Radiography—or an X-ray, as it is most commonly known—is the oldest and
most frequently used form of medical imaging. Discovered more than a
century ago, X-rays can produce diagnostic images of the human body
digitally on a computer screen. X-ray imaging is extremely fast and
provides a rapid method of evaluating the entire body—especially the
joints, bones and chest.
Radiography involves exposing a part of the body to a small dose of
invisible, electromagnetic radiation to produce an image of the internal
Main Line Health Imaging uses digital radiography (DR), which result in
a digital image that can be processed and made available for viewing in
a fraction of the time of traditional X-Rays. These techniques have the
added benefit that there is less chance of error and re-takes. The
images may be placed on film or may be stored electronically.
*Fluoroscopy is offered at Bryn Mawr, Lankenau, and Paoli hospitals
Fluoroscopy: Viewing Live X-Ray Images
Typical X-ray images are still pictures. A similar imaging method,
fluoroscopy, uses X-rays to capture an image of an organ while it is
functioning. Unlike a conventional X-ray, which shows a detailed yet
static image, fluoroscopy allows a physician to see a live image of the
body's internal organs on a TV monitor in order to observe their size,
shape and movement.
Fluoroscopy uses a continuous beam of X-rays to evaluate structures and
movement within the body, such as blood through an artery, lung
expansion and contraction, or food moving through the digestive tract.
It also can be used to help a physician locate a foreign object in the
body, position a catheter or needle for a procedure, or realign a broken
Applications for X-Ray Imaging and Fluoroscopy
Bone X-rays: Probably the most common use of
X-ray imaging is to assist the physician in identifying and
treating bone fractures including the arms, legs, knees, wrists,
shoulders, spine and skull. Images of the injury can show even
very fine hairline fractures or bone chips, while images
produced after treatment ensure that a fracture has been
properly aligned and stabilized for healing. X-ray images can
also be used to diagnose and monitor the progression of
degenerative diseases such as arthritis.
Chest X-rays: A chest X-ray is usually done for
the evaluation of lungs, heart and chest wall. Pneumonia, heart
failure, emphysema, lung cancer and other medical conditions can
be accurately diagnosed or suspected through a chest X-ray.
Upper/Lower Gastrointestinal (GI) Series: An
Upper Gastrointestinal (GI) Series is an X-ray or fluoroscopic
examination of the esophagus, stomach and first part of the
small intestine (the duodenum). In order for these organs to
show up on radiographic images, patients are usually asked to
swallow a solution of baking soda crystals and a barium liquid
A Lower Gastrointestinal (GI) Series is an X-ray or fluoroscopic
evaluation of the large intestine (colon) and the rectum. To aid
in this examination, patients are given an enema of liquid
barium contrast solution. The barium coats the inside of the
rectum and colon, producing a sharp, well-defined image.
Both GI examinations are useful for looking for ulcers, benign
tumors (polyps, for example), cancer, or signs of certain other
intestinal illnesses such as Crohn's disease and ulcerative
How Should I Prepare for an X-ray?
Most procedures require no special preparation. Once you arrive, you may
be asked to change into a gown before your examination. You will also be
asked to remove jewelry, eyeglasses and any metal objects that could
show up on the images and overlap important findings. If you are going
for an Upper or Lower GI Tract X-ray, you will be asked to avoid eating
and drinking before your procedure, as not to interfere with the image
quality. Women should always inform their doctor or X-ray technologist
if there is any possibility that they are pregnant.
Are X-rays Safe?
X-rays are a type of invisible electromagnetic radiation and create no
sensation when they pass through the body. Modern X-ray techniques use
only a fraction of the X-ray dose that was required in the early days of
radiology. During a single X-ray exposure, a patient is exposed to
approximately 20 milliroentgens of radiation. To put this into
perspective, we are all exposed to approximately 100 milliroentgens of
radiation each year from sources like the ultraviolet rays of the sun
and small traces of radioactive isotopes, such as uranium found in soil.
Special care is taken during X-ray examinations to ensure maximum safety
for the patient by paying attention to correct x-ray beam energies. Body
parts not being examined are shielded with a lead apron helps reduce
unnecessary radiation to the abdomen and pelvis. Modern X-ray systems
use tightly controlled X-ray beams with significant filtration to
minimize scatter of stray radiation. And today's high-speed X-ray films
require less amounts of radiation than ever before in order to produce
an optimal image. (Fluoroscopy can deliver more radiation than
conventional X-rays, however).
X-ray imaging itself is painless. For most procedures, patients must
remove their clothing and wear a loose-fitting gown. Patients will also
be asked to remove jewelry and metal as it may interfere with the image
quality. Some discomfort may result from lying on the table, which may
feel quite hard and cold. Sometimes, to get a clear image of an injury
such as a possible fracture, you may be asked to hold still an
uncomfortable position for a short time. Patients receiving chest X-rays
may be asked to hold their breath while the imaging is taking place. The
radiologist may also need to take additional views from different angles
to make a proper diagnosis.
If you are going for an Upper GI Tract, you will be asked to swallow a
barium contrast that may taste chalky. If you are going for a Lower GI
Tract X-ray, you will be asked to undergo a barium enema which may
produce some discomfort as the barium fills your colon, including
abdominal pressure or minor cramping.
Women should always inform their physician or X-ray technologist if
there is any possibility that they are pregnant.
What Happens Next?
An experienced Main Line Health radiologist will analyze your X-ray
images and send a report to your referring physician, who will inform
you on your test results. Results cannot be given directly to the
patient or family.
For more information, call 1.866.CALL.MLH.