Advertising on the portal

X-ray method of examining a patient. Types of radiography methods and their features

Radiography is a non-invasive diagnostic method that allows you to obtain images of individual areas human body on X-ray film or digital media using ionizing radiation. X-ray allows you to study the anatomical and structural features organs and systems, helping in the diagnosis of many internal pathologies that cannot be seen during a routine examination.

Carrying out radiography

Description of the method

The radiographic research method is based on the use of x-rays. The X-rays emitted by the device's sensor have high penetrating power. Passing through the tissues of the human body, the rays ionize cells and are retained in them in varying volumes, as a result of which a black and white image of the anatomical area under study appears on the X-ray film. Bone tissue is more radiopaque, so it looks lighter in the pictures; darker areas are soft fabrics, which absorb X-rays poorly.

The discovery of X-rays made a huge breakthrough in the diagnosis of many diseases that until then could only be detected using late stage when treatment becomes difficult or even impossible.

Today, most clinics and large hospitals are equipped with X-ray machines, with which you can short terms clarify the diagnosis and draw up a treatment plan. In addition, X-rays are also used for preventive examinations, helping to diagnose serious pathologies on early stages. The most common type of preventive examination is fluorography, the purpose of which is the early diagnosis of pulmonary tuberculosis.

There are several X-ray examination methods, the difference between which lies in the method of recording the image:

  • Classic radiography - the image is obtained by directly hitting the film with X-rays.
  • Fluorography – the image is displayed on a monitor screen, from where it is subsequently printed onto small-format film.

  • Digital X-ray – a black and white image is transferred to digital media.
  • Electroradiography - the image is transferred to special plates, from where it is then transferred to paper.
  • Teleradiography – using a special television system, the image is displayed on a TV screen.
  • Fluoroscopy - the image is displayed on a fluorescent screen.

The digital radiography method more accurately reflects the picture of the area under study, which greatly facilitates the diagnosis and selection of a treatment regimen for the identified pathology.

In addition to differences in the method of fixing the image, radiography is divided into types depending on the object of study:

  • X-ray spinal column and peripheral parts of the skeleton (limbs).
  • Chest X-ray.
  • Dental X-ray (intraoral, extraoral, orthopantomography).
  • Breast – mammography.
  • Colon - irrigoscopy.
  • Stomach and duodenum– gastroduodenography.
  • Biliary tract and gallbladder – cholegraphy and cholecystography.
  • Uterus - metrosalpingography.

Hysterosalpingogram

Indications and contraindications for examination

Radiography, like fluoroscopy and other x-ray examination methods, is carried out only when there are indications, and there are many of them - such a study is prescribed to patients for visualization internal organs and systems to identify pathological abnormalities in their structure. X-rays are indicated in the following cases:

  • Diagnosis of diseases of the skeleton and internal organs.
  • Checking the success of the treatment and identifying undesirable consequences.
  • Monitoring the position of installed catheters and tubes.

Before the start of the study, each patient is interviewed to find out possible contraindications to radiography.

These include:

  • Active form of tuberculosis.
  • Thyroid gland dysfunction.
  • Heavy general condition patient.
  • Pregnancy period.

Pregnant women undergo X-rays only for health reasons

  • Breastfeeding if contrast agent administration is necessary.
  • Heart and renal failure (relative contraindication for contrast).
  • Bleeding.
  • Allergy to iodine-containing substances, if necessary contrast agents.

Advantages of radiography over other methods:

  • The main advantage of X-ray examination is the availability of the method and the ease of its implementation. Most clinics are equipped with the necessary equipment, so there are usually no problems with finding a place where the scan can be performed. The cost of x-rays is usually low.

X-rays are available in almost any medical institution

  • There is no need to carry out complex preparations before the study. The exception is radiography with contrast.
  • Finished pictures are stored for a long time, so they can be shown to various specialists even after several years.

The main disadvantage of X-ray examination is the radiation exposure to the body, but subject to certain rules (scanning for modern devices and the use of personal protective equipment), undesirable consequences can be easily avoided.

Another disadvantage of the method is that the resulting images can only be viewed in one plane. In addition, some organs are almost not visible on the images, so a contrast agent must be injected to study them. Old-style devices do not provide the opportunity to obtain clear images, so it is often necessary to prescribe additional research to clarify the diagnosis. Today, the most informative is scanning on devices with digital recorders.

Difference between radiography and fluoroscopy

Fluoroscopy is one of the main types of x-ray examination. The point of the technique is to obtain an image of the area under study on a fluorescent screen using X-rays in real time. Unlike radiography, the method does not allow obtaining graphic images of organs on film, however, it allows one to evaluate not only the structural features of the organ, but also its displacement, filling, and stretching. Fluoroscopy often accompanies operations to install catheters and angioplasty. The main disadvantage of the method is the higher radiation exposure compared to radiography.

How is the examination carried out?

Woman lying on x-ray machine table

The technique for performing radiography is similar for different organs and systems, differing only in the position of the patient and the place of injection of the contrast agent. Immediately before entering the office, you should remove all metal objects from yourself, and already in the office you should put on a protective apron. Depending on the purpose of the study, the patient is placed on a couch in a certain position or seated on a chair. A film cassette is placed behind the area of ​​interest and the sensor is then aimed. During the examination, the laboratory technician leaves the room; the patient must remain completely still to obtain clear images.

In some cases, scanning is carried out in several projections - the specialist will tell the patient about changing the position. When using a contrast agent, it is injected as needed before the scan begins. After completion of the study, the specialist checks the received images to assess their quality, and if necessary, the scan is repeated.

Decoding the results

In order to correctly “read” a photograph, you need to have the appropriate qualifications; it is very difficult for an ignorant person to do this. The images obtained during the study are negatives, so the denser structures of the body appear as light areas, and the soft tissues appear as dark structures.

When decoding each area of ​​the body, doctors follow certain rules. For example, during a chest x-ray, specialists evaluate relative position and structural features of organs - lungs, heart, mediastinum; ribs and collarbones are examined for damage (fractures and cracks). All characteristics are assessed according to the patient's age.

A doctor examines an x-ray of the lungs

To make a final diagnosis, one x-ray is often not enough - you should rely on data from a survey, examination, other laboratory and instrumental methods examinations. Do not engage in self-diagnosis; the X-ray method is still quite complicated for people without higher medical education; its use requires special indications.

Radiography is one of the most effective methods for diagnosing various diseases of tissues and organs of the human body. In this case, the research is based on the unique properties of X-rays, which easily pass through a dense opaque medium and into varying degrees they are absorbed by it.

