X-Ray

What is an X-ray?

An X-ray is a type of medical imaging that uses radiation to take pictures of the inside of your body. We often think of X-rays as something providers use to diagnose broken bones or look at your teeth. But X-ray images can also help providers diagnose a wide range of injuries, disorders and diseases.

Most people use the term “X-ray” to mean a plain radiograph (plain film), or just one image. But X-rays are also the type of radiation that imaging machines use to create pictures. X-ray radiation is also used in other types of medical imaging, like CT scans, to get many images that are interpreted by a computer to form 3D pictures. This piece will focus on plain X-rays.

What is an X-ray with contrast material?

Some X-rays use contrast material (also called contrast agent or dye). It makes certain structures in your body, like blood vessels, easier to see.

The contrast material comes as a liquid, powder or pill. Your provider gives you the contrast material before the X-ray. Depending on the type of X-ray, you may receive the contrast material:

• Orally (by mouth).
• Through an injection into a vein (IV) or your cerebrospinal fluid.
• By inserting it into your rectum (enema).

When do you need an X-ray?

Your provider may order an X-ray to:

• Check for a broken bone (fracture).
• Identify the cause of symptoms, such as pain and swelling.
• Look for signs of infection in your lungs.
• Look for foreign objects in your body.
• Look for structural problems in your bones, joints or soft tissues.
• Plan and evaluate treatments.

What can an X-ray show?

Issues that can show up on X-rays include:

• Arthritis.
• Broken bones.
• Bone changes or abnormalities.
• Herniated discs in your spine.
• Infections.
• Kidney stones.
• Scoliosis and other spine curvature conditions.
• Tooth cavities.
• Tumors.

Keep in mind that while certain abnormalities can show up on X-rays, they don’t always. In other words, things like kidney stones and tumors aren’t always visible on an X-ray, even if they’re there.

Can an X-ray show cancer?

X-rays can show cancer, but it’s not the primary way that providers look for or diagnose most cancers. This is because tumors in your organs can be small or hidden behind other structures in your body (like your ribs in the case of a chest X-ray) or blend in with normal tissues.

What are the types of X-rays?

Several types of X-rays take pictures of different areas inside your body. Some of the most common types of X-rays include:

• Abdominal X-ray. This X-ray helps providers evaluate parts of your digestive system and diagnose conditions like kidney stones and bladder stones.
• Bone X-ray. You might get a bone X-ray if your provider suspects you have a broken bone, dislocated joint or arthritis. Images from bone X-rays can also show signs of bone cancer or infection.
• Chest X-ray. Your provider might order a chest X-ray if you have symptoms like chest pain, shortness of breath or a cough.
• Dental X-ray. A dental provider takes regular X-rays of your mouth to look for issues with your teeth and gums.
• Head X-ray. These can help providers see skull fractures from head injuries or conditions that affect how the bones in your skull form, like craniosynostosis.
• Spine X-ray. A provider can use a spine X-ray to look for spine curvatures, slipped discs and other spine issues.

Other types of medical imaging use a series of X-rays interpreted by a computer to make detailed images. These include:

• Bone density (DXA) scan.
• CT scan (computed tomography).
• Fluoroscopy.
• Mammogram.

How do X-rays work?

X-rays work by sending beams of radiation through your body to create images on an X-ray detector nearby. Radiation beams are invisible, and you can’t feel them.

As the beams go through your body, bones, soft tissues and other structures absorb radiation in different ways. Solid or dense objects (such as bones) absorb radiation easily, so they appear bright white on the image. Soft tissues (such as organs) don’t absorb radiation as easily, so they appear in shades of gray on the X-ray.

A radiologist interprets the image and writes a report for the physician who ordered the X-ray, noting if there’s anything in the image that’s abnormal or concerning.

How do I prepare for an X-ray?

Preparation for an X-ray depends on the type of X-ray you’re getting. Your provider may ask you to:

• Avoid using lotions, creams or perfume. These can cause shadows on your X-rays and make the results inaccurate.
• Remove metal objects like jewelry, hairpins or hearing aids. Metal can interfere with X-rays and make the results inaccurate.
• Stop eating or drinking several hours beforehand.
• Wear comfortable clothing or change into a gown before the X-ray.

