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Intravenous Pyelogram (IVP)

Definition:
An intravenous pyelogram (IVP) is an x-ray examination of the kidneys, ureters and urinary bladder that uses iodinated contrast material injected into veins.

You may click to see the pictures    :

An x-ray (radiograph) is a noninvasive medical test that helps physicians diagnose and treat medical conditions. Imaging with x-rays involves exposing a part of the body to a small dose of ionizing radiation to produce pictures of the inside of the body. X-rays are the oldest and most frequently used form of medical imaging.

The dye is injected through an IV (intravenous) line. Since your body clears away the dye by moving all of it into your urine, the organs that make and hold urine show up very brightly on the x-rays. This test is useful for finding kidney stones, tumors, or blockages in the urinary tract.

Why it is done:
An intravenous pyelogram examination helps the physician assess abnormalities in the urinary system, as well as how quickly and efficiently the patient’s system is able to handle waste.

The exam is used to help diagnose symptoms such as blood in the urine or pain in the side or lower back.

The IVP exam can enable the radiologist to detect problems within the urinary tract resulting from:

*kidney stones
*enlarged prostate
*tumors in the kidney, ureters or urinary bladder.

How should you prepare for the test
Your doctor will give you detailed instructions on how to prepare for your IVP study.

You will likely be instructed not to eat or drink after midnight on the night before your exam. You may also be asked to take a mild laxative (in either pill or liquid form) the evening before the procedure.

You should inform your physician of any medications you are taking and if you have any allergies, especially to iodinated contrast materials. Also inform your doctor about recent illnesses or other medical conditions.

On the day before your test, you should drink plenty of fluids. This will help prepare your kidneys for the job of clearing out the dye the next day.

Your doctor will instruct you to eat a special diet the night before the test, so that you have less solid stool in your large intestine. (Large amounts of stool in the intestine can make it harder to interpret your x-rays.) Typical instructions might include using a laxative in the afternoon before your test and limiting your dinner the night before to clear liquids such as broth and juice.

You may be asked to remove some or all of your clothes and to wear a gown during the exam. You may also be asked to remove jewelry, eye glasses and any metal objects or clothing that might interfere with the x-ray images.

Women should always inform their physician or x-ray technologist if there is any possibility that they are pregnant. Many imaging tests are not performed during pregnancy so as not to expose the fetus to radiation. If an x-ray is necessary, precautions will be taken to minimize radiation exposure to the baby. See the Safety page for more information about pregnancy and x-rays.

What does the equipment look like?


The equipment typically used for this examination consists of a radiographic table, an x-ray tube and a television-like monitor that is located in the examining room or in a nearby room. When used for viewing images in real time (called fluoroscopy), the image intensifier (which converts x-rays into a video image) is suspended over a table on which the patient lies. When used for taking still pictures, the image is captured either electronically or on film.

How does the procedure work?
X-rays are a form of radiation like light or radio waves. X-rays pass through most objects, including the body. Once it is carefully aimed at the part of the body being examined, an x-ray machine produces a small burst of radiation that passes through the body, recording an image on photographic film or a special digital image recording plate.

Fluoroscopy uses a continuous x-ray beam to create a sequence of images that are projected onto a fluorescent screen, or television-like monitor. When used with a contrast material, which clearly defines the area being examined by making it appear bright white, this special x-ray technique makes it possible for the physician to view internal organs in motion. Still images are also captured and stored either on film or electronically on a computer.

In the IVP exam, an iodine-containing contrast material is injected through a vein in the arm collects in the kidneys, ureters and bladder, giving these areas a bright white and sharply defined appearance on the x-ray images.

X-ray images are maintained as hard film copy (much like a photographic negative) or, more likely, as a digital image that is stored electronically. These stored images are easily accessible and are sometimes compared to current x-ray images for diagnosis and disease management.

How is the procedure performed?


This examination is usually done on an outpatient basis.

The patient is positioned on the table and still x-ray images are taken. The contrast material is then injected, usually in a vein in the patient’s arm, followed by additional still images.

You must hold very still and may be asked to keep from breathing for a few seconds while the x-ray picture is taken to reduce the possibility of a blurred image. The technologist will walk behind a wall or into the next room to activate the x-ray machine.

As the contrast material is processed by the kidneys a series of images is taken to determine the actual size of the kidneys and to capture the urinary tract in action as it begins to empty. The technologist may apply a compression band around the body to better visualize the urinary structures leading from the kidney.