Thus, our organs, which differ in density and chemical composition, absorb X-rays with different intensities, which affects the natural contrasts of the resulting images.

It is thanks to these features of X-rays and the human body that it is possible to conduct radiographic examination of various organs without special preparatory work. Any type of x-ray requires a qualified interpretation. Therefore, only specialist radiologists are able to correctly “read” the received images and make the correct diagnosis.

Type of radiography

Currently, the following types of radiography are distinguished:

  • : carried out to detect diseases such as tuberculosis and malignant tumors;
  • X-ray of the stomach: detection of ulcers, polyps, various malignant neoplasms; urography: examine the kidneys and urinary tract;
  • irrigoscopy: diagnosis of the colon;
  • Mammography: detection of breast diseases;
  • radiography of cranial bones (temporal); and other bones of the human skeleton, as well as joints; snapshot jaw bone(teeth), including panoramic (using an orthopantomograph);
  • X-ray of the paranasal sinuses: detection of sinusitis.

You can make an appointment to have an x-ray done. The resulting images are given to patients personally on the day of treatment.

Preparation

To be most effective, some types of radiography require special training. For: three days before the examination, you must strictly follow a diet (exclude all gas-forming foods), and on the day of the procedure, do a cleansing enema. At the same time, be sure to eat porridge for breakfast.

Urography is performed only after consultation with a radiologist. You need to drink 15 minutes before the procedure large number water (if the patient wishes, the doctor can introduce a special substance).

Mammography should be performed from days 6 to 12 of the menstrual cycle.

On the day of the stomach x-ray, you should not eat anything, since the procedure is performed on an empty stomach.

Modern methods of X-ray examination are classified, first of all, by the type of hardware visualization of X-ray projection images. That is, the main types of X-ray diagnostics are differentiated by the fact that each is based on the use of one of several existing types X-ray receivers: X-ray film, fluorescent screen, electron-optical X-ray converter, digital detector, etc.

Classification of X-ray diagnostic methods

In modern radiology, there are general research methods and special or auxiliary ones. Practical application of these methods is possible only with the use of X-ray machines K general methods include:

  • radiography,
  • fluoroscopy,
  • teleradiography,
  • digital radiography,
  • fluorography,
  • linear tomography,
  • computed tomography,
  • contrast radiography.

Special studies include a wide range of methods that allow solving a wide variety of diagnostic problems, and can be invasive or non-invasive. Invasive are associated with the introduction into various cavities (digestive canal, vessels) of instruments (x-ray contrast catheters, endoscopes) to carry out diagnostic procedures under X-ray control. Non-invasive methods do not involve the insertion of instruments.

Each of the above methods has its own advantages and disadvantages, and therefore certain limits of diagnostic capabilities. But all of them are characterized by high information content, ease of implementation, accessibility, the ability to mutually complement each other and, in general, occupy one of the leading places in medical diagnostics: in more than 50% of cases, diagnosis is impossible without the use of x-ray diagnostics.

Radiography

The radiography method is the production of fixed images of any object in the X-ray spectrum on a material sensitive to it (X-ray film, digital detector) using the reverse negative principle. The advantage of the method is low radiation exposure, high quality images with clear detail.

The disadvantage of radiography is the inability to observe dynamic processes and the long processing period (in the case of film radiography). To study dynamic processes, there is a method of frame-by-frame image recording - X-ray cinematography. Used to study the processes of digestion, swallowing, breathing, blood circulation dynamics: X-ray phase-cardiography, X-ray pneumopolygraphy.

X-ray

The fluoroscopy method is the production of an X-ray image on a fluorescent (luminescent) screen using the direct negative principle. Allows you to study dynamic processes in real time, optimize the patient’s position in relation to the X-ray beam during examination. Fluoroscopy allows you to evaluate both the structure of the organ and its functional state: contractility or distensibility, displacement, filling with contrast agent and its passage. The multi-projection nature of the method allows you to quickly and accurately identify the localization of existing changes.


A significant disadvantage of fluoroscopy is the large radiation load on the patient and the examining physician, as well as the need to carry out the procedure in a dark room.

X-ray television

Telefluoroscopy is a study that uses the conversion of an X-ray image into a telesignal using an electron-optical converter or amplifier (IEC). The positive x-ray image is displayed on a television monitor. The advantage of the technique is that it significantly eliminates the disadvantages of conventional fluoroscopy: the radiation exposure to the patient and staff is reduced, image quality can be controlled (contrast, brightness, high resolution, the ability to enlarge the image), the procedure is carried out in a bright room.

Fluorography

The fluorography method is based on photographing a full-dimensional shadow X-ray image from a fluorescent screen onto photographic film. Depending on the film format, analogue fluorography can be small-, medium- and large-frame (100x100 mm). Used for mass preventive studies, mainly of the chest organs. IN modern medicine more informative large-frame fluorography or digital fluorography is used.


Contrast X-ray diagnostics

Contrast x-ray diagnostics is based on the use of artificial contrast by introducing x-ray contrast agents into the body. The latter are divided into X-ray positive and X-ray negative. X-ray positive substances basically contain heavy metals - iodine or barium, and therefore absorb radiation more strongly than soft tissues. X-ray negative substances are gases: oxygen, nitrous oxide, air. They absorb x-ray radiation less than soft tissue, thereby creating contrast in relation to the organ being examined.

Artificial contrast is used in gastroenterology, cardiology and angiology, pulmonology, urology and gynecology, used in ENT practice and in the study of bone structures.

How does an X-ray machine work?

Plan:

1) X-ray studies. The essence of radiological research methods. X-ray examination methods: fluoroscopy, radiography, fluorography, X-ray tomography, computed tomography. Diagnostic value X-ray studies. The role of the nurse in preparing for x-ray examinations. Rules for preparing the patient for fluoroscopy and radiography of the stomach and duodenum, bronchography, cholecystography and cholangiography, irrigoscopy and graphy, plain radiography of the kidneys and excretory urography.

X-ray examination of the renal pelvis (pyelography) is carried out using urografin administered intravenously. X-ray examination bronchi (bronchography) is carried out after spraying a contrast agent - iodolipol - into the bronchi. X-ray examination of blood vessels (angiography) is carried out using a cardiotrast administered intravenously. In some cases, contrasting of an organ is performed using air, which is introduced into the surrounding tissue or cavity. For example, during an X-ray examination of the kidneys, when there is a suspicion of a kidney tumor, air is injected into the perinephric tissue (pneumorrhea) ; To detect tumor growth of the stomach walls, air is introduced into the abdominal cavity, i.e., the study is carried out under conditions of artificial pneumoperitoneum.

