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Darkening on X-rays in adults and children
Last reviewed: 07.06.2024
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Quite often, as part of diagnostic measures, the doctor prescribes a patient radiography. This procedure is performed to detect pathologies, damage to tissues and organs, as well as to clarify the results of other studies. Deciphering the X-ray image is engaged in a specialist radiologist, who then sends the information received to the attending physician. But for the average patient, such "decoding" is often incomprehensible. So, if any darkening is detected on the X-ray, many patients begin to worry unnecessarily, because they do not know the essence of the situation. Should we panic if the image contains spots or darkening, and what does it mean?
What does a blackout on an x-ray mean?
When patients are told of the presence of a blackout on x-ray, many become anxious, assuming malignancy. In fact, a tumor shows some darkening, but it is only one of the many causes of this symptom. Therefore, do not be immediately afraid: it is important to get as much information as possible about this phenomenon and familiarize yourself with all the possible factors for the occurrence of darkening on X-rays.
And the reasons could be as follows:
- Improper operation of the X-ray machine, use of low-grade film, improper image development procedure.
- The presence of foreign bodies in organs and tissues.
- Traces from previous surgical operations (scars).
- Inflammatory foci.
- Helminth accumulations, parasites.
- Fracture marks and other bone injuries.
- Presence of fluids.
- Benign and malignant tumors, metastases.
If the doctor detects a darkening on X-ray, additional diagnostics may be required. This is necessary to clarify the causes and nuances of the disease. Treatment can be prescribed only after the completion of all studies. In addition, the patient's complaints, clinical symptomatology, general well-being are taken into account.
What can a blackout in the lungs look like on an x-ray?
The darkening in the lungs is evaluated by the doctor by these indicators:
- The localization of the darkening is above, below, in the middle part of the lung. In addition, the darkening may be located in the outer, middle or inner lobe of the lung.
- The size of the darkening is important to assess the area of the pathologic process.
- The intensity of the darkening helps to determine the density of the focus (medium, weak and pronounced).
- General characteristics of outlines: borders are flat, jagged, etc. It is often this indicator that makes it possible to suspect a particular disease.
These are the most important, but not all the signs that the doctor pays attention to during the decipherment and diagnosis. In addition, the type and shape of the darkening on the X-ray must be taken into account:
- The lobular darkening has clear boundaries, a kind of concavity or convexity. It may be a sign of inflammatory or destructive process. Localization of lobular darkening in the middle-lower zone of the lung may indicate tumor formation.
- Focal darkening in the lungs on X-ray is a small (about 10 mm) spot, indicating an inflammatory process, vascular pathology, or the development of peripheral cancer, tuberculosis or pulmonary infarction. If the foci are detected along with the patient's complaints of head pain, cough and pressure in the chest, then bronchopneumonia can be suspected.
- Darkenings of indeterminate shape, as a rule, are not intense and do not have a clear configuration. In order to diagnose in such a situation, additional diagnostics is prescribed - in particular, magnetic resonance or computed tomography. Most often blurred spots are a sign of pleurisy, inflammation of the lungs, or some tumor processes.
- Fluid darkening is a sure sign of pulmonary edema. Moisture can collect due to high vascular pressure, with increased vascular permeability. In such a situation, there is a pronounced impairment of pulmonary function.
- Segmental darkening is similar to a triangle. This occurs in malignant diseases, tuberculosis, pneumonia, and so on. In such a situation, it is important that the doctor has sufficient qualification - both in terms of diagnosis and competent prescription of treatment.
- A focal darkening is a single spot up to 10 mm in size. This sign often indicates pneumonia, tuberculosis, cystic and purulent masses.
An adequate specialist will never make a diagnosis based solely on the type and localization of dark spots on X-rays. Usually a full comprehensive diagnosis is required, including laboratory tests.
When the doctor is faced with a combination of pathologic symptoms, additional diagnosis must necessarily follow. Moreover, when darkening is detected, the doctor should differentiate the disease and answer such questions:
- Is the stain found specific or not (tuberculosis)?
- Does the darkening have evidence of an inflammatory response?
- Could it be a malignant process?
- Is there evidence of any uncommon (rare) pathology?
Right lung darkening on X-ray.
It is important to understand that any darkening of the lungs, right or left, is not a diagnosis, but only one of the signs of the disease. What disease we are talking about will become clear after the whole complex of diagnostics. As a result, the doctor will compare all the results and symptoms and only then will make a final diagnosis.
Pulmonary pathologies are mostly accompanied by various foci of thickening in the lung tissue. This happens as a result of deterioration or complete blockage of air circulation in some areas of the organ. Such seals on the X-ray image have the appearance of darkening.
Small focal darkenings, predominantly on the right side, may indicate the onset of a lung disease. It is not possible to clearly answer questions about the cause of the problem and its origin by examining just one image. Therefore, auxiliary types of diagnostics should be appointed - for example, CT, MRI, or the same radiography, but performed from other angles. In addition, urine, blood, sputum secretions, etc. Are also examined in the laboratory.
If small darkenings on X-ray are noted at the same time with symptoms such as fever, weakness, headache, cough, chest pain, then pneumonia (bronchopneumonia) can be suspected.
If laboratory tests do not reveal obvious changes in the blood, it allows us to think about the presence of focal tuberculosis. In such a situation, the patient voices complaints of poor appetite, a feeling of fatigue, dry cough, chest pain. To exclude or confirm the suspicion, appropriate tests are prescribed.
In pulmonary infarction in most patients, thrombophlebitis of the lower extremities, cardiovascular disorders, lateral chest pain, and sometimes hemoptysis are found.
