X-rays in orthopaedics

An X-ray is appropriate when the expected information justifies the examination. For some symptoms, the consultation and examination initially provide enough information to decide what to do next. By contrast, imaging without a clear question may reveal findings whose significance remains uncertain. If you wonder why an X-ray has not been recommended for you, please ask. A clear explanation should describe the suspected cause, the basis for that assessment and when it would need to be reviewed. The extent of investigations should reflect your situation.

The area of the body is positioned for the planned X-ray. Depending on the region, you may lie, sit or stand. Different views are often needed to assess the structures more clearly. You hold still briefly for each image. Positioning can be uncomfortable if you are in pain. Tell the team which movements are difficult. They can then consider how to obtain a useful image with as little discomfort as possible. Metal objects in the area can interfere with the image and may need to be removed.

X-rays use ionising radiation. The dose depends, among other things, on the body region and type of image. Every examination should therefore have a medical reason, and exposure should be limited to what is necessary. Tell us about a possible pregnancy before the X-ray. Previous images are also relevant because they can help avoid unnecessary repeat examinations. A necessary examination is considered individually; broad comparisons between very different X-ray examinations are not particularly helpful for this.

We interpret the image alongside the location of your pain, your movement and previous findings. In osteoarthritis, for example, the extent of visible joint changes is not the only deciding factor. What actually causes difficulty when walking, climbing stairs or going about everyday life is just as important. During our discussion, we clarify which question the image has answered and what follows from it. It may support a treatment, justify another investigation or suggest holding off on additional measures for now. If the findings remain unclear, we explain what information is still missing.

Depending on the remaining question, ultrasound, MRI or CT may add information. Ultrasound is useful, for example, for certain superficial soft-tissue structures and fluid in a joint. MRI and CT have different strengths and requirements. At OrthoCoast, we arrange further imaging when medically necessary and include the results in the orthopaedic assessment. We review existing MRI images ourselves and discuss how they relate to your symptoms. Our ‘MRI and CT’ page explains the process for an examination outside the practice.

Your doctors for X-ray investigations are Priv. Doz. Dr. med. habil. Richard Kasch, Dr. med. Christoph Jährling and Björn Weidemann. Bring any relevant existing images together with their reports. A QR code for an imaging platform or a CD may provide access to the images. This allows us to consider existing information before deciding on new X-rays. If you would like to discuss symptoms or an investigation that has already been recommended, use ‘Appointments & enquiries’. We will agree with you which appointment suits your question. An acute injury causing considerable limitation first needs timely medical assessment and should not simply wait for a routine X-ray appointment.