Tomography - layer-by-layer radiography. In tomography, due to the movement of the X-ray tube on film during shooting at a certain speed, a sharp image is obtained only of those structures that are located at a certain, predetermined depth. Shadows of organs located at a shallower or greater depth are blurred and do not overlap the main image. Tomography facilitates the detection of tumors, inflammatory infiltrates and other pathological formations. The tomogram indicates in centimeters at what depth, counting from the back, the picture was taken: 2, 4, 6, 7, 8 cm.

One of the most advanced techniques that provides reliable information is computed tomography, which allows, through the use of a computer, to differentiate tissues and changes in them that differ very slightly in the degree of absorption of X-ray radiation.

On the eve of any instrumental research it is necessary to inform the patient in an accessible form about the essence of the upcoming study, the need for it, and obtain consent to conduct this study in writing.

Preparing the patient for X-ray examination of the stomach and duodenum. This is a research method based on X-ray examination of hollow organs using a contrast agent (barium sulfate), which allows one to determine the shape, size, position, mobility of the stomach and duodenum, localization of ulcers, tumors, assess the relief of the mucous membrane and the functional state of the stomach ( its towing capacity).

Before the study you must:

1. Instruct the patient according to the following plan:

a) 2-3 days before the test, it is necessary to exclude gas-forming foods (vegetables, fruits, brown bread, milk) from the diet;

b) on the eve of the study at 6 pm - light dinner;

c) warn that the study is carried out on an empty stomach, so on the eve of the study the patient should not eat or drink, take medications or smoke.

2. In case of persistent constipation, as prescribed by the doctor, in the evening, on the eve of the study, a cleansing enema is given.

5. In order to contrast the esophagus, stomach and duodenum, in the X-ray room the patient drinks an aqueous suspension of barium sulfate.

Performed to diagnose diseases of the gallbladder and biliary tract. It is necessary to warn the patient about the possibility of nausea and loose stool as a reaction to taking a contrast agent. It is necessary to weigh the patient and calculate the dose of contrast agent.

The patient is instructed according to the following scheme:

a) on the eve of the study within three days the patient follows a diet without high fiber content (exclude cabbage, vegetables, wholemeal bread);

b) 14 - 17 hours before the study, the patient takes the contrast agent in fractions (0.5 grams) for an hour every 10 minutes, washed down with sweet tea;

c) at 6 pm - light dinner;

d) in the evening 2 hours before bedtime, if the patient cannot empty his bowels naturally, give a cleansing enema;

e) in the morning on the day of the examination, the patient must come to the X-ray room on an empty stomach (do not drink, do not eat, do not smoke, do not take medications). Take 2 raw eggs with you. In the X-ray room, survey images are taken, after which the patient takes a choleretic breakfast (2 raw egg yolks or sorbitol solution (20g per glass of boiled water) for a choleretic effect). 20 minutes after taking the choleretic breakfast, a series of survey photographs are taken at certain intervals over a period of 2 hours.

Preparing the patient for cholegraphy(X-ray examination of the gallbladder of the biliary tract after intravenous administration of a contrast agent).

1. Find out allergy history (intolerance to iodine preparations). 1 - 2 days before the study, conduct a sensitivity test to the contrast agent. To do this, administer 1 ml of contrast agent, heated to t = 37-38 o C, intravenously, and monitor the patient’s condition. An easier way is to take it orally. potassium iodide a tablespoon 3 times a day. If the allergy test is positive, a rash, itching, etc. appears. If there is no reaction to the injected contrast agent, continue preparing the patient for the study.

2. Before the study, instruct the patient according to the following plan:

2 - 3 days before the study - a slag-free diet.

At 6 pm - light dinner.

2 hours before bedtime - a cleansing enema, if the patient cannot empty the intestines naturally.

- The study is carried out on an empty stomach.

3. In the X-ray room, inject slowly intravenously over 10 minutes 20-30 ml of contrast agent, heated to t = 37-38 0 C.

4. The patient undergoes a series of survey photographs.

5. Ensure monitoring of the patient’s condition within 24 hours after the test in order to exclude delayed types of allergic reactions.

Preparing the patient for bronchography and bronchoscopy.

Bronchography is a study of the respiratory tract, which allows one to obtain a radiographic image of the trachea and bronchi after introducing a contrast agent into them using a bronchoscope. Bronchoscopy- instrumental, endoscopic method examination of the trachea and bronchi, allowing for examination of the mucous membrane of the trachea, larynx, collection of contents or bronchial lavage water for bacteriological, cytological and immunological studies, as well as treatment.

1. To exclude idiosyncrasy to iodolipol, a single dose of 1 tablespoon of this drug is prescribed orally 2-3 days before the study and during these 2-3 days the patient takes a 0.1% solution of atropine 6-8 drops 3 times a day).

2. If bronchography is prescribed for a woman, warn that there is no varnish on her nails and no lipstick on her lips.

3. The night before, as prescribed by the doctor, the patient should take 10 mg of seduxen for sedative purposes (for sleep disturbances, a sleeping pill).

4. 30-40 minutes before performing the manipulation, administer premedication as prescribed by the doctor: inject subcutaneously 1 ml of a 0.1% atropine solution and 1 ml of a 2% promedol solution (make an entry in the medical history and narcotic drug log).

Preparing the patient for X-ray examination of the large intestine (irrigoscopy, irrigography), which allows you to get an idea of ​​the length, position, tone, shape of the colon, and identify motor function disorders.

1. Instruct the patient according to the following scheme:

a) three days before the study, a slag-free diet is prescribed; b) if the patient is bothered by intestinal bloating, then it can be recommended to take chamomile infusion, carbolene or enzyme preparations for three days;

c) on the eve of the study at 15-16 hours the patient receives 30 g castor oil(in the absence of diarrhea);

d) at 19:00 - light dinner; e) at 20:00 and 21:00 on the eve of the study, cleansing enemas are carried out until the effect of “clean water”;

f) in the morning on the day of the study, no later than 2 hours before irrigoscopy, 2 cleansing enemas are performed with an interval of one hour;

g) on ​​the day of the study, the patient should not drink, eat, smoke or take medications. Using an Esmarch mug in the office, the nurse administers an aqueous suspension of barium sulfate.

Preparing the patient for X-ray examination of the kidneys ( overview shot, excretory urography).

