X-rays are an important first step in diagnosing bone cancer. On an X-ray, bone cancers can make a person’s bones have a ragged, less solid appearance. Bones may also look as though holes formed within them.

Many signs of bone cancer can appear on X-rays. However, those signs are also consistent with other conditions. Doctors typically require further tests to diagnose bone cancer or rule it out.

This article discusses how doctors use X-rays to diagnose bone cancer.

It will detail their diagnostic value, describe what bone cancer looks like on an X-ray, and discuss the steps after an X-ray.

The article also describes what getting an X-ray is like.

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Bone cancer develops when bone cells begin to grow in an uncontrolled fashion. These cancers tend to be aggressive and require swift diagnosis.

According to the American Cancer Society (ACS), doctors diagnose most bone cancers after a person contacts a doctor after developing symptoms. These symptoms include:

If doctors suspect that bone cancer is causing these symptoms, they will recommend further testing. Those tests could involve imaging techniques, like X-rays.

X-rays are the most common tests during this early stage of diagnosis. They can detect some bone cancer tumors. They can also help diagnose other cancers, such as lung tumors.

Because bone cancers can begin in other organs, or could spread elsewhere, doctors sometimes recommend X-rays even after a bone cancer diagnosis.

As the ACS explains, bone cancers can present in many ways on an X-ray. For instance, bone tumors can make a person’s bones have a ragged, less solid appearance. Bones may also look as though holes formed within them.

In some cases, the tumor that extends into nearby tissue, such as fat or muscle, may be visible.

It is important to note that bone cancers do not always show up on X-rays. However, X-ray testing is quite sensitive.

Although scientists are unsure of the exact numbers, some research suggests that X-rays could detect around 91.56% of bone tumors.

X-rays use a brief pulse of radiation to create images of internal body parts. It only takes a brief moment for the X-ray technician to make an X-ray image, and it is not a painful procedure.

The procedure does not require significant preparation from the individual. However, medical staff may ask the individual to remove metallic items or jewelry, as this can compromise image quality.

They will then direct the individual to a room that contains the X-ray machine.

After guiding a person into the correct position, they will point the X-ray machine toward whichever bones the doctor wants to see.

They will then leave the room and operate the machine from another room or from behind a screen.

It is important for a person to remain still during this process. If the image quality is poor, or the doctor needs images from several angles, the X-ray technician will ask to take further images.

If people are pregnant, it is advisable for them to notify a doctor. Experts do not typically recommend X-rays for pregnant people unless it is an emergency.

Before speaking with a person, a doctor must interpret the X-rays. The next steps will depend upon the X-ray results.

The X-ray may reveal signs of bone cancer. However, these signs could also indicate other conditions. A 2019 study estimated that if doctors only relied upon X-ray results, then around 64% of bone cancer diagnoses would be false positives.

For this reason, doctors will usually recommend further testing. The most reliable method is a biopsy. This involves doctors removing tissue samples, before testing them in the laboratory. These laboratory tests can easily detect cancer cells.

If the laboratory tests suggest bone cancer, doctors will discuss treatment options. Since cancers spread, they may also recommend tests to detect cancer in other areas of the body.

The X-ray may not reveal any signs of bone cancer. At this point, doctors might want to check whether the person’s symptoms are due to a different condition. They might also recommend other tests for bone cancer.

The National Cancer Institute lists imaging tests for bone cancer as follows:

Doctors may recommend these tests if the X-ray suggests bone cancer. They might also recommend them if the X-ray shows nothing unusual, but the individual has persistent symptoms of bone cancer.

There are several symptoms of bone cancer. These include bone pain, swelling, and fractures.

If an individual has symptoms of bone cancer, doctors can recommend an X-ray. This short and painless procedure can have an important diagnostic role.

Bone cancer can leave several signs on an X-ray. The bones might look ragged, layered, or thin. They might also look perforated.

However, other conditions can lead to similar X-ray results. For this reason, doctors will need further testing.

Biopsies could confirm or rule out that someone has bone cancer. Other imaging tests can also help. Doctors may recommend further testing even if the X-ray does not suggest bone cancer. This is because some bone cancers do not show up on X-rays.