UNDERSTANDING BACK TROUBLE: X-RAYS

Posted by admin on April 1, 2009 under Healthy bones Osteoporosis Rheumatic | Be the First to Comment

You will almost certainly be sent to the X-ray department, either there and then, or at a later appointment, to have X-rays (radiographs) taken of your spine.

If you are a woman of childbearing age, you should first be asked about the date of your last menstrual period. There is a ‘ten-day rule’ allowing X-rays to be taken only during the ten days after the start of a menstrual period, before the probable time of ovulation. Later than this, there exists a possibility of conception, and an embryo could be damaged by irradiation.

Generally, three or four views of the spine are taken. Sometimes, one sideways view is taken with the spine bent fully forwards and another with it arched backwards. This can be uncomfortable, but do your best to relax and keep still so that the picture is not blurred. It is done like this in order to assess movement between these two postures at each vertebral

level – whether it is absent or excessive, or abnormal in some other way. One film may be taken in the standing position because the alignment of the bones and disc spaces may be significantly different when they are weight-bearing from when you are lying down.

On the film, the shadows of the bones show up in excellent detail, particularly if you are slim. It is possible to assess the size and shape of the spinal canal and its exits, which may be relevant. The discs themselves do not show, only the spaces they occupy. (Remember this in case you get a chance to look at your own X-rays.)

The X-rays are seen by the consultant, and may also be seen by the radiologist – a doctor specialising in X-ray diagnosis.

X-rays can reveal a fractured or cracked vertebra, or show the presence of degenerative changes in the vertebrae, such as the formation of osteophytes, or of bone thickening, as well as signs of abnormalities such as misalignment of vertebrae, of deformities, potential mechanical weaknesses, and possibly instability

X-rays can, however, be deceptive and show up an abnormality which causes the person no pain or, where a person is obviously in great pain, the X-rays may reveal nothing. The doctor may well not find anything abnormal, even though the patient may be suffering from acute disc prolapse, or serious muscular injury, because discs, muscles, ligaments and other ’soft’ tissues are not radio-opaque: they do not show up on X-rays, or only very faintly. If the space occupied by a disc is seen to be reduced, it suggests that the disc has been flattened, but this does not necessarily indicate a prolapse.

*50\111\2*