1. Provide instructions on preparing the patient for the study:

Exclude gas-forming foods (vegetables, fruits, dairy, yeast-like products, brown bread, fruit juices) from the diet for 3 days before the test.

Take for flatulence as prescribed by a doctor. activated carbon.

Avoid eating 18-20 hours before the test.

2. The night before at about 22:00 and in the morning 1.5-2 hours before the study, give cleansing enemas

3. Invite the patient to empty the bladder immediately before the study.

In the X-ray room, a radiologist performs a survey of the abdominal cavity. Nurse carries out a slow (over 5-8 minutes), constantly monitoring the patient’s well-being, administration of a contrast agent. The radiologist takes a series of images.

Thank you

The site provides reference information for informational purposes only. Diagnosis and treatment of diseases must be carried out under the supervision of a specialist. All drugs have contraindications. Consultation with a specialist is required!

X-ray diagnostic method. Types of X-ray examination of bones

X-ray of bones is one of the most common studies conducted in modern medical practice. Most people are familiar with this procedure, since the possibilities for using this method are very extensive. List of indications for x-ray bone disease includes a large number of diseases. Injuries and fractures of the limbs alone require repeated x-rays.

X-rays of bones are performed using various equipment, and there are also a variety of methods this study. The use of the type of x-ray examination depends on the specific clinical situation, the age of the patient, the underlying disease and associated factors. Radiation diagnostic methods are indispensable in the diagnosis of diseases of the skeletal system and play a major role in making a diagnosis.

There are the following types of x-ray examination of bones:

  • film radiography;
  • digital radiography;
  • X-ray densitometry;
  • x-ray of bones using contrast agents and some other methods.

What is an X-ray?

X-ray is a type of electromagnetic radiation. This type electromagnetic energy was opened in 1895. Electromagnetic radiation also includes sunlight, as well as light from any artificial lighting. X-rays are used not only in medicine, but are also found in ordinary nature. About 1% of the Sun's radiation reaches the Earth in the form of X-rays, which forms the natural background radiation.

The artificial production of X-rays became possible thanks to Wilhelm Conrad Roentgen, after whom they are named. He was also the first to discover the possibility of using them in medicine to “transilluminate” internal organs, primarily bones. Subsequently, this technology developed, new ways of using X-ray radiation appeared, and the radiation dose was reduced.

One of the negative properties of X-ray radiation is its ability to cause ionization in the substances through which it passes. Because of this, X-ray radiation is called ionizing radiation. In large doses, x-rays can lead to radiation sickness. The first decades after the discovery of X-rays this feature was unknown, which led to illness in both doctors and patients. However, today the dose of X-ray radiation is carefully controlled and we can say with confidence that the harm from X-ray radiation can be neglected.

The principle of obtaining an x-ray

Three components are required to produce an x-ray. The first of these is an X-ray source. The source of X-ray radiation is an X-ray tube. In it under the influence electric current interaction occurs certain substances and the release of energy, most of which is released as heat and a small part as x-rays. X-ray tubes are part of all X-ray machines and require significant cooling.

The second component for obtaining an image is the object under study. Depending on its density, partial absorption of X-rays occurs. Due to the difference in the tissues of the human body, X-ray radiation of varying powers penetrates outside the body, which leaves different spots on the image. Where the X-ray radiation was absorbed to a greater extent, shadows remain, and where it passed almost unchanged, clearings are formed.

The third component for obtaining an x-ray is the x-ray receiver. It can be film or digital ( X-ray sensor). The most commonly used receiver today is X-ray film. It is treated with a special emulsion containing silver, which changes when X-rays hit it. The highlight areas in the image have a dark tint, and the shadows have a white tint. Healthy bones have high density and leave a uniform shadow on the image.

Digital and film X-ray of bones

The first X-ray research techniques involved the use of a photosensitive screen or film as a receiving element. Today, X-ray film is the most commonly used X-ray detector. However, in the coming decades, digital radiography will completely replace film radiography, as it has a number of undeniable advantages. In digital radiography, the receiving element is sensors that are sensitive to x-ray radiation.

Digital radiography has the following advantages over film radiography:

  • the ability to reduce the radiation dose due to the higher sensitivity of digital sensors;
  • increasing the accuracy and resolution of the image;
  • simplicity and speed of taking an image, no need to process photosensitive film;
  • ease of storing and processing information;
  • the ability to quickly transfer information.
The only disadvantage of digital radiography is the slightly higher cost of equipment compared to conventional radiography. Because of this, not all medical centers you can find this equipment. If possible, patients are recommended to undergo digital x-rays, as they provide more complete diagnostic information and at the same time are less harmful.

X-ray of bones with contrast agent

X-rays of the limb bones can be performed using contrast agents. Unlike other body tissues, bones have a high natural contrast. Therefore, contrast agents are used to clarify formations adjacent to bones - soft tissues, joints, blood vessels. These X-ray techniques are not used very often, but in some clinical situations they are irreplaceable.

There are the following radiopaque techniques for examining bones:

  • Fistulography. This technique involves filling the fistula tracts with contrast agents ( iodolipol, barium sulfate). Fistulas form in bones when inflammatory diseases such as osteomyelitis. After the study, the substance is removed from fistula tract using a syringe.
  • Pneumography. This study involves the introduction of gas ( air, oxygen, nitrous oxide) with a volume of about 300 cubic centimeters into soft tissue. Pneumography is performed, as a rule, for traumatic injuries combined with crushing of soft tissues and comminuted fractures.
  • Arthrography. This method involves filling the joint cavity with a liquid radiopaque agent. The volume of contrast agent depends on the volume of the joint cavity. Arthrography is most often performed on the knee joint. This technique allows you to assess the condition of the articular surfaces of the bones included in the joint.
  • Angiography of bones. This type of study involves the introduction of a contrast agent into the vascular bed. The study of bone vessels is used for tumor formations, to clarify the characteristics of its growth and blood supply. In malignant tumors, the diameter and arrangement of blood vessels are uneven, and the number of vessels is usually greater than in healthy tissues.
Bone x-rays should be performed to make an accurate diagnosis. In most cases, the use of a contrast agent allows you to obtain more accurate information and provide better care to the patient. However, it must be taken into account that the use of contrast agents has some contraindications and limitations. The technique of using contrast agents requires time and experience from a radiologist.

X-ray and computed tomography ( CT) bones

Computed tomography is an x-ray method that has increased accuracy and information content. Today, computed tomography is the best method for studying the skeletal system. With the help of CT, you can obtain a three-dimensional image of any bone in the body or sections through any bone in all possible projections. The method is accurate, but at the same time it creates a high radiation dose.

