X-ray

An X-ray is a fast and simple procedure that uses a small dose of X-ray radiation to create images of the inside of your body to show damage and certain diseases. It’s particularly suitable for bones, but X-rays have many uses and are widely used in medical settings, from hospitals to dentists. For example, X-rays can be used to help diagnose and monitor osteoarthritis and are also used before and after joint replacement surgery.

There are many reasons why you may be referred for an X-ray, including diagnosing the cause of pain or discomfort, tracking the progress of a disease (eg osteoporosis) and checking the effectiveness of a treatment. However, X-rays are most commonly used to look at bones and joints for fractures or disease (eg arthritis or osteoporosis). They can also detect other conditions including:

• Breast cancer
• Gastrointestinal problems — this includes difficulties swallowing (dysphagia)
• Lung diseases — chest X-rays are used to detect lung cancer and pneumonia
• Scoliosis - a condition that causes the spine to curve
• Teeth problems — this includes tooth decay

Hand X-rays may also be used to monitor growth in children.

X-rays are sometimes used to help doctors by providing images during certain tests and procedures eg during a coronary angioplasty where a thin tube (catheter) is guided into your arteries using X-ray guidance in order to then be able to widen a narrowed artery.

An X-ray machine sends a beam of ionising radiation, called X-rays, into the area that’s being examined. You can’t see X-rays with your eyes and you can’t feel them either.

When X-rays pass through your body they’re absorbed differently by each type of tissue or organ. This information is captured on the X-ray image and shows up as shaded areas ranging from black to white.
As air absorbs the least X-ray radiation it appears more black on an X-ray image. Denser tissues absorb more X-ray radiation, which is why bones appear white on an X-ray image, while soft tissues are shades of grey.

An X-ray takes just a few seconds and you may only be in the room for 20 minutes. Certain specialist X-rays need you to have a contrast dye to help certain areas of your body to be seen more clearly. You’ll be told about this beforehand and it may take a little longer to prepare for your X-ray.

For standard X-rays ie where no contrast agent is needed, you don’t usually need to do anything special to prepare. This means you can eat, drink and take any medications as usual. However, if you are having a contrast agent for your X-ray, you may need to avoid eating and drinking for several hours before your X-ray and stop taking certain medications. Your care team will advise you on this before you come in for your X-ray. 

You may also need to fast and avoid drinking certain fluids before an X-ray to examine your gut. In some cases, you may also need to take medications to empty your bowels. 

On the day of your X-ray, make sure you are wearing loose, comfortable clothes without any metal attachments (eg zips, buckles or metal buttons) and try not to wear any jewellery on the area being X-rayed. Any metal items will need to be removed before your X-ray. In some cases, you may be asked to change into a hospital gown.

If you have any metal implants or shrapnel, tell your care team as these can prevent X-rays from passing through your body and disrupt the X-ray images collected.

You will sit down, lie down on a flat table or stand on or against a flat surface. This will allow your care team to correctly position the part of your body that needs to be imaged by the X-ray machine.

A person specially trained in taking X-rays (a radiographer) will operate the machine from behind a screen.

The X-ray only takes a few seconds and you will not feel anything as the X-rays pass through your body. You will need to remain still to prevent the X-ray image from blurring. You may need to have several X-rays taken from different angles.

If you have a young child who is having an X-ray, you can stay in the room with them but will need to wear a lead apron to prevent any unnecessary exposure to the X-rays.

Contrast X-rays

In some cases, you may need to have a contrast agent so that certain tissues in your body show up more clearly during your X-ray. You will be advised of any specialist requirements. These procedures usually need more time to prepare for than a standard X-ray without a contrast agent.

A radiographer will carry out your X-ray and afterwards, you can return to your usual activities. A radiologist (a doctor trained to read X-rays) will examine the X-ray images and they’ll send a report to your doctor who requested your scan. Depending on the results of your X-ray, your referring doctor may be able to make a clear diagnosis and recommend treatment, or they may recommend further imaging or blood tests.

Spire hospitals have an agreement with radiologists that reports should be completed within five working days - this is regardless of the body part that has been scanned. However, there are occasions when a specialist radiologist opinion is needed and in these cases it can take a little bit longer.

Results are always returned to your referrer - this can be your NHS GP, private consultant or private GP, or an organisation (such as the MoD).

You should arrange a follow up appointment with your referrer to receive the results of imaging examinations.

The results of imaging examinations often only form a part of the investigations and treatments requested or carried out by consultants, so should not be read in isolation. Your referrer will have a holistic view of your medical history, so can advise on the outcome of a radiology report alongside all other tests results and previous or current medical conditions.

X-ray side effects

A standard X-ray, where no contrast agent is used, doesn't have any side effects. You can therefore return to your usual activities immediately afterwards.

An X-ray is painless and although it uses ionising radiation, you’re exposed to a low dose for less than a second. Depending on how much of your body is X-rayed, the amount of radiation is the same as the background radiation you’d naturally be exposed to over a few days.

It is known that exposure to X-rays may slightly increase your chances of developing cancer many years later, although this risk is very small. For example, an X-ray of your chest, is equivalent to a few days' worth of background radiation. If you are pregnant or suspect you may be pregnant, tell your doctor — they may recommend a different imaging test that doesn’t use ionising radiation eg an MRI scan.

At Spire Healthcare, we’re careful to weigh up the benefits and risks of any X-ray and discuss it with you if you have any concerns.