What is an upper extremity X-ray?

The upper extremity includes the fingers, hand, wrist, elbow, forearm, upper arm and shoulder. An upper extremity X-ray is a test that uses radiation to produce detailed images of the bones of the upper extremity. During an X-ray, a black-and-white image is recorded on special film or on a computer. The image looks like a negative from a black and white photograph.

X-rays work because the body's tissues vary in density (thickness). Each type of tissue allows a different amount of radiation to pass through and expose the X-ray-sensitive film. Bones, for example, are very dense, and most of the radiation is prevented from passing through to the film. As a result, bones appear white on an X-ray. Tissues that are less dense--such as the lungs, which are filled with air--allow more of the X-rays to pass through to the film and appear on the image in shades of gray.

Why is an upper extremity X-ray ordered?

An upper extremity X-ray may be ordered to evaluate for various injuries and conditions, including:

  • Fractures (breaks)
  • Dislocations (joints that are pulled or pushed out of their normal position)
  • Arthritis
  • Unexplained swelling or pain
  • Bone deformities
  • Tumors (abnormal masses of cells)
  • Infections

In addition, an upper extremity X-ray may be used after treatment to ensure that a fracture has been properly aligned and stabilized for healing.

Who performs the test?

A radiology technologist, a skilled medical professional who is trained in x-ray procedures, will perform the test. A radiologist, a doctor who specializes in evaluating x-rays and other radiology procedures, will interpret the X-rays and report the test results to your doctor.

How do I prepare for an upper extremity X-ray?

There is no special preparation for an upper extremity X-ray; however, tell the technologist if you are or may be pregnant. X-rays generally are not used on pregnant women because of the possible risk of radiation exposure to the developing baby. Also, tell the technologist if you have an insulin pump.

Before the test begins, you may be asked to remove your clothing – usually just from the waist up – and put on a hospital gown. You also will be asked to remove your wristwatch, bracelets and rings. This is done because metal can obscure the image and interfere with the test results.

What happens during the test?

The technologist may cover you from the waist down with a lead shield or apron. This shield protects your pelvic and reproductive organs from exposure to the radiation. The technologist will position your body against the X-ray film in a way that produces the clearest image. Depending on the area being examined, you may be asked to stand, lie down on the X-ray table or sit in a chair with your arm on the table. Pillows or sandbags may be used to hold your arm in place while the X-rays are taken.

The technologist will ask you to be very still and hold your breath while the X-rays are passed through your body. (This only takes a few seconds.) It is necessary to hold your breath because movement that occurs when you breathe in and out can blur the X-ray image. You may be asked to place your arm in different positions so that X-rays may be taken from several angles.

What happens after the test?

After the X-rays are taken, the technologist will process the images. You may be asked to wait a few minutes while the technologist makes sure the X-rays are acceptable; for example, to be sure they are not blurred. If necessary, you may be asked to repeat the test to obtain a clearer image.

The report of your X-ray will be sent to your doctor, who will discuss the results with you. In non-emergency cases, results usually are available within a day or two.

What will I feel during the test?

An x-ray is painless. You will not feel the radiation as it passes through your body. If you have an injury, the positions required for the X-ray may feel uncomfortable, but you only have to stay in position for a few seconds. The X-ray room may be cool, because air conditioning is used to keep the equipment at a constant temperature.

The film plate also may feel cold.

What are the risks of an X-ray?

In general, X-rays are very safe and unlikely to produce side effects. The amount of radiation used is very small, so the risks are minimal. Young children and a developing fetus carried by a pregnant woman are more sensitive to X-rays and are at greater risk for tissue damage.


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This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. This document was last reviewed on: 11/20/2014...#10230