The advantages of CT over standard radiography are:

  • high resolution and accuracy of the method;
  • the ability to obtain any projection, while x-rays are usually performed in no more than 2 - 3 projections;
  • the possibility of three-dimensional reconstruction of the body part being studied;
  • absence of distortion, correspondence of linear dimensions;
  • possibility of simultaneous examination of bones, soft tissues and blood vessels;
  • the ability to conduct surveys in real time.
Computed tomography is performed in cases where it is necessary to diagnose complex diseases such as osteochondrosis, intervertebral hernias, and tumor diseases. In cases where diagnosis does not present any particular difficulties, conventional radiography is performed. It is necessary to take into account the high radiation exposure of this method, which is why CT is not recommended to be performed more often than once a year.

X-ray of bones and magnetic resonance imaging ( MRI)

Magnetic resonance imaging ( MRI) – comparatively new method diagnostics MRI allows you to obtain an accurate image of the internal structures of the body in all possible planes. Using computer modeling tools, MRI makes it possible to perform three-dimensional reconstruction of human organs and tissues. The main advantage of MRI is complete absence radiation exposure.

The operating principle of a magnetic resonance imaging scanner is to impart a magnetic impulse to the atoms that make up the human body. After this, the energy released by the atoms when returning to their original state is read out. One of the limitations of this method is the impossibility of use if there are metal implants or pacemakers in the body.

When performing an MRI, the energy of hydrogen atoms is usually measured. Hydrogen in the human body is most often found in water compounds. Bones contain much less water than other tissues of the body, so when examining bones, MRI gives less accurate results than when examining other areas of the body. In this respect, MRI is inferior to CT, but still exceeds conventional radiography in accuracy.

MRI is the best method for diagnosing bone tumors, as well as metastases of bone tumors in distant areas. One of the serious disadvantages of this method is the high cost and time-consuming research ( 30 minutes or more). All this time, the patient must remain stationary in the magnetic resonance imaging scanner. This device looks like a tunnel of a closed structure, which is why some people experience discomfort.

X-ray and bone densitometry

The study of the structure of bone tissue is carried out in a number of diseases, as well as during the aging of the body. Most often, a study of bone structure is carried out for a disease such as osteoporosis. Content reduction minerals in bones leads to their fragility, risk of fractures, deformations and damage to neighboring structures.

An X-ray allows you to evaluate the structure of the bones only subjectively. Densitometry is used to determine quantitative parameters of bone density and mineral content. The procedure is quick and painless. While the patient lies motionless on the couch, the doctor examines certain areas of the skeleton using a special sensor. The most important data is head densitometry femur and vertebrae.

There are the following types of bone densitometry:

  • quantitative ultrasound densitometry;
  • X-ray absorptiometry;
  • quantitative magnetic resonance imaging;
  • quantitative computed tomography.
X-ray densitometry is based on measuring the absorption of an x-ray beam by bone. If the bone is dense, it blocks most of the X-rays. This method is very accurate, but has an ionizing effect. Alternative Methods densitometry ( ultrasonic densitometry) are safer, but also less accurate.

Densitometry is indicated in the following cases:

  • osteoporosis;
  • mature age ( over 40 – 50 years old);
  • menopause in women;
  • frequent bone fractures;
  • diseases of the spine ( osteochondrosis, scoliosis);
  • any bone damage;
  • sedentary lifestyle ( physical inactivity).

Indications and contraindications for x-rays of skeletal bones

X-ray of skeletal bones has an extensive list of indications. Various diseases may be characteristic of different ages, however, bone injuries or tumors can occur at any age. For diagnosing diseases of the skeletal system, x-rays are the most informative method. The X-ray method also has some contraindications, which, however, are relative. However, be aware that bone x-rays can be dangerous and harmful if used too frequently.

Indications for bone x-ray

X-ray examination is extremely common and informative research for skeletal bones. Bones are inaccessible for direct examination, but X-rays can be used to obtain almost all of the bones. necessary information about the condition of the bones, their shape, size and structure. However, due to the release of ionizing radiation, x-rays of bones cannot be performed too often and for any reason. The indications for bone x-rays are determined quite accurately and are based on the complaints and symptoms of the patients’ diseases.

X-ray of bones is indicated in the following cases:

  • traumatic injuries of bones with pronounced pain syndrome, deformation of soft tissues and bones;
  • dislocations and other joint injuries;
  • abnormalities of bone development in children;
  • children's growth retardation;
  • limited mobility in joints;
  • pain at rest or with movement of any part of the body;
  • an increase in bone volume, if a tumor is suspected;
  • preparation for surgical treatment;
  • assessment of the quality of treatment provided ( fractures, transplantations, etc.).
The list of skeletal diseases that are detected using x-rays is very extensive. This is due to the fact that diseases of the skeletal system are usually asymptomatic and are detected only after an X-ray examination. Some diseases, such as osteoporosis, are age-related and are almost inevitable as the body ages.

X-ray of bones in most cases makes it possible to differentiate between the listed diseases, due to the fact that each of them has reliable radiological signs. In difficult cases, especially before surgical operations, the use of computed tomography is indicated. Doctors prefer to use this study because it is the most informative and has the least amount of distortion compared to the anatomical dimensions of the bones.

Contraindications for X-ray examination

Contraindications to x-ray examination are associated with the presence of the ionizing effect of x-ray radiation. At the same time, all contraindications to the study are relative, since they can be neglected in in case of emergency, such as skeletal bone fractures. However, if possible, you should limit the number of x-ray examinations and not carry them out unnecessarily.

TO relative contraindications X-ray examinations include:

  • the presence of metal implants in the body;
  • acute or chronic mental illness;
  • serious condition of the patient ( massive blood loss, unconsciousness, pneumothorax);
  • first trimester of pregnancy;
  • children's age ( up to 18 years old).
X-rays using contrast agents are contraindicated in the following cases:
  • allergic reactions to components of contrast agents;
  • endocrine disorders ( thyroid diseases);
  • severe liver and kidney diseases;
Due to the fact that the radiation dose in modern X-ray installations is decreasing, the X-ray method is becoming increasingly safer and allows restrictions on its use to be removed. In case of complex injuries, x-rays are taken almost immediately in order to begin treatment as early as possible.

