Today’s topic is going to be short and sweet, and just a quick little post about the importance of artifacts in X-ray. Well, in every modality, but especially x-ray, anything metal or hard plastics shows up on our x-ray images. Now most radiologists are pretty understanding. However, it is important as our role as a radiologic technologist to make sure that we are removing any artifact from those images before we expose.
Now what I’m saying is if you take a pelvis x-ray and you take a look and you quick think none of their pants have any buttons, zippers, anything like that, you know any metal in the area of interest and you take the x-ray and their back pockets are fully bedazzled. Okay. Well that’s something we should have caught ahead of time. It’s no different than going back to a routine chest x-ray. Do they have a necklace on? Do they have a bra on any of those clasps hooks? Do they have a tank top on? Do they have suspenders on? Those are good ones. Any of that stuff is gonna show up in our image, and depending where it’s at, it’s gonna cause some pretty nasty artifact. Now it is super important to be asking these questions before we expose, right? We don’t wanna expose anyone with extra radiation than we have to. Yes, we use as lowest dose possible. Yes, all of those things, however. It’s still extra, right? We don’t want to have to do it, and it’s a quick, easy question to ask before we expose.
Now, hospital gowns, man. Oh man. Most places, those hospital gowns, they’ve got snaps all the way from about the neck all the way down the arms. I mentioned those specifically because those get really interesting when it comes to doing shoulder x-rays and getting those buttons out of the view. Now. Ideally, you can have them slide their arm out, you can unbutton it. Otherwise, it’s highly important to just keep the artifact if it’s unremovable from the image out of the area of interest. Right? So say you’re doing, I don’t even know. Okay, say you’re doing a lumbar spine x-ray and the person has a bra and that is underwire, but the underwire is over the anatomy of T 11, so the middle of the T-spine. Well, it’s not in your area of interest. You wouldn’t necessarily have to repeat for it. However, it is something moving forward you should keep in the back of your mind and you shouldn’t make that mistake again because you now know what the outcome like. You got lucky and it worked out. However, next time you might not be.
Now, to take this a step farther, it also depends on your radiologist and where you’re at. Some radiologists make every patient change because even they take those artifacts a step farther. Say they’ve got compression socks all the way up and you’re doing a tib fib, they’ve got compression socks all the way up to their knees. That shows up in our images. Will it show up like a metal artifact? No. But will it change what the tissue looks like? Yes. Same for abdomens or really anything. Wrists, jewelries, rings, all of it. Those all cause artifacts, and even though some are metal and some aren’t, they can cause an artifact on the image.
I usually will also just make a note. If the patient you’re doing a wrist x-ray on and they refute, they have one of the permanent bracelets that is metal, it will show up like metal. However, if they’re like, I don’t want you to cut it off, I am not that worried about it, I first would warn them and say, Hey, you know.
It’s not gonna hurt you or harm you, but it’s gonna show an artifact that could possibly obscure something. And if they’re okay with it, make a note. Tell your radiologist, put a note on the order. Put a note on the image that patient refused, right? Like we can only do so much at some point. However, it is important to try our best. Now going back to the ER gowns. So the ER gowns have tons of buttons on them, right? When you’re doing portable things, typically you come and see them and they have the telemetry, um, hooked up to them. So all of the different wires for the heart, monitors and patches, and sometimes they have a pulse ox or oxygen to the tubing.
They’ve got everything right. Our goal is to get most of that out of our image. So if the nurse, if the ER provider is okay with it, take the tele off, right? Leave the stickers. Most of the stickers are fine, but take all those wires, get ’em out of the way. Move them out of the way. Our goal is to try to have the most clear un obstructive imaging as we can. So it’s best to just take one last glance before you expose. Is there something in the way? How are they dressed? Are they in their own clothes? Do they have a necklace on? Do they have metal on? Do they have something that could be in the way? For my images, it’s usually best to just take that one last glance before you expose or just get in the habit when you’re positioning them and it’s a knee or something or it’s a hip. Do they have any buttons, zippers, metallic, eyelets, anything like that? Knees, are you wearing a knee brace? Are you wearing something on your knee? Shoulders? Do you have a tank top on a bra on? All that stuff? Those little simple questions can make a big difference in getting a good image without repeats and getting an image that your radiologist is gonna be happier to read.