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SKULL AND SPINAL X-RAY – General Instructions, Procedure and After Care

A skull X-ray is an imaging test doctors use to see the bones of the skull, including the facial bones, the nose, and the sinuses. It is an easy, quick and effective method that has been used for decades to help doctors view the area that houses most vital organ. Skull X-ray studies reveal the size and shape of the skull bones, suture separation in infants, fractures or bony defects, erosion, calcification, sella turcica and pineal gland shift. Spinal X-ray studies show fractures, dislocation, compressions, curvature, erosion, narrowed spinal cord and degenerative processes


Skull X-rays are performed to examine the nose, sinuses, and facial bones. These studies may also be referred to as sinus X-rays. X-rays studies produce films, also known as radiographs, by aiming X-rays at soft bones and tissues of the body. X-ray beams are similar to light waves, except their shorter wavelength allows them to penetrate dense substances, producing images and shadows on film

Radiological film taken at different planes of skull and various regions of spine is to identify fractures, anomalies or possibly tumors


Doctors may order skull X-rays to aid in the diagnosis of a variety of diseases or injuries

Sinusitis: sinus X-rays may be ordered to confirm a diagnosis of sinusitis, or sinus infection

Fractures: a skull X-ray may detect bone fractures resulting from injury or disease. The skull X-ray should clearly show the entire skull, jaw bones, and facial bones

Tumors: skull radiographs may indicate tumors in facial bones, tissues, or sinuses. Tumors may be benign (not cancerous) or malignant (cancerous)

Other: birth defects (referred to as congenital anomalies) may be detected on a skull X-ray by changes in bone structure. Abnormal tissues or glands resulting from various conditions or diseases may also be shown on a skull radiographs

Skull X-ray

  • To identify skull fracture
  • To detect the position of pineal body
  • To identify the unusual calcification
  • To conform the shape and size of skull bones
  • To detect bone erosion
  • To identify abnormal vascularity

Spine X-ray

A lumbosacral spine X-ray is a picture of the small bones (vertebrae) in the lower part of the spine, which includes the lumbar region and the sacrum, the area that connects the spine to the pelvis

  • To diagnose wedging of collapsed vertebra
  • To detect erosion of bone called by neoplasm
  • To identify irregular calcification as a result of inflammatory process
  • To detect vertebral fractures and dislocations
  • To detect spondylosis and spurs
  • To identify trauma to vertebral; column


Skull or sinus X-rays may be performed in a doctor’s office that has X-ray equipment and a technologist available. The exam may also be performed in an outpatient radiology facility or a hospital radiology department. In many instances, particularly for sinus views, the patient will sit upright in a chair, perhaps with the head held stable by a foam vise. A film cassette is located behind the patient. The X-ray tube is in front of the patient and may be moved to allow for different positions and views. A patient may also be asked to move his or her head at various angles and positions. In some cases, technologists will ask the patient to lie on a table and will place the head and neck at various angles. In routine skull X-rays, as many as five different views may be taken to allow a clear picture of various bones and tissues. The length of the test will vary depending on the number of views taken, but in general, it should last about 10 minutes. The technologist will usually ask a patient to wait while the films are being developed to ensure that they are adequate before going to the radiologist


  • Some clients with neurological disorders require nursing support throughout the X-ray study, especially clients who are confused, combative or ventilator dependent
  • If the client has suspected spinal fracture the neck is immobilized prior to moving the client to make X-ray films
  • Metal items should be removed from body parts

Client preparation: there is no preparation for the patient prior to arriving at the radiology facility. Patients will be asked to remove jewelry, dentures, or other metal objects that may produce artifacts on the film. The referring doctor or X-ray technologist can answer any questions regarding the procedure. Any woman who is or may be pregnant should tell the technologist

  • Explain the procedure to the client in simple words
  • Remove jewelry, dentures, hairclips and glasses
  • Send the client to X-ray department in wheelchair or stretcher
  • Spinal precautions that are cervical collar and strict maintenance of head alignment done for suspected neck fracture


  • Place the client in proper positioning
  • A lateral view of the cervical spine is taken first with minimal movement to determine whether fracture has occurred
  • A C1 –C2 view is obtained by taking the X-ray through the open mouth of the client
  • For C6-C7 views adequate visualization often requires the nurse or technician to pull down firmly on the client’s arms while the film is being taken


  • Transfer the client to the bed
  • Monitor the vital signs and neurological status
  • Collect the X-ray and inform to the consultant
  • Record the procedure in the nurse’s record

Normal results: normal results should indicate sinuses, bones, tissues, and other observed areas are of normal size, shape, and thickness for the patient’s age and medical history. Results, whether normal or abnormal, will be provided to the referring doctor in a written report

Abnormal results: abnormal results may include:

  • Sinusitis: air in sinuses will show up on a radiograph as black, but fluid will be cloudy or white (opaque). This helps the radiologist to identify fluid in the sinuses. In chronic sinusitis, the radiologist may also note thickening or destruction of the bony wall of an infected sinus
  • Fractures: radiologists may recognize even tiny facial bone fractures as a line of defect
  • Tumors: tumors may be visible if the bony sinus wall is distorted or destroyed. Abnormal findings may result in follow-up imaging studies
  • Other: skull X-rays may also detect disorders that show up as changes in bone structure, such as Paget’s disease of the bone or acromegaly (a disorder associated with excess growth hormones from the pituitary gland). Areas of calcification or gathering of calcium deposits, or destruction may indicate a condition such as an infection of bone or bone marrow (osteomyelitis)
SKULL AND SPINAL X-RAY – General Instructions, Procedure and After Care
SKULL AND SPINAL X-RAY – General Instructions, Procedure and After Care
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