Radiation doses for various x-ray examination methods

Modern radiation diagnostics adheres to strict safety standards. X-ray radiation is measured using special dosimeters, and X-ray installations undergo special certification for compliance with radiological exposure standards. Radiation doses are not the same for different research methods, as well as for different anatomical areas. The unit of measurement for radiation dose is milliSievert ( mSv).

Radiation doses at various methods x-ray of bones

As can be seen from the above data, computed tomography carries the greatest x-ray load. At the same time, computed tomography is the most informative method for studying bones today. We can also conclude that digital radiography has a great advantage over film radiography, since the x-ray load is reduced by 5 to 10 times.

How often can an x-ray be taken?

X-ray radiation poses a certain danger to the human body. It is for this reason that all the radiation that was received from medical purpose, should be reflected in medical card sick. Such records must be maintained in order to comply with annual standards limiting the possible number of x-ray examinations. Thanks to the use of digital radiography, their quantity is sufficient to solve almost any medical problem.

The annual ionizing radiation that the human body receives from environment (natural background), ranges from 1 to 2 mSv. The maximum permissible dose of X-ray radiation is 5 mSv per year or 1 mSv for each of 5 years. In most cases, these values ​​are not exceeded, since the radiation dose for a single examination is several times less.

The number of X-ray examinations that can be performed in a year depends on the type of examination and the anatomical area. On average, 1 computed tomography scan or 10 to 20 digital x-rays are allowed. However, there is no reliable data on the impact of radiation doses of 10–20 mSv annually. All we can say with certainty is that to some extent they increase the risk of certain mutations and cellular disorders.

What organs and tissues suffer from ionizing radiation from X-ray machines?

The ability to cause ionization is one of the properties of X-ray radiation. Ionizing radiation can cause spontaneous decay of atoms, cellular mutations, failure of cell reproduction. That is why X-ray examination, which is a source of ionizing radiation, requires normalization and establishment of threshold values ​​of radiation doses.

Ionizing radiation has the greatest impact on the following organs and tissues:

  • bone marrow, hematopoietic organs;
  • lens of the eye;
  • endocrine glands;
  • genitals;
  • skin and mucous membranes;
  • fetus of a pregnant woman;
  • all organs of the child's body.
Ionizing radiation at a dose of 1000 mSv causes acute radiation sickness. This dose enters the body only in case of disasters ( atomic bomb explosion). In smaller doses, ionizing radiation can lead to premature aging, malignant tumors, and cataracts. Despite the fact that the dose of X-ray radiation today has significantly decreased, there are a large number of carcinogenic and mutagenic factors in the surrounding world, which together can cause such negative consequences.

Is it possible to do bone x-rays for pregnant and breastfeeding mothers?

Any X-ray examination is not recommended for pregnant women. According to the World Health Organization, a dose of 100 mSv almost inevitably causes fetal developmental disorders or mutations leading to cancer. Greatest value has the first trimester of pregnancy, since during this period the most active development fetal tissues and organ formation. If necessary, all X-ray examinations are transferred to the second and third trimester of pregnancy. Studies conducted on humans have shown that x-rays taken after 25 weeks of pregnancy do not lead to abnormalities in the baby.

For nursing mothers, there are no restrictions in taking x-rays, since the ionizing effect does not affect the composition of breast milk. Complete research in this area has not been conducted, so in any case, doctors recommend that nursing mothers express the first portion of milk while breastfeeding. This will help you be on the safe side and maintain confidence in your child’s health.

X-ray examination of bones for children

X-ray examination for children is considered undesirable, since it is in childhood that the body is most susceptible to the negative effects of ionizing radiation. It should be noted that it is in childhood that what happens greatest number injuries that lead to the need to perform an x-ray examination. This is why x-rays are performed on children, but various protective devices are used to protect developing organs from radiation.

X-ray examination is also required in case of growth retardation in children. In this case, x-rays are taken as many times as required, since the treatment plan includes x-ray examinations after a certain period of time ( usually 6 months). Rickets, congenital anomalies skeleton, tumors and tumor-like diseases - all these diseases require radiation diagnosis and cannot be replaced by other methods.

Preparing for a bone x-ray

Research preparation is at the core of any successful research. Both the quality of diagnosis and the result of treatment depend on this. Preparing for an x-ray examination is a fairly simple undertaking and usually does not pose any difficulties. Only in some cases, such as x-rays of the pelvis or spine, does the x-ray require special preparation.

There are some features of preparing for x-rays of children. Parents should help doctors and properly psychologically prepare their children for the study. It's difficult for children for a long time remain motionless; they are also often afraid of doctors, people “in white coats.” Thanks to cooperation between parents and doctors, good diagnosis and quality treatment of childhood diseases can be achieved.

How to get a referral for a bone x-ray? Where is X-ray examination performed?

Bone x-rays can be performed today in almost any center that provides medical care. Although x-ray equipment is widely available today, x-ray examinations are performed only on the direction of a physician. This is due to the fact that x-rays are harmful to human health to a certain extent and have some contraindications.

Bone x-rays are performed at the direction of doctors of various specialties. Most often it is performed urgently when providing first aid in trauma departments and emergency hospitals. In this case, the referral is issued by the on-duty traumatologist, orthopedist or surgeon. Bone x-rays can also be performed on the direction of family doctors, dentists, endocrinologists, oncologists and other doctors.

X-rays of bones are performed in various medical centers, clinics, and hospitals. For this purpose, they are equipped with special X-ray rooms, which have everything necessary for this type of research. X-ray diagnostics are carried out by radiologists with special knowledge in this area.

What does an X-ray room look like? What's in it?

An X-ray room is a place where X-rays of various parts of the human body are taken. The X-ray room must meet high standards of radiation protection. In the decoration of walls, windows and doors, special materials are used that have a lead equivalent, which characterizes their ability to block ionizing radiation. In addition, it contains dosimeters-radiometers and personal protective equipment against radiation, such as aprons, collars, gloves, skirts and other elements.

The X-ray room must have good lighting, primarily artificial, since the windows are small and natural light is not enough for high-quality work. The main equipment of the office is an X-ray unit. X-ray machines come in different forms as they are designed for different purposes. Large medical centers have all types of X-ray machines, but the simultaneous operation of several of them is prohibited.

A modern X-ray room contains the following types of X-ray units:

  • stationary x-ray machine ( allows you to perform radiography, fluoroscopy, linear tomography);
  • ward mobile X-ray unit;
  • orthopantomograph ( installation for performing x-rays of jaws and teeth);
  • digital radiovisiograph.
In addition to X-ray units, the office contains a large number of auxiliary instruments and equipment. It also includes equipment for the workplace of a radiologist and laboratory assistant, tools for obtaining and processing X-ray images.