Tell your healthcare provider about your health history, allergies and any medications you’re taking. If you’re pregnant, think you might be pregnant or are breastfeeding (chestfeeding), tell your provider before getting an X-ray. If you’re getting an X-ray with contrast, let your provider know if you have a kidney condition.

What can I expect during an X-ray?

The exact steps of an X-ray depend on what kind of X-ray you’re getting. In general, during an X-ray your provider will:

1. Give you contrast medium (if necessary) through an injection or enema, or have you swallow it. You may feel flushed or warm for a little while after an IV injection of dye. Some people get a metallic taste in their mouth. These side effects go away in a few minutes.
2. Ask you to sit, stand or lie down on a table. In the past, your provider may have covered you with a heavy lead shield (apron), but new evidence suggests that they aren’t necessary.
3. Position the camera near the body part that they’re getting a picture of.
4. Move your body or limbs in different positions and ask you to hold still. They may also ask you to hold your breath for a few seconds so the images aren’t blurry.

Sometimes children can’t stay still long enough to produce clear images. Your child’s provider may recommend using a restraint during an X-ray. The restraint (or immobilizer) helps your child stay still and reduces the need for retakes. The restraints don’t hurt and won’t harm your child.

What happens after an X-ray?

Most of the time, there aren’t any restrictions on what you can do after an X-ray. If you received contrast medium, your provider might give you special instructions, like drinking plenty of water afterwards.

What are the risks or side effects of X-rays?

X-rays are generally safe and low-risk. Some people have side effects from contrast dye, which may include:

• Nausea or vomiting.
• Stomach cramps or diarrhea.
• Headaches.

There’s a small risk of an allergic reaction to the contrast material. People who have allergies or asthma are more likely to have an allergic reaction to contrast dye. Talk to your provider about your risk of a reaction, and call them right away if you have unusual symptoms after an X-ray with contrast.

Although X-rays use radiation (which can cause cancer and other health problems), you’re exposed to a very small amount during a plain radiograph — usually not much more than you’d get just from naturally occurring radiation you’re exposed to in your daily life (background radiation). For instance, a chest X-ray exposes you to about 10 days’ worth of background radiation. A dental X-ray exposes you to about one day of background radiation.

X-rays in pregnancy

While the amount of radiation exposure to an adult during an X-ray isn’t usually harmful, it can harm a fetus. If you’re pregnant, your provider may choose another imaging study, such as MRI (magnetic resonance imaging) or ultrasound.

What type of results do you get from an X-ray?

A radiologist will review your X-ray and note any findings. They may note if they recommend a follow-up. Your healthcare provider will receive both the images and the radiologist’s notes. They’ll review the images, too, and let you know if there’s anything concerning.

How long does it take to get X-ray results?

Results from a bone X-ray are often ready right away, but the time it takes for a radiologist to look at them can vary. Your provider might share your results with you after the X-ray, or you might see them show up in your electronic health records.

Results from other types of X-rays (such as a GI test) may take longer. Talk to your provider about when you can expect results.

If the results are abnormal what are the next steps?

Your provider will let you know if you need follow-up imaging or testing. Not all abnormal findings are concerning — in fact, many incidental findings are benign (not harmful). But check with your provider if you have any questions about the X-ray results.

When should I call my doctor?

If you received contrast material before your X-ray, call your provider if you have:

• Skin rash, hives or itching.
• Headaches.
• Nausea or vomiting.
• Trouble breathing or shortness of breath.

Symptoms can appear up to a day or two after the X-ray.

A note from Cleveland Clinic

X-rays are one of the oldest, most reliable medical technologies. And despite it being almost 130 years since their discovery, they’re still relevant thanks to research into new, better ways to use them. Modern X-rays are far more detailed and use less radiation than in the past, thanks to advances in imaging resolution.

X-rays allow providers to quickly check what might be going on inside your body. This means you can know fast whether there’s something concerning that needs treatment or additional testing. Let your provider know if you have any questions about getting an X-ray or the findings.