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How to Read an X-Ray Report: Understanding Radiology Report Terminology

X-ray report and image of skull AP and lateral view

Not sure how to understand your X-ray report? Here’s a breakdown of some of the most common radiology report terminology.

An X-ray is a painless, low-risk imaging technique that doctors use to identify, locate and monitor illnesses and injuries. Your doctor may refer you for an X-ray to diagnose a broken bone or an illness like pneumonia.

In Canada and the U.S., you have the right to access the health information contained in your medical and health records. Having access to your medical records, including X-ray results, allows you to advocate for your own health and treatment, while also relieving ‘scanxiety’, the stress of waiting for medical results.

PocketHealth gives you easy access to your X-ray images and radiology report, as soon as your records are released by the hospital imaging department, patient portal or imaging clinic, often before your follow-up appointment. Access your records here.

But even when you have access to your medical records, they aren’t always easy to understand. The terminology in an X-ray radiology report can be full of medical jargon since it’s written by a radiologist for your referring physician. This article breaks down:

  • What an X-ray is and how it works
  • How to read an X-ray radiology report
  • Typical vocabulary found in an X-ray report
  • What an X-ray image might show
  • How to access your X-ray images and results

What is an X-ray and how does it work?

An X-ray procedure is a painless scan technique that uses a low dose of electromagnetic radiation exposure to create images of the internal structure of your body. As the rays pass through your body, the degree to which they are absorbed depends on the density of the structure they encounter. The non-absorbed ray is captured as visible light on the other side.

What you have X-rayed will depend on your particular symptoms and circumstances. There are several types of X-rays, including:

  • Abdominal X-ray: for abdominal blockages or if you have symptoms of gall or kidney stones.
  • Bone X-ray: if you have a potential break or fracture, or joint injury.
  • Chest X-ray: to determine if you have bronchitis, pneumonia or another chest illness or injury.
  • Mammogram: a special X-ray used in regular breast cancer screening and also to diagnose any unusual symptoms or abnormalities.
  • DXA or DEXA: a dual-energy X-ray absorptiometry scan measures the mineral density of your bones to determine your fracture risk.
  • CT scan: short for computed tomography, a CT scan uses X-ray technology to take multiple images from different angles which are digitally compiled into a detailed 3D image.

Why get an X-ray instead of an ultrasound?

X-rays use electromagnetic radiation to create images, while ultrasounds use sound waves. Both provide your healthcare team with valuable information about the internal health of your body.

X-rays are better able to penetrate hard internal structures like bone. They are particularly helpful when diagnosing or locating bone illness or injury, or in areas like the chest, where the bones of the rib cage might obscure views of organs such as the lungs.

Depending on your needs and situation, an X-ray might be used in conjunction with another medical imaging technique.

How to read an X-ray report

Your X-ray results consist of your images and a report written by a radiologist. That report can be full of complex medical terminology. These are some of the most commonly used acronyms, phrases and terms you may encounter when reviewing your reports.

What’s the difference between AP, PA, LAT and oblique views?

The views refer to the manner of projection, meaning the way the X-ray is taken.

  • AP: with your back against the X-ray film, the X-ray beam enters from the front (anterior) and travels through to the back (posterior).
  • PA: your chest is positioned towards the X-ray film in this view, and the X-ray beam enters from the back (posterior) and travels through to the front (anterior). PA is the standard projection, as these views are generally sharper and more accurately portray the size and margins of organs like the heart.
  • LAT: a lateral view is a side view, meaning the X-ray is taken from the side.
  • Oblique: an oblique X-ray is taken on an angle, meaning neither from the front/back or from the side. The exact angle will depend on what is being X-rayed, such as a joint like an elbow.

LAT and oblique X-ray views are taken in conjunction with AP and PA views to provide more perspective and can reveal nodules and lesions not seen from the front or back views.

Your X-ray will also likely mention the plane on which it is taken. The term “plane” is used to describe the viewing angle of a patient in an X-ray image. Images are obtained in 1 plane and then reconstructed along 3 different planes to provide the radiologist with a 360° view of your body’s internal structures and organs:

  • Coronal, which divides the body into front and back halves.
  • Sagittal, which divides the body into left and right halves.
  • Axial, which divides the body into top and bottom halves.

What is undulation?

Undulation is an uneven or wavy spot in an X-ray image. Undulation can be caused by several factors, including air or fluid in the body or the way you’re positioned when the X-ray is taken.

What’s the difference between density and lucency?

Density and lucency are descriptions of how the soft tissues and structures inside your body absorb X-ray beams.

  • Hard tissues like bone are dense. Dense tissues absorb X-rays and appear light or white on X-ray images.
  • Fat- or air-filled tissues like lungs are lucent. Lucent tissues don’t absorb X-rays to the same degree and appear darker in X-ray images.

Density is also sometimes described relative to surrounding tissues.

  • Hypodense tissue is darker (less dense, more lucent) than other tissues or structures nearby.
  • Hyperdense tissue is lighter (more dense, less lucent) than other tissues or structures nearby.

What abnormalities can an X-ray detect?

The type of abnormalities an X-ray will reveal depends on the part of your body being X-rayed.

An X-ray can detect:

  • Bone abnormalities (also called osseous lesions)
  • Bone or joint fractures
  • Chronic conditions like emphysema
  • Collapsed lungs
  • Infections like pneumonia
  • Masses, nodules or tumors, including bone cancer and lung cancer
  • Pericardial effusion (the buildup of fluid around the heart)
  • Pleural effusion (the buildup of fluid between the lung and the chest wall)

What does NF stand for?

NF is an acronym for ‘not found’. It means a specific abnormality or finding was not present in your image. This is a good result if your X-ray was ordered to investigate a specific issue. You may also encounter the term negative to describe the same thing.

No acute osseous findings is another common term that may show up in your report. It means your X-ray specifically showed no bone abnormalities.

How to access your X-ray results using PocketHealth

The technician who takes your X-rays will send them to the hospital imaging department or clinic radiologist who interprets them to create a radiology report. The report and images are released to your referring physician, who then sets up a follow-up appointment with you to discuss the results. The process can take 2-5 business days.

With PocketHealth, you can have early access to your images and radiology report as soon as they’re released, often before your follow-up appointment. With PocketHealth you can see, share and store all your medical images in one secure, easy-to-use location. Access your records here.

Report Reader can help you better understand your medical X-ray report by providing definitions for complex medical terms. In addition, MyCare Navigator highlights personalized insights, including follow-up recommendations your report contains and questions to ask your doctor. If you’re concerned about your risk for osteoporosis, it also provides access to preventative bone health screening tools.

The importance of advocating for your health

An X-ray is a painless, low-risk diagnostic imaging test that provides your healthcare team with valuable information about the condition of your inner structures and tissues. When you have secure access to your X-ray images and radiology reports, you can be confident and fully informed, armed with the information you need to take the next steps in your health journey.

How PocketHealth works

Learn how to use PocketHealth to access, read and share your X-ray results.

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