TO additional equipment X-ray rooms include:

  • computer for processing and storing digital images;
  • equipment for developing film photographs;
  • film drying cabinets;
  • consumables ( film, photo reagents);
  • negatoscopes ( bright screens to view pictures);
  • tables and chairs;
  • cabinets for storing documentation;
  • bactericidal lamps ( quartz) for disinfection of premises.

Preparing for a bone x-ray

Tissues of the human body, differing in different densities and chemical compositions, absorb x-ray radiation differently and, as a result, have a characteristic x-ray image. Bones have a high density and very good natural contrast, so X-rays of most bones can be performed without special preparation.

If a person needs an x-ray examination of most of the bones, then it is enough to come to the x-ray room on time. There are no restrictions on food intake, liquids, or smoking before the X-ray examination. It is recommended not to take any metal items with you, especially jewelry, as they will have to be removed before performing the test. Any metal objects interfere with the X-ray image.

The process of obtaining an x-ray does not take much time. However, in order for the image to be of high quality, it is very important for the patient to remain still while it is being taken. This is especially true for young children who can be restless. X-rays are performed for children in the presence of parents. For children less than 2 years old, x-rays are performed in a lying position; it is possible to use a special fixation that secures the child’s position on the x-ray table.

One of the serious advantages of x-rays is the ability to use them in emergency cases ( injuries, falls, traffic accidents) without any preparation. There is no loss in image quality. If the patient is not transportable or is in in serious condition, then it is possible to perform an x-ray directly in the room where the patient is located.

Preparation for x-rays of the pelvic bones, lumbar and sacral spine

X-ray of the pelvic bones, lumbar and sacral region Spinal X-ray is one of the few types of x-rays that requires special preparation. It is explained by its anatomical proximity to the intestines. Intestinal gases reduce the sharpness and contrast of an x-ray image, which is why special preparation is carried out to cleanse the intestines before this procedure.

Preparing for x-rays of the pelvic bones and lumbar region The spine includes the following main elements:

  • cleansing the intestines with laxatives and enemas;
  • following a diet that reduces the formation of gases in the intestines;
  • conducting the study on an empty stomach.
The diet should begin 2–3 days before the test. It excludes flour products, cabbage, onions, legumes, fatty meats and dairy products. In addition, it is recommended to take enzyme preparations ( pancreatin) and activated carbon after meals. On the day before the test, an enema is performed or medications such as Fortrans are taken, which help cleanse the intestines naturally. The last meal should be 12 hours before the examination, so that the intestines remain empty until the time of the examination.

Bone x-ray techniques

X-ray examination is designed to examine all the bones of the skeleton. Naturally, for the study of most bones there are special methods for obtaining x-rays. The principle of obtaining images remains the same in all cases. It involves placing the body part being examined between the X-ray tube and the radiation receiver, so that the X-ray beams pass at right angles to the bone being examined and to the cassette of X-ray film or sensors.

The positions that the components of an X-ray installation occupy relative to the human body are called placements. Over the years of practice, a large number of X-ray installations have been developed. The quality of X-ray images depends on the accuracy of their observance. Sometimes the patient has to take a forced position to carry out these instructions, but the x-ray examination is performed very quickly.

Styling usually involves taking pictures in two mutually perpendicular projections - frontal and lateral. Sometimes the study is supplemented with an oblique projection, which helps to get rid of the overlap of some parts of the skeleton with each other. In case of severe injury, some styling may become impossible. In this case, an x-ray is performed in the position that causes the least discomfort to the patient and which will not lead to displacement of the fragments and aggravation of the injury.

Methodology for studying the bones of the extremities ( arms and legs)

X-ray examination of the tubular bones of the skeleton is the most common x-ray examination. These bones make up the bulk of the bones; the skeleton of the arms and legs is composed entirely of tubular bones. The X-ray technique should be familiar to anyone who has suffered injuries to their arms or legs at least once in their life. The examination takes no more than 10 minutes and does not cause pain or discomfort.

Tubular bones can be examined in two perpendicular projections. The main principle of any X-ray image is the location of the object under study between the emitter and the X-ray sensitive film. The only condition for a high-quality image is that the patient remains motionless during the examination.

Before the examination, the limb section is exposed, all metal objects are removed from it, and the examination area is located in the center of the cassette with X-ray film. The limb should “lie” freely on the film cassette. The X-ray beam is directed to the center of the cassette perpendicular to its plane. The image is taken in such a way that adjacent joints are also included in the x-ray. Otherwise it is difficult to distinguish between the top and bottom ends tubular bone. In addition, the large coverage area helps prevent damage to joints or adjacent bones.

Typically, each bone is examined in frontal and lateral projections. Sometimes photographs are taken together with functional tests. They involve flexion and extension of a joint or loading a limb. Sometimes, due to injury or the inability to change the position of a limb, special projections have to be used. The main condition is to maintain the perpendicularity of the cassette and the X-ray emitter.

Technique for X-ray examination of skull bones

X-ray examination of the skull is usually performed in two mutually perpendicular projections - lateral ( in profile) and straight ( in frontal view). X-rays of the skull bones are prescribed for head injuries, endocrine disorders, and to diagnose deviations from indicators of age-related bone development in children.

X-ray of the skull bones in a direct anterior projection provides general information about the condition of the bones and the connections between them. It can be performed in a standing or lying position. Typically, the patient lies on the X-ray table on his stomach, with a cushion placed under his forehead. The patient remains motionless for several minutes while the X-ray tube is aimed at the back of the head and the image is taken.

X-rays of the skull bones in a lateral projection are used to study the bones of the base of the skull and nasal bones, but are less informative for other bones of the facial skeleton. To perform an X-ray in a lateral projection, the patient is placed on the X-ray table on his back, a cassette with film is placed on the left or right side of the patient’s head parallel to the axis of the body. The X-ray tube is directed perpendicular to the cassette on the opposite side, 1 cm above the ear-pupillary line.

Sometimes doctors use x-rays of the skull bones in the so-called axial projection. She matches vertical axis human body. This placement has a parietal and chin direction, depending on which side the X-ray tube is located on. It is informative for studying the base of the skull, as well as some bones of the facial skeleton. Its advantage is that it avoids much of the overlap of bones on each other that is characteristic of the direct projection.