When the examination is complete, you will be asked to wait until the radiologist determines that all the necessary images have been obtained.

An IVP study is usually completed within an hour. However, because some kidneys empty at a slower rate the exam may last up to four hours.

How you feel:
The IVP is usually a relatively comfortable procedure.

You will feel a minor sting as the contrast material is injected into your arm through a small needle. Some patients experience a flush of warmth, a mild itching sensation and a metallic taste in their mouth as it begins to circulate throughout their body. These common side effects usually disappear within a minute or two and are harmless. Rarely, some patients will experience an allergic reaction. Itching that persists or is accompanied by hives, can be easily treated with medication. In very rare cases, a patient may become short of breath or experience swelling in the throat or other parts of the body. These can be indications of a more serious reaction to the contrast material that should be treated promptly. Tell the radiologist immediately if you experience these symptoms.

During the imaging process, you may be asked to turn from side to side and to hold several different positions to enable the radiologist to capture views from several angles. Near the end of the exam, you may be asked to empty your bladder so that an additional x-ray can be taken of your urinary bladder after it empties.

The contrast material used for IVP studies will not discolor your urine or cause any discomfort when you urinate. If you experience such symptoms after your IVP exam, you should let your doctor know immediately.

Who interprets the results and how to get it
A radiologist, a physician specifically trained to supervise and interpret radiology examinations, will analyze the images and send a signed report to your primary care or referring physician, who will discuss the results with you.

What are the benefits vs. risks?
Benefits:-
*Imaging of the urinary tract with IVP is a minimally invasive procedure.
*IVP images provide valuable, detailed information to assist physicians in diagnosing and treating urinary tract conditions from kidney stones to cancer.
*An IVP can often provide enough information about kidney stones and obstructions to direct treatment with medication and avoid more invasive surgical procedures.
*No radiation remains in a patient’s body after an x-ray examination.
X-rays usually have no side effects in the diagnostic range.


Risks
:-

*The dye used in the test can affect your kidneys, and sometimes they do not work as well after exposure to this dye. This effect is almost always temporary, but some people can have permanent damage. There is also a small chance of having an allergic reaction to the x-ray dye used in the test.

*There is always a slight chance of cancer from excessive exposure to radiation. However, the benefit of an accurate diagnosis far outweighs the risk.
*The effective radiation dose from this procedure is about 1.6 mSv, which is about the same as the average person receives from background radiation in six months. See the Safety page for more information about radiation dose.
*Contrast materials used in IVP studies can cause adverse allergic reactions in some people, sometimes requiring medical treatment.
*Women should always inform their physician or x-ray technologist if there is any possibility that they are pregnant. See the Safety page for more information about pregnancy and x-rays.

A Word About Minimizing Radiation Exposure
Special care is taken during x-ray examinations to use the lowest radiation dose possible while producing the best images for evaluation. National and international radiology protection councils continually review and update the technique standards used by radiology professionals.

State-of-the-art x-ray systems have tightly controlled x-ray beams with significant filtration and dose control methods to minimize stray or scatter radiation. This ensures that those parts of a patient’s body not being imaged receive minimal radiation exposure.

What are the limitations of IVP studies?
An IVP shows details of the inside of the urinary tract including the kidneys, ureters and bladder. Computed tomography (CT) or magnetic resonance imaging (MRI) may add valuable information about the functioning tissue of the kidneys and surrounding structures nearby the kidneys, ureters and bladder.

IVP studies are not usually indicated for pregnant women.

Resources:
https://www.health.harvard.edu/fhg/diagnostics/intravenous-pyelogram.shtml
http://www.radiologyinfo.org/en/info.cfm?pg=ivp

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Abdominal Ultrasound

Alternative Names:- Ultrasound – abdomen; Abdominal sonogram

Definition :-
Abdominal ultrasound is an imaging procedure used to examine the internal organs of the abdomen, including the liver, gallbladder, spleen, pancreas, and kidneys. The blood vessels that lead to some of these organs can also be looked at with ultrasound.

.Click to see the pictures

It uses reflected sound waves to produce a picture of the organs and other structures in the upper abdomen. Occasionally a specialized ultrasound is ordered for a detailed evaluation of a specific organ, such as a kidney ultrasound.

