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Tests and Procedures

X-rays of the Extremities

What are X-rays of the extremities?

X-rays use invisible electromagnetic energy beams to make images of internal tissues, bones, and organs. Standard X-rays are done for many reasons, including diagnosing tumors or bone injuries.

X-rays are made by using external radiation to produce images of the body, its organs, and other internal structures for diagnostic purposes. X-rays pass through body structures onto specially-treated plates (similar to camera film). It makes a "negative" type picture is made (the more solid a structure is, the whiter it appears on the film). Instead of film, X-rays may also be made by using computers and digital media.

When the body undergoes X-rays, different parts of the body allow varying amounts of the X-ray beams to pass through. Images are produced in degrees of light and dark, depending on the amount of X-rays that penetrate the tissues. The soft tissues in the body (such as blood, skin, fat, and muscle) allow most of the X-ray to pass through and appear dark gray on the film. A bone or a tumor, which is denser than the soft tissues, allows few of the X-rays to pass through and appears white on the X-ray. At a break in a bone, the X-ray beam passes through the broken area and appears as a dark line in the white bone.

X-rays of the arms and legs are often used as the first step in diagnosing injuries. X-rays may also be used to check for other problems in the bones and/or soft tissues.

Why might I need an extremity X-ray?

X-rays of the arm, leg, hand, foot, ankle, shoulder, knee, hip or hand may be done to assess the bones for injuries. This includes fractures or broken bones. X-rays can also show evidence of other injuries or conditions, such as infection, arthritis, tendinitis, bone spurs, tumors, or birth defects. X-rays may also be used to see bone growth and development in children.

X-rays of joints may be done to check for damage to soft tissues, such as cartilage, muscle, tendons, or ligaments. Joint X-rays may also help check for fluid in the joint, and other abnormalities of the joint such as bone spurs, narrowing of the joint, and changes in the structure of the joint.

There may be other reasons for your doctor to recommend an X-ray of the arms and legs.

What are the risks of an extremity X-ray?

You may want to ask your doctor about the amount of radiation used during the procedure and the risks related to your particular situation. It is a good idea to keep a record of your radiation exposure, such as previous scans and other types of X-rays, so that you can inform your doctor. Risks associated with radiation exposure may be related to the cumulative number of X-ray exams and/or treatments over a long period.

If you are pregnant or think you might be, tell your doctor. Radiation exposure during pregnancy may lead to birth defects. If it is necessary for you to have an X-ray of the extremities, special precautions will be made to minimize the radiation exposure to the fetus.

There may be other risks depending on your specific medical condition. Be sure to discuss any concerns with your doctor prior to the procedure.

How do I get ready for an extremity X-ray?

  • Your doctor will explain the procedure to you and ask if you have questions.
  • Generally, no prior preparation, such as fasting or sedation, is required.
  • Tell the radiologic technologist if you are pregnant or think you might be.
  • Tell the radiologic technologist if you have had a recent barium X-ray procedure, as this may interfere with obtaining an optimal X-ray exposure of the lower back area during a hip X-ray.
  • Based on your medical condition, your doctor may request other specific preparation.

What happens during an X-ray of an extremity?

An X-ray may be done on an outpatient basis or as part of your stay in a hospital. Procedures may vary depending on your condition and your doctor's practices.

Generally, an X-ray procedure of the extremities follows this process:

  1. You will be asked to remove any clothing, jewelry, hairpins, eyeglasses, hearing aids, or other metal objects that might interfere with the procedure.
  2. If you are asked to remove clothing, you will be given a gown to wear.
  3. The type of procedure being performed will dictate your positioning, such as lying on a table, sitting, or standing, and the type of X-ray equipment used. You will be positioned on an X-ray table that carefully places the part of the body that is to be X-rayed between the X-ray machine and a cassette containing the X-ray film or digital media. Exams in the sitting or standing position are done in a similar manner, with the body part being examined placed between the X-ray machine and the X-ray film or digital media.
  4. Body parts not being imaged may be covered with a lead apron (shield) to avoid exposure to the X-rays.
  5. The radiologic technologist will ask you to hold the extremity still in a certain position for a few moments while the X-ray exposure is made.
  6. If the X-ray is being done to determine an injury, special care will be taken to prevent further injury. For example, a splint or brace may be applied to the leg or arm if a fracture is suspected.
  7. Some X-ray studies may require several different positions of the extremity. It is extremely important to remain completely still while the exposure is made, as any movement may distort the image and even require another X-ray to be done to obtain a clear image of the body part in question.
  8. The X-ray beam will be focused on the area to be photographed.
  9. The radiologic technologist will step behind a protective window while the image is taken.

While the X-ray procedure itself causes no pain, moving a potentially injured body part may cause some discomfort or pain. The radiologic technologist will use all possible comfort measures and complete the procedure as quickly as possible to minimize any discomfort or pain.

What happens after an extremity X-ray?

Generally, there is no special type of care after X-rays. However, your doctor may give you other instructions after the procedure, depending on your particular situation.

Next steps

Before you agree to the test or the procedure make sure you know:
  • The name of the test or procedure
  • The reason you are having the test or procedure
  • The risks and benefits of the test or procedure
  • When and where you are to have the test or procedure and who will do it
  • When and how will you get the results
  • How much will you have to pay for the test or procedure
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