to the bladder) and bladder.
The presence of blood in urine, history of stones, pain in the back, flank
or abdomen, re-evaluation of known urinary tract disease or suspected urinary
obstruction are among the reasons for the exam.
For IVP examination, an iodinated contrast agent is injected into a vein
in the arm. The contrast agent collects in the kidneys almost immediately.
It is common to experience a warm, flushed sensation during the injection.
Before proceeding with a kidney x-ray, it is important to inform the technologist
and your physician of any previous reactions experienced during a contrast
injection. Contrast reactions and allergies to
the contrast material are rare.
X-ray images of the kidney and abdomen are taken 5 minutes after injection
and followed by a series of x-rays taken at timed intervals as the contrast
progresses through the ureter and collects in the bladder (process takes
about 30 minutes). Once the bladder is filled, patients are excused to urinate
and directed to return for images of the empty bladder.
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