An abdominal ultrasound can evaluate the:
*Abdominal aorta, which is the large blood vessel (artery) that passes down the back of the chest and abdomen. The aorta supplies blood to the lower part of the body and the legs.

*Liver, which is a large dome-shaped organ that lies under the rib cage on the right side of the abdomen. The liver produces bile (a substance that helps digest fat), stores sugars, and breaks down many of the body’s waste products.

*Gallbladder, which is a saclike organ beneath the liver. The gallbladder stores bile. When food is eaten, the gallbladder contracts, sending bile into the intestines to help in digesting food and absorbing fat-soluble vitamins.

*Spleen, which is the soft, round organ that helps fight infection and filters old red blood cells. The spleen is located to the left of the stomach, just behind the lower left ribs.

*Pancreas, which is the gland located in the upper abdomen that produces enzymes that help digest food. The digestive enzymes are then released into the intestines. The pancreas also releases insulin into the bloodstream; insulin helps the body utilize sugars for energy.
*Kidneys, which are the pair of bean-shaped organs located behind the upper abdominal cavity. The kidneys remove wastes from the blood and produce urine.

A pelvic ultrasound evaluates the structures and organs in the lower abdominal area (pelvis).

Why It Is Required to be Done:-
The specific reason for the test will depend on your symptoms. Abdominal ultrasound is mostly  done to:

*Determine the cause of abdominal pain.

*Detect, measure, or monitor an aneurysm in the aorta. An aneurysm may cause a large, pulsing lump in the abdomen.

*Evaluate the size, shape, and position of the liver. An ultrasound may be done to evaluate jaundice and other problems of the liver, including liver masses, cirrhosis, fat deposits in the liver (called fatty liver), or abnormal liver function tests.

*Detect gallstones, inflammation of the gallbladder (cholecystitis), or blocked bile ducts. See an illustration of a gallstone.

*Detect kidney stones.

*Determine the size of an enlarged spleen and look for damage or disease.

*Detect problems with the pancreas, such as pancreatitis or pancreatic cancer.

*Determine the cause of blocked urine flow in a kidney. A kidney ultrasound may also be done to determine the size of the kidneys, detect kidney masses, detect fluid surrounding the kidneys, investigate causes for recurring urinary tract infections, or evaluate the condition of transplanted kidneys.

*Determine whether a mass in any of the abdominal organs (such as the liver) is a solid tumor or a simple fluid-filled cyst.

*Determine the condition of the abdominal organs after an accident or abdominal injury and look for blood in the abdominal cavity. However, computed tomography (CT) scanning is more commonly used for this purpose because it is more precise than abdominal ultrasound.

*Guide the placement of a needle or other instrument during a biopsy.

*Detect fluid buildup in the abdominal cavity (ascites). An ultrasound also may be done to guide the needle during a procedure to remove fluid from the abdominal cavity (paracentesis).
How the Test is Performed :-
This test is done by a doctor who specializes in performing and interpreting imaging tests (radiologist) or by an ultrasound technologist (sonographer) who is supervised by a radiologist. It is done in an ultrasound room in a hospital or doctor’s office.

You will need to remove any jewelry that might interfere with the ultrasound scan. You will need to take off all or most of your clothes, depending on which area is examined (you may be allowed to keep on your underwear if it does not interfere with the test). You will be given a cloth or paper covering to use during the test.

An ultrasound machine creates images that allow various organs in the body to be examined. The machine sends out high-frequency sound waves, which reflect off body structures to create a picture. A computer receives these reflected waves and uses them to create a picture. Unlike with x-rays or CT scans, there is no ionizing radiation exposure with this test.

You will be lying down for the procedure. A clear, water-based conducting gel is applied to the skin over the abdomen. This helps with the transmission of the sound waves. A handheld probe called a transducer is then moved over the abdomen.

You may be asked to change position so that the health care provider can examine different areas. You may also be asked to hold your breath for short periods of time during the examination.

Abdominal ultrasound usually takes 30 to 60 minutes. You may be asked to wait until the radiologist has reviewed the information. The radiologist may want to do additional ultrasound views of some areas of your abdomen.

How To Prepare For the Test:-
Tell your doctor if you have had a barium enema or a series of upper GI (gastrointestinal) tests within the past 2 days. Barium that remains in the intestines can interfere with the ultrasound test.

