The conventional use of x-rays in the radiodiagnosis of muskelo-skeletal afflictions is widely known to the public at large. X-rays evaluation contributes to therapeutic decision making, patient care and management.
X-rays can also be used to guide radiologists, surgeons and other doctors to access and work on some internal organs through the use of guidewires, catheters and probes (long, thin, flexible and specialized tubes) passed along the blood vessels.
Different Energy Levels
The fact that other imaging modalities in our hospitals, like the fluoroscopes, mammograms, dental imaging, bone densitometry and CT scans all use X-rays of different energy levels, may however, not be so obvious to everybody.
X-rays are a type of electromagnetic energy that can pass through the body. They cannot be seen by the naked eye and cannot be felt physically.
As they pass through the body, the energy from X-rays is absorbed at different rates by different body tissues. A detecting medium coupled to the X-Ray generating equipment picks up the X-rays after they have ‘filtered’ through the tissues along its path through the area of interest and then turns them into the useful clinical images.
Dense tissues in our body that X-rays find more difficult to pass through, such as bone, are said to be more radio-opaque and show up as clear white areas on the image. Softer tissues are less so, or rather more radio-luscent that X-rays can pass through more easily, such as fat and lungs, which then show up as darker areas in X-Ray images. Trained persons make use of differences in the tissue penetration rates of X-Rays to delianate the several organs of the body, and also assess diseased ones.
Some medications may also have to be appropriately administered to aid differentiation and detection of tissues and pathologies the administration of such medication in instances where necessary should also be done by trained staff who will assess the existing conditions of patients prior to administration and also monitor for any adverse reactions during and after the procedure. Some drug related reactions can be life-threatening.
Some little energy is left in the body tissues that were not easily penetrable to the electromagnetic X-rays. Beyond certain threshold, and for different body tissues, such retained energy can become harmful in several different ways. The tissues directly involved can be affected immediately and visibly, it may be cumulative and the effect may be delayed, or worse still the effects may only show up in the offspring of the persons affected.
The fact that X-Rays cannot be seen by the naked eyes, cannot be felt passing through one’s body and the effects generally not immediately noticeable, is what makes it potentially dangerous in the wrong hands.
The benefits and risks of undergoing X-ray examination, and the frequency is carefully weighed up by trained professionals like Doctors, Radiologists and Radiographers before it is recommended and the right doses delivered to achieved the required results with the minimum possibility of harmful effects to patients.
X-ray equipment are taken through stringent quality control checks periodically and licensed for use in clinical work by the Nuclear Regulatory Authority. The examination rooms where x-rays are dispensed are specially built and to internationally approved specifications and subjected to meticulous testing against radiation leakages, so as not to inadvertently irradiate persons working in adjacent areas or who may find themselves in the general vicinity of the generating source. The licensed professionals working with radiation sources like X-rays are at all times monitored by devices attached on themselves to monitor their compliance with radiation safety measures for their own safety and that of their co-workers and offspring.
The Allied Health Professions Council is also mandated to ensure that Radiographers with the requisite training are licensed to handle these X-Ray equipment. These measures are put in place to ensure the safety of patients and the unsuspecting general public.
In our situation, however, these regulating bodies are not adequately resourced in terms of the implementing legal framework and/or the personnel and logistics to police the entire country as of now.
Some money-minded people therefore take the opportunity to set up unlicensed X-Ray units, manned by persons without the required training and licensing, who expose unsuspecting patients, students and some worker groups, to unnecessary and excessive irradiation. Some even take these suspicious setups along to schools and other workplaces to irradiate everybody in the name of Medical Examinations.
Of course there are mobile prefabricated trucks dedicated for such purposes which meet the requirements for outdoor uses.
It is therefore necessary for the public to be wary where they access X-rays services and who exposes them to radiation. Licenses should be boldly displayed in X-Ray units and/or one may ask to see them. All qualified personnel also carry their authorized identification on them and should be able to produce them on request.
X-Rays are very useful in clinical settings but can be potentially harmful in the untrained hands.
Author: Abraham Akwasi Sarfo
Chief Radiographer And Technical Head
Department of Radiology
Komfo Anokye Teaching Hospital