Do I need to take off my clothes for an X-ray?

Recently, a 19-year-old girl from Changzhou went to a private hospital for a physical examination. When she was taking a chest X-ray, the doctor said that he couldn't see clearly and asked her to take off her top.

After the medical examination, the girl and her parents called the police, and the incident is being further investigated...

Here, let’s discuss whether we need to take off clothes for X-rays?

Do I need to take off my clothes for an X-ray?

When taking X-ray examinations in the hospital, there are certain requirements for the clothing you wear.

If it is ordinary fabric, it will not have much impact on the shooting effect, because most of the materials of clothes are polymers composed of carbon, hydrogen and oxygen elements, which are equivalent to a piece of glass for X-rays.

However, because the X-ray dose is very low, many non-fabric decorations may cause image artifacts, thereby affecting imaging diagnosis.

Moreover, most lung diseases tend to occur in marginal areas such as the apex of the lung. If the image is not clear, it may lead to problems such as missed diagnosis. From this perspective, removing clothes is also a manifestation of responsibility to the patient.

A chest radiograph showing a metallic foreign body on the body surface. Image from the Imaging Department of Zhen'an County Hospital

Some women's underwear and clothes with metal zippers and metal buckles will affect the shooting effect. Before shooting, the doctor will ask you to take off these clothes as much as possible.

Jewelry such as metal necklaces and jade pendants also need to be removed.

Clothes with diamonds, scales, plastic prints, and metal decorations will affect the effect. Metal buttons, zippers, lighters, coins, work cards, etc. are also key items that need to be removed. In addition, if there is ointment on the skin, it should be cleaned.

There are also some clothing materials that are difficult to judge, such as adding some metal atoms or high-density materials to the fabric: lead clothing with added lead, black-tech heating clothing (the copper and silver circuits inside will block X-rays), which will also lead to inaccurate results.

However, you may be worried: if you happen to be wearing a top with diamonds and an underwire bra on the day you go to the hospital, do you really have to take off all your clothes?

In fact, there is no need to worry too much about this. Some hospitals have taken this into consideration and will provide special clothes to change into during filming.

Schematic diagram

When the doctor asks us to take off all clothes, we can ask to change into hospital gowns for filming. (Don't worry about being naked for filming~)

Why are there strict requirements on clothing materials?

In fact, in front of X-rays, most objects are translucent, but the degree of transparency is different. The higher the density or the higher the atomic number of the material, the greater the absorption of X-rays.

It uses the principle of X-ray imaging, that is, the density of tissues in various parts of the human body is different, and thus the attenuation of X-rays is different, thus forming a difference in the intensity of transmitted X-rays and imaging on latex film.

Image source: "Analysis of the pros and cons of X-ray examination in clinical diagnostic applications"

X-rays have strong penetrating power, but their penetrating ability varies for different objects.

Generally, materials with higher density or higher atomic number absorb more X-rays.

For example: the main components of muscles in the human body are carbon, hydrogen, oxygen and other elements, and have a lower density, so they absorb less X-rays; the calcium content in bones is higher and the density is larger, so they absorb more X-rays.

When X-rays pass through the complex human body, the X-rays transmitted by the various organs and tissues of the human body will form light and dark patterns on the film, and then through computer imaging processing, we can get the X-ray photos we want to see.

Compared with medical X-rays, the imaging processing of security scanners at airports and subway stations is more complicated.

In order to make it easier for staff to identify the types of items in the suitcase, it is far from enough to just get the outline of the items. Therefore, the computer classifies and marks the various substances in color based on the degree to which different substances absorb X-rays. For example, metal substances are usually marked as blue, and liquids are usually marked as orange.

Proper use of X-rays

Since X-ray imaging was invented by Roentgen in 1895, it has been widely used in clinical practice due to its many advantages such as simplicity, speed, accuracy and painlessness for patients.

It can make preliminary diagnosis of chest diseases, bone and joint diseases, abdominal diseases and facial diseases. It can show the changes of tissue thickness and density on the film, and can also record the changes of disease contour, density and function.

Image source: pexels

X-rays are convenient and efficient, but many people question their safety.

X-rays are a type of ionizing radiation that can cause atomic-level damage to the DNA in human cells, causing the cells to be unable to synthesize proteins normally or to cause abnormalities in the protein synthesis process.

When X-rays were first discovered, they attracted a lot of interest. Even aristocrats enjoyed taking X-rays. Eventually, hundreds of thousands of people were killed or disabled by X-rays, and almost all of the earliest scientists who studied X-rays developed cancer.

Because of this, the world later set very strict standards for the use of X-rays. Nowadays, the X-rays we use are usually less than 3 millisieverts, and the dose used in medical imaging is even more precise, even as low as a few tenths of a millisievert.

If this dose of X-rays is to cause harm to the human body, it would probably need to be done more than 1,000 times in a row. Therefore, we don't need to worry too much about the dangers of X-rays.

In short, X-rays are a good helper to help us judge our physical condition. If the doctor asks us to take off our clothes during the examination, we can also ask to change into the hospital gown prepared by the hospital.

END

Reviewer: Qu Bo, chief physician of general surgery at Yangtze River Shipping General Hospital, professor at Wuhan University School of Medicine.

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Editor/Xiao Xitushuo