Preparation for the procedure depends on the nature of the problem and your age. Usually patients are asked to not eat or drink for several hours before the examination. Your health care provider will advise you about specific preparation.

For ultrasound of the liver, gallbladder, spleen, and pancreas, you may be asked to eat a fat-free meal on the evening before the test and then to avoid eating for 8 to 12 hours before the test.

For ultrasound of the kidneys, you may not need any special preparation. You may be asked to drink 4 to 6 glasses of liquid (usually juice or water) about an hour before the test to fill your bladder. You may be asked to avoid eating for 8 to 12 hours before the test to avoid gas buildup in the intestines. This could interfere with the evaluation of the kidneys, which lay behind the stomach and intestines.

For ultrasound of the aorta, you may need to avoid eating for 8 to 12 hours before the test.

How It Feels:-
There is little discomfort. The conducting gel may feel slightly cold and wet when it is applied to your stomach unless it is first warmed to body temperature. You will feel light pressure from the transducer as it passes over your abdomen. The ultrasound usually is not uncomfortable. However, if the test is being done to assess damage from a recent injury, the slight pressure of the transducer may be somewhat painful. You will not hear or feel the sound waves.

Risks Factors:
There is no documented risk. No ionizing radiation exposure is involved.

Results:-
An abdominal ultrasound uses reflected sound waves to produce a picture of the organs and other structures in the abdomen.

Abdominal ultrasound  Normal:
The size and shape of the abdominal organs appear normal. The liver, spleen, and pancreas appear normal in size and texture. No abnormal growths are seen. No fluid is found in the abdomen.

The diameter of the aorta is normal and no aneurysms are seen.

The thickness of the gallbladder wall is normal. The size of the bile ducts between the gallbladder and the small intestine is normal. No gallstones are seen.

The kidneys appear as sharply outlined bean-shaped organs. No kidney stones are seen. No blockage to the system draining the kidneys is present.

Abdominal ultrasound Abnormal:
An organ may appear abnormal because of inflammation, infection, or other diseases. An organ may be smaller than normal because of an old injury or past inflammation. An organ may be pushed out of its normal location because of an abnormal growth pressing against it. An abnormal growth (such as a tumor) may be seen in an organ. Fluid in the abdominal cavity (ascites) may be seen.

The aorta is enlarged, or an aneurysm is seen.

The liver may appear abnormal, which may indicate liver disease (such as cirrhosis or cancer).

The walls of the gallbladder may be thickened, or fluid may be present around the gallbladder, which may indicate inflammation. The bile ducts may be enlarged because of blockage (from a gallstone or an abnormal growth in the pancreas). Gallstones may be seen inside the gallbladder.

The kidneys may be enlarged because of urine that is not draining properly through the ureters. Kidney stones are seen within the kidneys (not all stones can be seen with ultrasound).

An area of infection (abscess) or a fluid-filled cyst may appear as a round, hollow structure inside an organ. The spleen may be ruptured (if an injury to the abdomen has occurred).

Resources:
http://www.nlm.nih.gov/medlineplus/ency/article/003777.htm
http://health.yahoo.com/digestive-diagnosis/abdominal-ultrasound/healthwise–hw1430.html

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Abdominal CT Scan

Introduction:
An abdominal CT scan is an imaging method that uses x-rays to create cross-sectional pictures of the belly area. CT stands for computed tomography.
CT scans are pictures taken by a specialized x-ray machine. The machine circles your body and scans an area from every angle within that circle. The machine measures how much the x-ray beams change as they pass through your body. It then relays that information to a computer, which generates a collection of black-and-white pictures, each showing a slightly different “slice” or cross-section of your internal organs. Because these “slices” are spaced only about a quarter-inch apart, they give a very good representation of your internal organs and other structures. Doctors use CT scans to evaluate all major parts of the body, including the abdomen, back, chest, and head.

..CLICK & SEE

CT stands for computerized tomography. In this procedure, a thin X-ray beam is rotated around the area of the body to be visualized. Using very complicated mathematical processes called algorithms, the computer is able to generate a 3-D image of a section through the body. CT scans are very detailed and provide excellent information for the physician.

