A pelvic X-ray is a type of X-ray that captures detailed images of the pelvic region, which includes the pelvis, hips, and upper legs.
Healthcare professionals use these X-ray studies (radiographs) to diagnose numerous health conditions, such as pelvic fractures and certain types of arthritis.
Pelvic X-rays are typically quick and painless, requiring little preparation and no recovery time. Pelvic X-rays do involve radiation exposure, but it is minimal, and the X-ray benefits outweigh the potential risks.
This article looks at reasons for a pelvic X-ray, what a pelvic X-ray entails, risks associated with pelvic X-rays, and more.
Doctors use pelvic X-rays to find the cause of pain, swelling, or abnormalities in the pelvic region, which includes the pelvis, hips, and upper legs.
Conditions can include:
- pelvis fractures
- hip joint dislocation
- intestinal or genitourinary abnormalities
- inflammation where the spine meets the pelvis (sacroiliitis)
- certain kinds of arthritis, such as ankylosing spondylitis and osteoarthritis in the hips and lower back
- bone cysts
- bone cancer
Additionally, surgeons typically want X-rays before performing pelvic surgery, and they use follow-up X-rays to monitor the condition.
Radiologic technologists, also called X-ray technicians, perform pelvic X-rays. The X-ray may take place in a hospital’s radiology department or a radiology clinic.
Once it is time to begin, the X-ray tech will help the person position themselves to get the best images.
Usually, this means lying in the supine position (face up) on an exam table, but the technician may want standing images as well.
The X-ray tech may provide a lead apron or blanket to help protect the person from radiation exposure in areas not being studied.
They may also ask the person to hold their breath and be still while they perform the X-ray. This is to ensure they get the clearest images possible.
Once the person is properly positioned and covered, the technician will move behind a wall or to another room to operate the X-ray machine. They will return to reposition the person as needed.
Once the technician captures the required images, the person may get dressed and go back to their normal daily routine.
Once the X-rays are complete, a radiologist will analyze the images and send a report to the referring doctor, who will then meet with the person to discuss the results and possible treatment options.
Several factors can affect the quality of the X-rays.
For instance, an X-ray technician may have trouble capturing clear images if the person does not understand that they must remain still, such as a young child or someone with dementia or delirium.
Likewise, it can be difficult to X-ray someone who is unable to position their body correctly due to a physical condition or extreme pain from an accident or fall.
In cases such as these, the radiologist or doctor may need more images.
Furthermore, pelvic X-rays are not always accurate. In 2022, researchers studied the cases of 285 adults aged 18 years and older who were admitted to a level 1 trauma center from January 2010 through May 2019 with a severe blunt pelvic fracture.
Among other findings, they discovered that pelvic fractures were missed in 15.8% of these individuals. The researchers suggested that CT scans might be a more effective test if high clinical suspicion persists after no fracture is identified on the pelvic X-ray.
Radiation exposure is the main concern regarding X-rays.
When someone has an X-ray, radiation passes through their body. This radiation allows the radiologist or X-ray technician to create images of internal body parts, such as bones, organs, and tissues.
Cumulative excess ionizing radiation can damage or even kill cells, so there is a risk of developing organ failure and cancer.
Doctors weigh these risks against the benefits of performing X-rays, and radiologists and X-ray technicians use the least amount of radiation necessary to capture a quality image.
Someone who is concerned about radiation exposure from X-rays or who has had many X-rays over their lifetime may discuss these issues with their physician.
Anyone who is pregnant, might be pregnant, or is breastfeeding should tell their doctor before an X-ray procedure.
Depending on the reason for the X-ray, their doctor might suggest imaging procedures that do not use radiation, such as an MRI scan or ultrasound.
If an X-ray procedure is unavoidable, radiologists might then reduce the amount of time a person is exposed to radiation. Radiation exposure safety strategies
Sometimes, doctors need to give a person a contrast material to improve the quality of the X-ray images. This may be in the form of a pill that the person can swallow.
Mild to moderate side effects of contrast materials include:
- nausea and vomiting
- headache or lightheadedness
- skin issues, including itching, hives, or rash
- high or low blood pressure
- wheezing or shortness of breath
Severe side effects are rare and include:
- trouble breathing
- itching, tightening, or swelling of the throat
- significant decrease in blood pressure
A person should immediately notify a medical professional if they experience severe side effects.
This section answers some frequently asked questions about pelvic X-rays.
What do you wear for a pelvic scan?
After removing any clothing that covers the pelvic region, someone having a pelvic X-ray will dress in a hospital-provided gown.
Their X-ray technician may provide a lead apron or blanket to help prevent unnecessary radiation exposure to other body parts.
Is a pelvic X-ray the same as a hip X-ray?
The two procedures are technically different, but they are very similar.
A hip radiograph, also called a hip X-ray or a hip series, is a pelvic X-ray with an additional lateral (side) view of the affected hip.
So, a hip X-ray captures front and back images, just like a regular pelvic X-ray, as well as side images that show the hip in question.
Depending on the condition, the tech may also capture images from different positions.
Healthcare professionals typically use hip X-rays for concerns such as an abnormal gait, inability to bear weight, and even knee pain.
Pelvic X-rays are quick, painless, and relatively safe procedures that allow doctors to look inside the body’s pelvic region and diagnose a variety of conditions.