Last updated date: 30-Oct-2023
Originally Written in English
Although sonography, computed tomography (CT), and magnetic resonance imaging (MRI) are prominent radiology technologies, traditional X-rays remain useful in orthopedic diagnostic investigations. The benefits of radiographic imaging include great local resolution of bone, time savings, relatively inexpensive prices, and global expertise.
The traditional X-ray is essential for surgical planning and clinical monitoring. An X-ray is adequate for diagnosis and treatment of numerous disease conditions (i.e. degeneration, fracture). X-rays cannot identify early bone alterations (such as osteonecrosis).
What is Conventional Radiography?
The phrase "simple x-rays" is occasionally used to distinguish x-rays used alone from x-rays mixed with other techniques in conventional radiography (eg, CT)
An x-ray beam is created and delivered through a patient to a piece of film or a radiation detector, resulting in a picture. Depending on tissue density, different soft tissues attenuate x-ray photons differently; the denser the tissue, the whiter (more radiopaque) the picture. Metal (white or radiopaque), bone cortex (less white), muscle and fluid (gray), fat (darker gray), and air or gas depict the densities from most to least dense (black, or radiolucent).
This radiation imaging approach, which is now taken for granted, has a lengthy history: We currently apply this approach in our clinics in extremely advanced digital quality, which was discovered by chance in 1895 by the German scientist Wilhelm Conrad Röntgen in one of his experiments. Our patients benefit from very low dosage radiation exposure thanks to this advanced digital method.
During the x-ray method, a radiation source generates a very short radiation pulse that is attenuated as it travels through the body, producing a picture on an x-ray film, known as an x-ray radiograph. Low-density tissue (such as skin, muscles, and fat) absorbs very little radiation during this process and looks black on the picture. Because hard tissue absorbs a lot of radiation, it appears white. In this regard, x-rays portray various areas of the body and distinct tissue.
Conventional and Digital Imaging
The picture in digital radiography is created in discrete pieces, whereas a film image is continuous. A great amount of theory and practical application will be taught in the classroom and in your clinical practice for each subject briefly mentioned in this work.
The radiologic technician is responsible for acquiring the finest diagnostic pictures possible when the physician determines the necessity for and orders radiographic examinations. In the imaging department, the radiologic technologist reviews the physician's instructions and meets the patient. Developing a friendly relationship with the patient aids the radiologic technician in obtaining the necessary diagnostic test.
The placement of the patient is the first step in the diagnostic exam. The technician then decides the exposure settings that will be utilized to imprint the picture on the image receptor. The image receptor might be a traditional film screen or, more frequently, a photosensitive phosphor plate as in computed radiography (CR), or a charged electronic device as in digital radiography, also known as direct digital radiography (DR). In CR, the image receptor is a photostimulable phosphor plate.
When x-rays pass through the body part and contact the phosphor, some emit light while others are trapped within the phosphor particles, generating a latent picture. In DR, the image receptor is a charged electrical device. X-ray photons collide with a scintillator or a photoconductor. The latent picture is represented by an electrical signal. In any instance, the picture is latent; it is not visible to the naked eye and must be processed to become visible.
Benefits of Conventional X-ray
- Because of the shorter exposure duration, it minimizes the dosage of radiation absorbed by patients and practically eliminates the need for repeat X-rays.
- Improved image quality: it boosts contrast and imaging detail automatically. It also improves bone detail and soft tissue contrast by reducing picture noise.
- Medically efficient:
- It enhances the utilization of picture material by enabling for further processing; measurements may be taken right on the image, and indications or observations on a specific detail can be added.
- Images from X-rays are included and saved in the patient's records so that they may be compared later and progress can be tracked.
- We can send pictures to your doctor without using X-ray films.
- Patient safety is improved by reducing inquiry time and using just the appropriate dosage of radiation.
- Flat Panel Detector (FPD) technology is used in almost all clinical applications, including:
- Osteoarticular radiology
- Chest radiology
- Digestive radiology
- Genitourinary radiology
- More comfortable for the patient:
- Low table height, easier access for the patient.
- Patient coverage of up to 190 cm.