A CT scan is an excellent way to view the organs inside your abdomen. It is especially useful for looking at solid organs, such as the liver, pancreas, spleen, kidneys, and adrenal glands. It is also excellent for viewing the large blood vessels that pass through the abdomen (the aorta and vena cava) and for finding lymph nodes in the abdomen. Organs that can change their shape when they are empty or full, such as stomach and intestines, are harder for a CT scan to evaluate well, because it is sometimes difficult for a doctor to tell for sure if they are abnormal. Often the CT can give some information about these organs, though. Abdominal CT scans are often used to look for signs of inflammation or infection inside the abdomen in different organs, to look for cancer, or to look for injury to one or another internal organ.

A CT scan provides a better picture of internal organs than traditional x-rays. The benefits of an abdominal CT scan usually far outweigh the risks of radiation exposure.

How the Test is Performed
You will be asked to lie on a narrow table that slides into the center of the CT scanner. Usually, you will lie on your back with your arms raised above the head.

The health care provider may inject a dye into one of your veins. This helps certain diseases and organs show up better on the images.

Once inside the scanner, the machine’s x-ray beam rotates around you. Small detectors inside the scanner measure the amount of x-rays that make it through the abdomen. A computer takes this information and creates several individual images, called slices.

You must be still during the exam, because movement causes blurred images. You may be told to hold your breath for short periods of time.

The actual scan time only takes a few minutes, although the entire procedure usually takes much longer.
A CT scan is an excellent way to view the organs inside your abdomen. It is especially useful for looking at solid organs, such as the liver, pancreas, spleen, kidneys, and adrenal glands. It is also excellent for viewing the large blood vessels that pass through the abdomen (the aorta and vena cava) and for finding lymph nodes in the abdomen. Organs that can change their shape when they are empty or full, such as stomach and intestines, are harder for a CT scan to evaluate well, because it is sometimes difficult for a doctor to tell for sure if they are abnormal. Often the CT can give some information about these organs, though. Abdominal CT scans are often used to look for signs of inflammation or infection inside the abdomen in different organs, to look for cancer, or to look for injury to one or another internal organ.

Why the Test is Performed
An abdominal CT rapidly creates detailed pictures of the belly area. The test may be used to:

*Study blood vessels
*Identify masses and tumors, including cancer
*Look for infections, kidney stones, or appendicitis
.How to Prepare for the Test
If you are having an abdominal CT scan, you might have to fast 2–4 hours before your test. You also may have to drink a large quantity of oral contrast, a fluid that will show up on the CT scan and help define the lining of some internal organs.

Tell your doctor if you’re allergic to x-ray contrast dyes, may be pregnant, or have diabetes and take insulin. Insulin can cause hypoglycemia after missing a meal. or have had difficulty with previous CT scans.

If contrast or sedation is used, you may also be asked not to eat or drink anything for 4-6 hours before the test.

Since x-rays have difficulty passing through metal, you will be asked to remove jewelry and wear a hospital gown during the study.

What happens when the test is performed?
The test is done in the radiology department of a hospital or in a diagnostic clinic. You wear a hospital gown and lie on your back on a table that can slide back and forth through the donut-shaped CT machine. A technician or other health care professional inserts an IV and injects more contrast dye through it. This dye outlines blood vessels and soft tissue to help them show up clearly on the pictures.

The technologist moves the table with a remote control to enable the CT machine to scan your body from all of the desired angles. You will be asked to hold your breath for a few seconds each time a new level is scanned. The technologist usually works the controls from an adjoining room, watching through a window and sometimes speaking to you through a microphone. A CT scan takes about 30–45 minutes. Although it’s not painful, you might find it uncomfortable if you don’t like to lie still for extended periods.

How the Test Will Feel
The x-rays are painless. Some people may have discomfort from lying on the hard table.

Contrast give through an IV may cause a slight burning sensation, a metallic taste in the mouth, and a warm flushing of the body. These sensations are normal and usually go away within a few seconds.

Risk Factors:-
There are a few small risks. The contrast dye used in the test can damage your kidneys, especially if they are already impaired by disease.However, some newer dyes are less likely to cause kidney injuries. If kidney damage does occur, this is usually temporary, although in some rare cases it becomes permanent. If you are allergic to the dye used in the procedure, you may get a rash or your blood pressure may drop enough to make you feel faint until you get treatment. As with x-rays, there is a small exposure to radiation. The amount of radiation from a CT scan is greater than that from regular x-rays, but it’s still too small to be likely to cause harm unless you’re pregnant.

An abdominal CT scan is usually not recommended for pregnant women, because it may harm the unborn child. Women who are or may be pregnant should speak with their health care provider to determine if ultrasound can be used instead.

