An X-ray procedure uses ionizing radiation to create images of internal structures, such as bones and soft tissues. This diagnostic tool helps medical professionals visualize anatomy to identify fractures, infections, or foreign objects. To ensure clear, diagnostically useful images and maintain patient safety, specific preparation regarding clothing and protective gear is necessary.
Patient Preparation and Required Clothing Changes
Patients are typically asked to change into a hospital gown to ensure personal items do not interfere with the X-ray beam. Clothing often contains materials dense enough to block or scatter radiation, creating artifacts that obscure the image. Items with metal components are particularly problematic, including zippers, snaps, buttons, bra underwires, and metallic embellishments.
These dense materials absorb X-ray photons and appear as bright white spots or shadows, potentially concealing a fracture or other area of concern. The removal of all personal items within the field of view is critical for image quality, which is why patients must empty their pockets of coins or keys. In some cases, such as imaging the legs or pelvis, loose-fitting clothing without metal elements may be permitted.
Beyond clothing, all jewelry, including necklaces, rings, watches, and sometimes removable piercings, must be taken off if they are near the area being examined. Eyeglasses and hearing aids can also block the X-ray beam and create ghost images, requiring temporary removal for head and neck studies. Any item denser than soft tissue must be removed to prevent distortion and the need for a repeat scan.
The Role of Lead Shielding and Protective Gear
Lead shielding is traditionally used to minimize a patient’s radiation exposure to radiosensitive organs outside the primary area of interest. This protective equipment, provided by the healthcare facility, is typically made of materials like lead-infused rubber. Lead’s high density and atomic number allow it to effectively absorb X-ray photons, stopping them from penetrating shielded tissues.
Common types of shielding include lead aprons, which cover the torso, and specialized shields for the gonadal area (reproductive organs) and the thyroid gland. Positioning these shields adheres to the principle of keeping radiation exposure As Low As Reasonably Achievable (ALARA). Protecting reproductive organs aims to reduce the risk of potential genetic changes to egg or sperm cells.
Modern X-ray equipment and evolving safety guidelines have introduced nuance to the use of patient shielding. Contemporary digital imaging systems are highly sensitive and require a much lower radiation dose than older machines, significantly reducing overall patient risk. Placing a lead shield within the image area can sometimes interfere with the machine’s automatic exposure control, potentially increasing the radiation dose to compensate. It may also obscure the image, necessitating a repeat exam. Therefore, the decision to use lead shielding is often made case-by-case, focusing on the specific body part and the patient’s individual circumstances.
How Requirements Vary by Procedure Location
The specific items a patient must remove, and the necessity of protective gear, depend entirely on the body part being examined. The goal is to maximize image clarity while minimizing the radiation dose to surrounding tissues. For a chest X-ray, the patient must remove all clothing and jewelry from the neck to the waist, including bras, since metal components would obscure the lungs and heart.
In contrast, an X-ray of an extremity, such as a hand or foot, requires minimal preparation. The patient only needs to remove jewelry like rings or watches and ensure the limb is free of thick or metallic clothing. For these localized studies, a small, localized shield may be placed over the patient’s abdomen if it is not in the path of the primary X-ray beam.
Dental X-rays are a distinct example where requirements are specific to the head and neck region. Patients must remove any glasses, earrings, or tongue and lip piercings, as these items would directly overlap the teeth and jaw structures, creating artifacts. In a dental setting, a thyroid collar, a type of lead shield, is almost always draped around the patient’s neck to protect the radiosensitive thyroid gland during the procedure.