The Definitive Guide to X-Ray Artifacts and How to Avoid Them

All You Need to Know About X-Ray Artifacts and How You Can Avoid Them

X-rays have officially been around since the late 19th century. The invention of the X-ray was credited to Wilhelm Rontgen in 1895; however, it's thought that they were accidentally produced by William Morgan in 1795. Either way, they have become an incredibly useful tool in the modern world, especially in the medical field. 

An X-ray is a photographic image of the internal composition of something, such as the human body. The image is created by producing an electromagnetic wave of high energy that has a short wavelength. X-ray imaging allows doctors to diagnose many different conditions, including bone fractures, arthritis, lung conditions, bone cancer, breast tumors, infections, and more.

Unfortunately, X-ray images don't always come out clear due to  X-ray artifacts, which make it difficult for doctors to make a proper diagnosis.

What is an X-ray Artifact?

An X-ray artifact is a flaw in the image quality that can obscure what you were attempting image. It can also cause a misdiagnosis as an artifact may be mistaken for a foreign body. This imaging error causes flaws in the quality of the image and can include:

• Motion artifacts
• Finger marks
• Black lightning marks
• Crescent-shaped white lines
• Clear spots
• Ghosting
• Stitching artifacts
• Dead pixels
• Scratches

Why X-ray Artifacts are Problematic

X-ray images that contain artifacts can be problematic for a number of reasons. The artifact may be disruptive enough that it's difficult to identify what you're looking at in the image. For example, if the image is blurry as a result of patient movement when the image was taken,  it will be extremely difficult to identify any issues and to make a proper diagnosis.

Other artifacts, such as a white speck or scratch in the bone of the patient's foot, could be mistaken for something else. This kind of mistake could result in the doctor ordering more tests, wasting both time and money in an attempt to identify what is simply a flaw in the image.

Even if you are able to identify the artifact as an artifact, if it affects the image in a significant way, you will have to perform the X-ray again. This means you will have to reschedule the patient to come back, which they will not likely be happy about and which won't reflect well on you and your staff.

How Do X-Ray Artifacts Occur

Artifacts can appear in your X-ray images due to numerous reasons, from mistakes made during the processing and exposure of the X-rays to the handling of the images following their capture. The following are a few of the more specific ways in which artifacts can end up in your X-ray images.

Technical Errors

Technical errors made in the process of capturing the X-ray images can result in a number of different artifacts. The following are some of the common artifacts caused by technical errors:

• Small trapezoidal regions - These flaws in the image can be caused by the presence of debris in the housing.
• Backscatter - Backscatter results from  electronics that are visible behind the patient on the image. If properly placed, a grid will help remove undesired scattered X-rays.
• Grid cutoff - Grid cutoff occurs when the grid strips absorb primary x-ray beams, thereby preventing them from reaching the image receptor. This issue occurs if the grid wasn't properly positioned.
• Radiopaque lines - The appearance of radiopaque lines in a spoke-like arrangement can be caused by incorrect detector orientation.
• White dots - A white dot is the sign of a dead pixel usually caused by a problem with the transistor in a digital X-ray machine.

Patient Movement

Poor patient preparation can also be a cause for artifacts. For example, the patient should be instructed not to move and, with some procedures, to hold their breath during the X-ray image capture. Telling the patient exactly when to do this will help avoid patient movement from distorting the image. 

Also note that if the patient is still wearing jewelry, glasses, or other radiopaque items, they need to be removed or moved from the area being  X-rayed. They will block the X-ray from capturing any images beyond it, obscuring part of your X-ray image. 

Learn More

Different types of artifacts occur depending on the type of X-ray you're taking. For example, the artifacts of a digital X-ray machine will differ from those that appear on X-ray film. While traditional film X-ray machines are generally more affordable, there's more room for user error, especially in the preparation and development of the images. With a digital machine, you can see the image that was captured within minutes, meaning if there was a problem, you probably have the time to correct it and take the X-ray again while the patient is still there.

How To Avoid X-Ray Artifacts

X-ray artifacts can be caused by technical errors, development errors, and patient movement. But it is possible to prevent many artifacts from ruining your X-ray images. Properly trained staff will be aware of the proper procedures for taking X-ray images, not skipping steps or lacking in attention to detail. It's also important that they instruct the patient to remove any item on their person that might interfere with the X-ray and to remain motionless when the X-ray is taken. Simply knowing how to identify common artifacts will make it easier to prevent them.

Taking as many precautionary steps as you can to avoid artifacts from showing up on your x-rays will make it much easier to diagnose your patients and to avoid frustration and miscommunication.