CT scans and other x-rays are strictly monitored and controlled to make sure they use the least amount of radiation. CT scans do create low levels of ionizing radiation, which has the potential to cause cancer and other defects. However, the risk associated with any individual scan is small. The risk increases as numerous additional studies are performed.

In some cases, a CT scan may still be done if the benefits greatly out weigh the risks. For example, it can be more risky not to have the exam, especially if your health care provider thinks you might have cancer.

The most common dye used is iodine based. A person who is allergic to iodine may have nausea, sneezing, vomiting, itching, or hives. Rarely, the dye may cause anaphylaxis (a life-threatening allergic response).

Results:-
What Abnormal Results Mean

The CT scan may show the following:

*Abdominal aortic aneurysm
*Abscesses
*Acute bilateral obstructive uropathy
*Acute cholecystitis
*Acute unilateral obstructive uropathy
*Addison’s disease
*Amebic liver abscess
*Appendicitis
*Bilateral hydronephrosis
*Bowel wall thickening
*Carcinoma of the renal pelvis or ureter
*Cholangiocarcinoma
*Choledocholithiasis
*Cholelithiasis
*Chronic bilateral obstructive uropathy
*Chronic cholecystitis
*Chronic pancreatitis
*Chronic unilateral obstructive uropathy
*Complicated UTI (pyelonephritis)
*Cystinuria
*Cysts
*Echinococcus
*Enlarged lymph nodes
*Enlarged organs
*Gastrointestinal or bowel obstruction
*Glucagonoma
*Hairy cell leukemia
*Hepatocellular carcinoma
*Histoplasmosis; disseminated
*Hodgkin’s lymphoma
*Islet of Langerhans’ tumor
*Multiple endocrine neoplasia (MEN) II
*Nephrocalcinosis
*Nephrolithiasis
*Non-Hodgkin’s lymphoma
*Ovarian cancer
*Pancreatic abscess
*Pancreatic carcinoma
*Pancreatic pseudocyst
*Pancreatitis
*Pheochromocytoma
*Primary hyperaldosteronism
*Pyelonephritis – acute
*Pyogenic liver abscess
*Renal cell carcinoma
*Retroperitoneal fibrosis
*Sclerosing cholangitis
*Stones (bladder, kidney, liver, gall bladder)
*Testicular cancer
*Tumors
*Unilateral hydronephrosis
*Ureterocele
*Wilms’ tumor
*Wilson’s disease
*Zollinger-Ellison syndrome

Additional conditions under which the test may be performed include the following:-
*Acute renal failure
*Alcoholic liver disease (hepatitis/cirrhosis)
*Atheroembolic renal disease
*Chronic glomerulonephritis
*Chronic renal failure
*Cushing syndrome
*Cushing syndrome caused by adrenal tumor
*Injury of the kidney and ureter
*Medullary cystic kidney disease
*Multiple endocrine neoplasia (MEN) I
*Polycystic kidney disease
*Reflux nephropathy
*Renal artery stenosis
*Renal vein thrombosis
*Skin lesion of histoplasmosis

How long is it before the result of the test is known?
The radiologist can probably give you preliminary results within a day. The formal reading of your CT scan might take another day.

Resources:
https://www.health.harvard.edu/fhg/diagnostics/abdominal-ct-scan.shtml
http://www.nlm.nih.gov/medlineplus/ency/article/003789.htm

Chest X-Ray

Definition:The chest x-ray is the most commonly performed diagnostic x-ray examination. A chest x-ray makes images of the heart, lungs, airways, blood vessels and the bones of the spine and chest.

An x-ray (radiograph) is a noninvasive medical test that helps physicians diagnose and treat medical conditions. Imaging with x-rays involves exposing a part of the body to a small dose of ionizing radiation to produce pictures of the inside of the body. X-rays are the oldest and most frequently used form of medical imaging.

Doctors have used x-rays for over a century to see inside the body in order to diagnose a variety of problems, including cancer, fractures, and pneumonia. During this test, you usually stand in front of a photographic plate while a machine sends x-rays, a type of radiation, through your body. Originally, a photograph of internal structures was produced on film; nowadays, the image created by the x-rays goes directly into a computer. Dense structures, such as bone, appear white on the x-ray films because they absorb many of the x-ray beams and block them from reaching the plate (see Figure 16). Hollow body parts, such as lungs, appear dark because x-rays pass through them. (In some other countries, like the United Kingdom, the colors are reversed, and dense structures are black.)

