Orthopedics

X-rays of the Extremities

What are X-rays of the extremities?

X-rays use invisible electromagnetic energy to make images of the bones and surrounding soft tissues. Standard X-rays are done for many reasons, including diagnosing tumors, infections, foreign bodies, or bone injuries.

X-rays pass through body structures onto specially treated plates similar to camera film. It makes a "negative" type of picture. The more solid a structure is, the whiter it looks on the film. Instead of film, X-rays may also be made by using computers and digital media.

When you have X-rays done, 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. They appear dark gray on the film. A bone or a tumor is denser than the soft tissues. It 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.

Why might I need an extremity X-ray?

X-rays of the arm, leg, foot, ankle, shoulder, knee, hip, or hand may be done to assess the bones for injuries or bony masses. X-rays can show evidence of several injuries or conditions, such as breaks (fractures), infection, arthritis, tendinitis, bone spurs, foreign bodies, tumors, or birth defects. X-rays may also be used to see bone growth and development in children.

Your healthcare provider may request X-rays of joints to check for 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 healthcare provider to advise an X-ray of the arms and legs. Talk with your provider about the reason for your X-ray.

What are the risks of an extremity X-ray?

You may want to ask your healthcare provider 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 X-rays and other scans, so you can tell your providers. Risks linked to radiation exposure may be related to the number of X-ray exams or treatments over time.

Tell your provider if you are pregnant or think you might be. Radiation exposure during pregnancy may lead to birth defects. If you need an X-ray of the extremities, special safety steps will be taken to keep the radiation exposure to the fetus to a minimum.

You may have other risks depending on your specific health condition. Discuss any concerns with your provider before the procedure.

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

Your healthcare provider will explain the procedure to you and ask if you have questions.
Generally, you don't need to fast or get medicine (sedation) to help you relax.
Tell the radiologic technologist if:
- You are pregnant or think you might be.
- You have had a recent barium X-ray procedure. This may interfere with getting the best X-ray exposure of the lower back area during a hip X-ray.
Your provider may have other specific instructions for you.

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 healthcare provider's practices.

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

You will be asked to remove any clothing, jewelry, hairpins, eyeglasses, hearing aids, or other metal objects that might interfere with the procedure.
If you are asked to remove clothing, you will be given a gown to wear.
The type of procedure being done 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 X-ray 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.
Body parts not being imaged may be covered with a lead apron (shield) to avoid exposure to the X-rays.
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.
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.
Some X-ray studies may require several different positions of the extremity. It's 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.
The X-ray beam will be focused on the area to be photographed.
The radiologic technologist will step behind a protective window while the image is taken.

The X-ray procedure itself causes no pain, but 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 healthcare provider 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
What results to expect and what they mean
The risks and benefits of the test or procedure
What the possible side effects or complications are
When and where you are to have the test or procedure
Who will do the test or procedure and what that person’s qualifications are
What would happen if you did not have the test or procedure
Any alternative tests or procedures to think about
When and how you will get the results
Who to call after the test or procedure if you have questions or problems
How much you will have to pay for the test or procedure