See also Radiology and Imaging
An X-ray or radiograph is similar to having a photograph taken in a studio. A radiologic technologist (RT) uses non-visible X-rays (short wavelength) to create an image of internal structures/organs. The image is called a radiograph or X-ray. X-rays reveal body structures proportional with their density; the denser the tissue, (bone versus fat) less X-ray passes through it and this difference in body tissue density is why bone (high body tissue density) is white on a radiograph, compared to fat (low body tissue density) which is gray, or air (no density) which is black.
Radiographs are a reliable and accurate means of obtaining information to help your physician diagnosis the cause of your pain. An X-ray examination is commonly used to determine the presence or absence of disease, a bone fracture, joint malalignment, arthritis, or cause of other painful conditions.
Your examination will be performed by a qualified radiologic technologist (RT) licensed by New York State. Your examination will be interpreted by a radiologist. A radiologist is a physician specializing in radiology, including MRI, ultrasound, nuclear medicine and CT in addition to X-rays. Radiologists specialize in the imaging and diagnosis of disease. Interpretation of a radiograph, MRI, CT, ultrasound, or nuclear medicine examination requires expertise in pattern recognition and in the identification of artifacts or findings that could be mistaken for pathology. Radiologists are trained in the variable sensitivity and specificity of each imaging technique, and in the potential for hazards related to the examination that could cause harm and must be avoided. All the radiologists at Hospital for Special Surgery are board certified by the American Board of Radiology, have years of experience in the imaging of musculoskeletal disorders, and the majority have additional formal fellowship training beyond residency in musculoskeletal or body imaging.
After changing into an examination gown, if necessary the radiologic technologist (RT) will instruct you to remove specific articles of your clothing that may interfere with the radiograph to ensure that the radiograph is free of artifacts (e.g. material from your clothing, snaps, buttons, clips, etc...). You will be taken into an e-ray room and instructed to lie, sit or be positioned on X-ray table. Just as a photographer has special equipment in the portrait studio to achieve the best portrait, the radiologic technologist (RT) uses special equipment such as an X-ray source (camera), positioning blocks and sponges to achieve an optimal image.
No preparation is required for a routine X-ray examination. If you are pregnant or think you may be pregnant, be sure to inform your physician, and the technologist prior to the start of the X-ray examination. Most examinations using X-ray will not be performed on pregnant women unless the benefits of the examination outweigh the risks of radiation exposure to the fetus. Extremity examinations can safely be performed with appropriate lead shielding.
X-ray uses ionizing radiation. The technologists are experts in utilizing the minimal dose to achieve optimal results. Lead aprons and shields are used, and the equipment is routinely inspected by both New York City and New York State, for safety and adequate shielding. All examinations are well within permissible levels of diagnostic radiation dosage.
Alternate diagnostic imaging tests such as MRI or ultrasound may be performed without utilizing ionizing radiation, however their use is dependent on your condition and the information your doctor requires.
After the radiological technologist (RT) has completed taking your X-rays, you will be asked to wait in the X-ray room while your images are reviewed for diagnostic quality. Additional images are occasionally required to ensure the examination completely demonstrates the area in clinical questions. The radiographic examination will be interpreted by a radiologist. Your HSS physician will be able to view the images immediately. If your referring physician is not at HSS, your images will be shared either with a CD or cloud technology.
The radiologist generates a written report which will be sent to the physician who referred you for the examination. The radiograph and the report become part of your medical record. Copies of the report can be obtained through your referring physician's office. Your physician can call the file room at 212.606.1015 and a copy of the report can be faxed or mailed free of charge to their office. The images are the property of the institution as are biopsy slides or blood samples. Copies of the images can be obtained by contacting the file room. There is a charge for copies.
Depending on the findings on the X-ray, additional tests may be ordered including, other X-ray exams utilizing different views/positions, a CT examination, bone scan, MR, ultrasound, or special interventional procedures that utilize imaging guidance.