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Common Investigations

X-ray is an imaging technique that has been used since 1895 to show problems in bones and body tissue. X-rays are a type of radiation which are like light waves but higher in energy. An X-ray machine produces short bursts of radiation that pass easily through fluids and soft tissues of the body but are blocked by dense tissue such as bone.

X-rays, or radiographs, produce clear images of bone and are used to detect fractures (breaks), or other bony abnormalities. These include 'erosions' due to inflammatory arthritis and osteophytes (new bone growth) which may be present in osteoarthritis.

Ultrasound scanning is a way of producing images of the body without using radiation. Because it does not use radiation, it is thought to be completely safe.

It uses very high frequency sound waves to create an image of part of the body in a similar principle to the sonar systems used to detect submarines. When the sound waves are directed at part of the body, different density tissue reflects it in different ways. These reflected waves are translated into an image by a computer.

MRI scan
Magnetic resonance imaging (MRI) uses a strong magnetic field and radio waves to produce detailed pictures of the inside of your body. MRI scans can show muscles, joints, bone marrow, blood vessels, nerves and other structures within your body which cannot be seen on an ordinary X-ray. The images the scans produce are usually two-dimensional, but in some cases several different scans can be taken to build up a three-dimensional image that can be displayed on a computer screen.

MRI scans are commonly used to examine the brain, spine, abdomen and pelvis.

CT scan
A CT scan, sometimes also called a CAT scan, takes pictures of the body and uses a computer to put them together. CT stands for computerised tomography and is a painless procedure. A series of X-rays are taken of the body at intervals, to produce very detailed images of the inside of the body.

The images produced by CT scans are called tomograms and they provide doctors with information to help them reach a diagnosis about a variety of conditions. Because of the way CT images are produced, they have advantages over normal X-ray images in distinguishing between different types of soft tissue.

Bone scan
A 'bone scan' is a radioisotope scan, which is a test carried out in the Nuclear Medicine Department. This involves injecting a small amount of radioactive material into a vein in your arm, which can then be detected by a special camera to produce pictures. The amount of radiation you receive is very small: similar to that from an X-ray.

You may have to wait some time between receiving the injection and having the pictures taken: this varies according to the particular test. During the scan you will be asked to sit in a chair or lie on a bed. You will not be enclosed in a tunnel and should not need to get undressed, although you may be asked to remove coins, keys or other metal objects such as belt buckles.

The injection is no more painful than having an ordinary blood test, and you should not suffer any ill effects. It will not make you drowsy or prevent you from driving afterwards. You may be asked to drink more than usual for the rest of the day to help flush the radioactivity out of your body. You should avoid close contact with young children for the remainder of the day, to avoid exposing them to unnecessary radiation. If you work with photographic film or radioactive substances you may not be able to return to work immediately and should contact the department for further advice.

You will not be given the results of your scan immediately - these have to be reviewed by a radiologist, who will send a report to the doctor who requested the test. It is important to tell staff before you have the injection if there is any possibility that you are pregnant, or if you are breastfeeding.

Information about DXA (bone density) scans.