Uses of Conventional Radiography
Radiography is the most widely used imaging technique. It is typically the initial imaging modality recommended to check the limbs, chest, and, in rare cases, the spine and abdomen. These locations have essential structures with densities that differ from neighboring tissues. Radiography, for example, is a first-line test for identifying the following:
- Fractures: White bone is well seen because it is adjacent to gray soft tissues.
- Pneumonia: Inflammatory exudate that fills the lungs is well seen because it contrasts with adjacent, more radiolucent air spaces.
- Intestinal obstruction: Dilated, air-filled loops of intestine are well seen amidst the surrounding soft tissue.
Variations of Conventional Radiography
When the density of neighboring tissues is comparable, a radiopaque contrast agent is frequently used to distinguish one tissue or structure from its surrounds. Blood arteries (for angiography) and the lumina of the gastrointestinal, biliary, and genitourinary tracts are common structures that require a contrast agent. Gas can be used to dilate and make the lower gastrointestinal system visible.
Other imaging procedures (for example, CT and MRI) have essentially superseded contrast investigations because their tomographic pictures enable more accurate anatomic localization of an issue. Endoscopic techniques for the esophagus, stomach, and upper intestinal system have essentially replaced barium contrast examinations.
Real-time photographs of moving structures or objects are produced using a continuous x-ray beam. Fluoroscopy is the most often utilized technique.
- With contrast agents (eg, in swallowing studies or coronary artery catheterization)
- During medical procedures to guide placement of a cardiac lead, catheter, or needle (eg, in electrophysiologic testing or percutaneous coronary interventions)
Disadvantages of Conventional Radiography
In many cases, diagnostic accuracy is inadequate. Other imaging examinations may provide advantages such as more detail, safety, or speed. If employed, gastrointestinal contrast agents such as barium and gastrografin (an iodine-based oral contrast agent) have drawbacks, while IV contrast agents have hazards.
Role of conventional X-rays in the diagnosis of vascular anomalies
Traditional radiographs offer an overview of the damaged bones and joints. Using standard radiography, leg length disparities may be easily measured.
Phleboliths are occasionally apparent on conventional imaging in patients with venous malformation. Phleboliths are diagnostic of a venous abnormality outside of the pelvis. The cortex of an afflicted bone may thicken or become lytic in people with arteriovenous malformation. Tubular flaws are occasionally observed in intraosseous AVMs.
Pediatric Conventional X-rays
The techs are at ease and skilled in dealing with and placing youngsters for X-ray exams. Toys, stickers, and coloring books are utilized to keep the youngster entertained, and our staff provides a gift for them to take home following their hospital visit.
Infants and children of all ages and sizes are given personalized shielding, pediatric gowns, and customized positioning devices as needed. In the case of ionizing radiation from an X-ray or CT examination, pediatric parameters are usually used.
Advantages of Digital Radiography
Digital imaging provides a number of benefits over traditional radiography. One advantage is that images may be created without the need of film or wet processing. This time-consuming phase is no longer required. Because a digital picture is created in a couple of seconds, the patient can stay on the examination table while the image is evaluated for diagnostic quality.
Even with poor skill, the picture may be edited and changed by the technician to get it into an acceptable diagnostic range—another significant benefit. This capacity reduces retakes since the image may be adjusted without further exposure to the patient, which is obviously a significant convenience; as a result, efficiency in patient care is increased.
The ability to modify images is a mixed blessing. Some technicians who are negligent with exposure technical aspects may overexpose the patient, knowing that the picture may be altered, exposing the patient to more radiation than is necessary. The tremendous variety in radiation exposure will provide a diagnostic-quality digital image but she also reminds operators that overexposing patients is a bad idea. Although digital imaging may withstand a broad range of exposure method errors, adequate technical considerations are still as vital as ever in safeguarding patients from undesired or needless radiation.
Despite the current trend in radiology toward cross-sectional imaging technologies like CT, MRI, and ultrasound, traditional radiography remains an important diagnostic tool and the first-line test in many disciplines of medicine. Using X-rays, conventional X-ray imaging offers an overview of a bodily region. In contrast to cross-sectional imaging, this is merely a summation image.