X-ray of the skull in axial projection consists of the following steps:

  • the patient takes off metal objects and outer clothing;
  • the patient takes a horizontal position on the X-ray table, lying on his stomach;
  • the head is positioned in such a way that the chin protrudes forward as much as possible, and only the chin and the front surface of the neck touch the table;
  • There is a cassette with X-ray film under the chin;
  • the x-ray tube is directed perpendicular to the plane of the table, towards the crown area, the distance between the cassette and the tube should be 100 cm;
  • after this, a picture is taken with the chin direction of the X-ray tube in a standing position;
  • the patient throws his head back so that the crown of his head touches the support platform, ( raised x-ray table), and the chin was as high as possible;
  • The X-ray tube is directed perpendicular to the front surface of the neck, the distance between the cassette and the X-ray tube is also 1 meter.

X-ray techniques of the temporal bone according to Stenvers, according to Schuller, according to Mayer

The temporal bone is one of the main bones that forms the skull. IN temporal bone there are a large number of formations to which muscles are attached, as well as holes and canals through which nerves pass. Because of the abundance bone formations V facial area x-ray examination temporal bone is difficult. That is why various positions have been proposed for obtaining special X-ray images of the temporal bone.

Currently, three projections of x-ray examination of the temporal bone are used:

  • Mayer's technique ( axial projection). Used to study the condition of the middle ear, pyramid of the temporal bone and mastoid process. Mayer's X-ray is performed in the supine position. The head is turned at an angle of 45 degrees to the horizontal plane, and a cassette with X-ray film is placed under the ear being examined. The X-ray tube is directed through frontal bone on the opposite side, it should be directed exactly to the center of the external auditory opening of the side being examined.
  • Method according to Schuller ( oblique projection). With this projection, the condition of the temporomandibular joint, mastoid process, and the pyramid of the temporal bone is assessed. X-rays are performed lying on your side. The patient's head is turned to the side, and a cassette with X-ray film is placed between the ear of the side being examined and the couch. The X-ray tube is located at a slight angle to the vertical and directed towards the foot end of the table. The X-ray tube is centered on the auricle of the side being examined.
  • Stenvers method ( transverse projection). An image in a transverse projection allows you to assess the condition of the inner ear, as well as the pyramid of the temporal bone. The patient lies on his stomach, his head is turned at an angle of 45 degrees to the line of symmetry of the body. The cassette is placed in a transverse position, the X-ray tube is beveled at an angle to the head end of the table, and the beam is directed to the center of the cassette. All three techniques use an X-ray tube in a narrow tube.
Various x-ray techniques are used to examine specific formations of the temporal bone. In order to determine the need for a particular type of styling, doctors are guided by the patient’s complaints and objective examination data. Currently, an alternative to various types of X-ray imaging is computed tomography of the temporal bone.

X-ray placement of zygomatic bones in tangential projection

To examine the zygomatic bone, the so-called tangential projection is used. It is characterized by the fact that X-rays propagate tangentially ( tangentially) in relation to the edge of the zygomatic bone. This placement is used to identify fractures of the zygomatic bone, the outer edge of the orbit, and the maxillary sinus.

The X-ray technique of the zygomatic bone includes the following steps:

  • the patient takes off his outer clothing, jewelry, metal prostheses;
  • the patient takes a horizontal position on his stomach on the X-ray table;
  • the patient's head is rotated at an angle of 60 degrees and placed on a cassette containing X-ray film measuring 13 x 18 cm;
  • the side of the face being examined is on top, the X-ray tube is positioned strictly vertically, however, due to the tilt of the head, the X-ray rays pass tangentially to the surface of the zygomatic bone;
  • During the study, 2–3 photographs are taken with slight turns of the head.
Depending on the research task, the angle of rotation of the head can vary within 20 degrees. The focal length between the tube and the cassette is 60 centimeters. An X-ray of the zygomatic bone can be supplemented with a survey image of the bones of the skull, since all formations examined in a tangential projection are quite clearly visible on it.

Technique for x-ray examination of the pelvic bones. Projections in which x-rays of the pelvic bones are performed

X-ray of the pelvis is the main examination for injuries, tumors, and other diseases of the bones in this area. An X-ray of the pelvic bones takes no more than 10 minutes, but there is a wide variety of methods for this study. Most often, a survey x-ray of the pelvic bones is performed in the posterior projection.

The sequence of performing a survey x-ray of the pelvic bones in the posterior projection includes the following steps:

  • the patient enters the X-ray room, removes metal jewelry and clothing, except for underwear;
  • the patient lies on the X-ray table on his back and maintains this position throughout the procedure;
  • arms should be crossed on the chest, and a cushion should be placed under the knees;
  • the legs should be slightly spread, the feet should be fixed in the established position using tape or sandbags;
  • a film cassette measuring 35 x 43 cm is located transversely;
  • the X-ray emitter is directed perpendicular to the cassette, between the superior anterior iliac crest and the symphysis pubis;
  • The minimum distance between the emitter and the film is one meter.
If the patient's limbs are damaged, the legs are not given a special position, as this can lead to displacement of the fragments. Sometimes x-rays are performed to examine only one part of the pelvis, for example, in cases of injury. In this case, the patient takes a position on his back, but a slight rotation occurs in the pelvis, so that the healthy half is 3–5 cm higher. The uninjured leg is flexed and elevated, the thigh is positioned vertically and extends beyond the scope of the study. The X-ray beams are directed perpendicular to the femoral neck and cassette. This projection gives a lateral view of the hip joint.

The posterior oblique projection is used to examine the sacroiliac joint. It is performed by raising the side being examined by 25 - 30 degrees. In this case, the cassette must be positioned strictly horizontally. X-ray directed perpendicular to the cassette, the distance from the beam to the anterior iliac spine is about 3 centimeters. When the patient is positioned in this way, the x-ray image clearly shows the connection between the sacrum and the iliac bones.

Determining the age of the skeleton using X-rays of the hand in children

Bone age accurately indicates the biological maturity of the body. Indicators of bone age are the points of ossification and fusion of individual parts of bones ( synostoses). Based on bone age, it is possible to accurately determine the final height of children and determine whether they are behind or ahead in development. Bone age is determined by radiographs. After radiographs have been taken, the results obtained are compared with the standards using special tables.

The most revealing way to determine the age of the skeleton is an x-ray of the hand. The convenience of this anatomical area is explained by the fact that ossification points appear in the hand with a fairly high frequency, which allows regular examination and monitoring of growth rates. Bone age determination is mainly used for diagnosis endocrine disorders such as growth hormone deficiency ( somatotropin).

Comparison of the child’s age and the appearance of ossification points on an x-ray of the hand

Ossification points