Back x-rays and chest x-rays are among the most common conventional x-ray tests. You should not have an x-ray if you’re pregnant, because radiation can be harmful to a developing fetus.

A chest x-ray provides black-and-white images of your lungs, ribs, heart, and diaphragm.

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Some common uses:
The chest x-ray is performed to evaluate the lungs, heart and chest wall.

A chest x-ray is typically the first imaging test used to help diagnose symptoms such as:

*shortness of breath
*a bad or persistent cough
*chest pain or injury
*fever.
Physicians use the examination to help diagnose or monitor treatment for conditions such as:

*pneumonia
*heart failure and other heart problems
*emphysema
*lung cancer
*other medical conditions.


How should you prepare for the test?

A chest x-ray requires no special preparation.

You may be asked to remove some or all of your clothes and to wear a gown during the exam. You may also be asked to remove jewelry, eye glasses and any metal objects or clothing that might interfere with the x-ray images.

Women should always inform their physician or x-ray technologist if there is any possibility that they are pregnant. Many imaging tests are not performed during pregnancy so as not to expose the fetus to radiation. If an x-ray is necessary, precautions will be taken to minimize radiation exposure to the baby. See the Safety page for more information about pregnancy and x-rays.

You are usually asked to remove all clothing, undergarments, and jewelry above your waist, and to wear a hospital gown.

What does the equipment look like?
The equipment typically used for chest x-rays consists of a wall-mounted, box-like apparatus containing the x-ray film or a special plate that records the image digitally and an x-ray producing tube, that is usually positioned about six feet away.
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The equipment may also be arranged with the x-ray tube suspended over a table on which the patient lies. A drawer under the table holds the x-ray film or digital recording plate.

A portable x-ray machine is a compact apparatus that can be taken to the patient in a hospital bed or the emergency room. The x-ray tube is connected to a flexible arm that is extended over the patient while an x-ray film holder or image recording plate is placed beneath the patient.

What happens when the test is performed?
Chest x-rays usually are taken while you are standing. A technician positions you against the photographic plate (which looks like a large board) to obtain the clearest pictures. He or she takes pictures from the front and from one side while asking you to take in a deep breath just before each picture. The technician leaves the room or stands behind a screen while the x-rays are taken.

How does the procedure work?
X-rays are a form of radiation like light or radio waves. X-rays pass through most objects, including the body. Once it is carefully aimed at the part of the body being examined, an x-ray machine produces a small burst of radiation that passes through the body, recording an image on photographic film or a special digital image recording plate.

Different parts of the body absorb the x-rays in varying degrees. Dense bone absorbs much of the radiation while soft tissue, such as muscle, fat and organs, allow more of the x-rays to pass through them. As a result, bones appear white on the x-ray, soft tissue shows up in shades of gray and air appears black.

On a chest x-ray, the ribs and spine will absorb much of the radiation and appear white or light gray on the image. Lung tissue absorbs little radiation and will appear dark on the image.

Until recently, x-ray images were maintained as hard film copy (much like a photographic negative). Today, most images are digital files that are stored electronically. These stored images are easily accessible and are sometimes compared to current x-ray images for diagnosis and disease management.

How is the procedure performed?

Typically, two views of the chest are taken, one from the back and the other from the side of the body as the patient stands against the image recording plate. The technologist, an individual specially trained to perform radiology examinations, will position the patient with hands on hips and chest pressed the image plate. For the second view, the patient’s side is against the image plate with arms elevated.

 

Patients who cannot stand may be positioned lying down on a table for chest x-rays.

You must hold very still and may be asked to keep from breathing for a few seconds while the x-ray picture is taken to reduce the possibility of a blurred image. The technologist will walk behind a wall or into the next room to activate the x-ray machine.

When the examination is complete, you will be asked to wait until the radiologist determines that all the necessary images have been obtained.

The chest x-ray examination is usually completed within 15 minutes.

Additional views may be required within hours, days or months to evaluate any changes in the chest.

What will you experience during and after the procedure?
A chest x-ray examination itself is a painless procedure.

