X-rays (or diagnostic images) play a vital role in chiropractic. They allow chiropractors to view your bones and joints with clarity, and to some extent, the related soft tissues. With the help of x-rays, chiropractors can evaluate the health of your bones and derive an accurate diagnosis. However, x-rays are not always necessary…

The purpose of this information sheet is to answer some frequently asked questions, and clarify some common misconceptions, of the role of x-rays in chiropractic.

What can a chiropractor see on x-rays?

The x-rays that your chiropractor takes or has taken, will show your bones and joints along with the related soft tissues such as muscle or fat. However, the detail of muscle is not good on x-rays as compared to your bones and joints. If the chiropractor takes your x-ray in a standing or weight-bearing position, the various normal and abnormal curves of the spine can be seen as well as the severity of changes in joints.

The chiropractor can evaluate the general health of your bones; determine whether or not you have any congenital anomalies (unusual shapes to your bones from birth), fractures, dislocations, and arthritic conditions, infections of the bones, or joints and tumours which would significantly alter the plan of treatment.

Do all chiropractic patients receive x-rays?

Years ago most chiropractic patients underwent an x-ray examination. With new research and better education, chiropractors now use x-rays less often. The decision as to whether or not your chiropractor takes x-rays will depend on the case information that he or she obtains from you as well as the information that is found during the physical examination. Certainly chiropractors will usually take x-rays in cases of serious trauma to assess for fracture. Patients with a history of cancer will also often have x-rays taken. These are only two examples demonstrating the clinical thinking which underlies your chiropractor’s decision as to whether or not you need to have x-rays taken.

It is more common to take x-rays of older patients as the likelihood of finding a chiropractically relevant problem is greater. Older people are much more likely to have “brittle bone disease” for example, which would change the type of treatment given by the chiropractor.

Are x-rays dangerous?

There is a slight risk from exposure to x-rays and this risk is always taken into consideration when your chiropractor decides whether or not to x-ray you. The risk to children and young people is higher than the risk to older people because the potentially harm that x-rays can cause takes years to develop. If your chiropractor owns x0ray equipment, that machine must be inspected regularly and meet the standards of the national radiation protection board. Chiropractors also use a special type of x-ray film and screens that dramatically reduce the radiation dose to you. The radiation dose to patients in the 21^st century is a fraction of what it was only a few decades ago. The slight risks of radiation exposure are always compared to the potential benefit that will arise from the information on your films. For example, in patients with a likely fracture or infection, the information from the x-rays is vital to appropriate treatment.

Shouldn’t I keep x-rays since I paid for them?

Patients often think that because they have paid for x-rays that they own them. This is not the case. The law is very clear about this. The practice or practitioner, who ordered the x-rays, owns the x-rays. The patient is paying for the diagnostic information and the chiropractor’s or medical doctor’s expertise in interpreting these films. It is important for the chiropractor (or doctor) to keep these x-rays as part of your file as they are often needed at a later date for comparison.

All health care providers who take x-rays must keep them for 7 years in case of an adult, or to the age of 21 in the case of a child.

However, it is important for you to know that if another chiropractor or medical doctor with whom you consult wishes to see your x-rays, the original chiropractor or doctor MUST SEND THEM, allow the clinician to come and read them, or provide copies, with your consent. This is to protect you, the patient from receiving additional, unnecessary exposures. If you really wish to have your own x-rays, they can be copied for a fee.

Do chiropractors know about CT and MRI?

Most chiropractors have now received training in basic interpretation of CT and MRI of the spine either in Chiropractic College or during post-graduate courses. They should at least be able to explain to you why these procedures were done and what structures are seen. They are also aware of when these procedures are useful and when they are not. In some areas of the UK chiropractors are even able to refer their patients directly for these valuable procedures.