You may experience discomfort from the cool temperature in the examination room and the coldness of the recording plate. Individuals with arthritis or injuries to the chest wall, shoulders or arms may have discomfort trying to stay still during the examination. The technologist will assist you in finding the most comfortable position possible that still ensures diagnostic image quality.
Who interprets the results and how do you get them?
A radiologist, a physician specifically trained to supervise and interpret radiology examinations, will analyze the images and send a signed report to your primary care or referring physician, who will discuss the results with you.

In an emergency, the results of a chest x-ray can be available almost immediately for review by your physician.
What are the benefits vs. risks?
Benefits:

*No radiation remains in a patient’s body after an x-ray examination.
*X-rays usually have no side effects in the diagnostic range.
*X-ray equipment is relatively inexpensive and widely available in emergency rooms, physician offices, ambulatory care *centers, nursing homes and other locations, making it convenient for both patients and physicians.
*Because x-ray imaging is fast and easy, it is particularly useful in emergency diagnosis and treatment.

Risks:

*There is always a slight chance of cancer from excessive exposure to radiation. However, the benefit of an accurate diagnosis far outweighs the risk.

*The chest x-ray is one of the lowest radiation exposure medical examinations performed today. The effective radiation dose from this procedure is about 0.1 mSv, which is about the same as the average person receives from background radiation in 10 days. See the Safety page for more information about radiation dose.

*Women should always inform their physician or x-ray technologist if there is any possibility that they are pregnant. See the Safety page for more information about pregnancy and x-rays.

How long is it before the result of the test is known?
Although digital images may be available immediately, it will take additional time for a doctor to examine and interpret them. You’ll probably get the results later in the day.

A Word About Minimizing Radiation Exposure:
Special care is taken during x-ray examinations to use the lowest radiation dose possible while producing the best images for evaluation. National and international radiology protection councils continually review and update the technique standards used by radiology professionals.

State-of-the-art x-ray systems have tightly controlled x-ray beams with significant filtration and dose control methods to minimize stray or scatter radiation. This ensures that those parts of a patient’s body not being imaged receive minimal radiation exposure.

What are the limitations of Chest Radiography?
The chest x-ray is a very useful examination, but it has limitations. Because some conditions of the chest cannot be detected on an x-ray image, this examination cannot necessarily rule out all problems in the chest. For example, very small cancers may not show up on a chest x-ray. A blood clot in the lungs, a condition called a pulmonary embolism, cannot be seen on chest x-rays.

Further imaging studies may be necessary to clarify the results of a chest x-ray or to look for abnormalities not visible on the chest x-ray.

Click for More Additional Information and Resources: ->
*RadiologyInfo: Radiation Therapy for Lung Cancer

*RTAnswers.org: Radiation Therapy for Lung Cancer

Resources:
https://www.health.harvard.edu/diagnostic-tests/chest-x-ray.htm
http://www.radiologyinfo.org/en/info.cfm?PG=chestrad

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How Can One Combat IHD?

In their mid-forties, suffer from heart diseases

Heart diseases are becoming common. Why so?
Today, 11 to 12 per cent of the urban and four to five per cent of the rural population are suffering from coronary artery diseases. The percentage is likely to increase every year. The situation in India is worse when compared to other countries.

Many, in their mid-forties, suffer from heart diseases, whereas in the Western countries the age group is higher. This is a malignant form of Ischemic Heart Disease (IHD). Initially, scientists felt that IHD happened due to genetic problems but later it was found that lifestyle and food habits are also to be blamed.

What should we do to prevent this disease?
Irregular working hours and excessive smoking lead to IHD. One needs to workout regularly. Food habit is another important concern. Junk food and food with preservatives are extremely harmful. Avoid eating red meat, coconut, butter and prawn.

These increase cholesterol in blood and lead to obesity. The other major risk factors are presence of diabetes and high BP.

What are the symptoms of cardiac problem?
The symptoms are very deceptive. In most cases, people can’t differentiate cardiac pain from gastric pain. And there are misconceptions like cardiac pain will always be felt in the left part of the chest. One can feel the pain even in the middle or right side of the chest.

Regular blood tests are extremely important and your cholesterol level should be below 200 unit, Triglyceride level should be below 150 unit and low-density cholesterol should be below 100.

What are the treatments for IHD?
The treatment is three-fold. Sometimes, it can be treated with medicines. Angioplasty is another good option to remove the blockage and when there Is multiple blockage, one has to undergo a bypass surgery.

Source: The Telegraph (Kolkata, India)