Lung cancer is a malignant disease that develops more often in the right lung. The upper lobes are affected more often than the lower lobes. Therefore, darkening of the upper part of the lung on X-ray should be alarming and become a reason for further careful diagnosis, including differential diagnosis: this phenomenon should be distinguished from tuberculosis.
These are the most common pathologies, which are recorded on the X-ray image in the form of blackouts. However, there are a number of other less common pathologies, and the likelihood of their development should also be considered.
Darkening in the lungs on a child's x-ray
Detection of pulmonary darkening in pediatric patients requires a special approach. The interpretation of the image should be as detailed as possible, with full characteristics of all pathologic changes.
- Enlarged lung roots on the left or right most often indicate bronchitis or pneumonia.
- Deepened vascular pattern of the lung on the left or right indicates impaired blood circulation in the respiratory system, cardiovascular problems, but may be a sign of bronchitis, pneumonia or the initial stage of oncopathology.
- The presence of fibrosis (fibrotic tissue) is the result of previous surgery or trauma to the respiratory system.
- The presence of focal shadows with simultaneous enhancement of the vascular pattern is a typical picture of pulmonary inflammation.
Detected darkening can indicate a host of different diseases. Therefore, you should not diagnose the child on your own. It is important to continue the diagnosis. For example, the doctor can prescribe these types of studies:
- a diaskin test (preferred) or a Mantoux test;
- sputum analysis;
- CT scan of the lungs;
- bronchoscopy, tracheobronchoscopy;
- general blood test, biochemical blood test, oncomarker test.
The need for certain tests is determined on an individual basis.
The darkening on the bone on the x-ray
X-ray of the bone and joint system is one of the common diagnostic methods that helps to establish a diagnosis, identify complications and determine further treatment. First of all, such an examination is performed when fractures, bone fractures, dislocations and subluxations, ligament injuries are suspected. It is also possible to detect secondary bone and joint disorders, degeneration processes, etc.
In bone fracture, there is a linear brightening of the damaged area, against the background of the remaining structural darkening. The fracture line is not visible in all cases.
In osteoporosis, the density of calcium salts in the bone tissue decreases, which is noted on X-rays in the form of areas of darkening. If the disorder is of a pronounced nature, the structure transmits X-rays well, which leads to the appearance of obvious dark spots.
Assimilated periostitis reveals articulations of calcium deposits with the underlying bone, which should be distinguished from excessive bone callus after a comminuted fracture.
Damage to fasciae, tendons, ligaments causes the formation of hematomas, in which calcium salts are deposited, so this process is seen by darkening on the image. The causes of such pathology can be trauma, physical overload, etc.
Darkening on the rib on X-rays, as on other bones, appears during the formation of bone callus after a fracture. In this case, the callus is an area of connective tissue that is formed during bone healing. Radiologically, the regeneration process looks as follows:
- after a few weeks, a weakly intense muffle-shaped darkening appears along the bony circumference;
- the intensity of the blackout gradually increases;
- upon completion of the formation of the bone callus, a pronounced darkening of the circumference is determined, and bone beams appear between the fragments.
Darkening of the sinuses on x-ray.
How dangerous can darkening of the nose on X-ray be? Such a conclusion is often voiced when diagnosing various pathologies of the ENT organs. To put it simply, the darkening most often indicates an inflammatory reaction in one or another section (sinus) with the appearance of discharge. X-ray examination is often recommended for patients with maxillary sinusitis, frontitis and sinusitis.
The X-ray image shows the maxillary and frontal sinuses and the lattice labyrinth. And the intensity of darkening makes it possible to assess the stage of the disease and its neglect. Expressed shadows indicate strong accumulations of purulent secretions - that is, the active reproduction of pathogenic flora. The causative agents of maxillary and frontitis most often become pneumococci and streptococci, which become especially active against the background of prolonged rhinitis, if the treatment was not carried out, or was illiterate. Inflammatory reaction causes swelling of the mucosa, which blocks the excretion of accumulated secretions, which becomes an additional factor for increased multiplication of microbes.
Darkening of the maxillary sinus on X-ray may be combined with thickening of the mucosal tissues, which happens as a result:
- of an acute inflammatory process;
- of the allergic process;
- of prolonged chronic inflammation.
However, the problem may not only be caused by inflammation - for example, a darkened frontal sinus on X-ray may mean a cyst, which is clearly visualized on the image. Other causes can be adenoids and polyps, which are particularly prone to runny noses and can lead to sinusitis over time.
Radiography of the sinuses is prescribed to assess the stage of development of the pathology. For example, if the process is sufficiently neglected, then on the X-ray image it may have the form of subtotal or total darkening.
A characteristic X-ray sign of various kinds of secretions in the sinuses is "milk in a glass". This symptom occurred because of the property of the fluid to always take a horizontal position, regardless of the position of the patient. Darkening on the X-ray in this case can be unilateral or bilateral.
When deciphering the image of a patient in whom maxillary sinusitis is suspected, attention is drawn to the presence of fluid, which is displayed on a dark background with a light contour. With a strong inflammatory process, darkening will be detected above the nose, and if shadows are present simultaneously in several cavities, then they say not about maxillary sinusitis, but about frontitis. Since not always the darkening of the sinuses on the X-ray means the presence of inflammation, the doctor can additionally prescribe contrast radiography. This is necessary to determine cystic and tumor neoplasms, which will be clearly displayed in the form of a pronounced rounded contour.
Blackouts occur if a foreign body enters the nasal cavity.
Darkening on dental x-rays
Radiography is widely used in the field of medical and orthopedic dentistry, maxillofacial surgery, traumatology, as well as for the detection of cystic and tumor formations. This diagnostic method helps to determine the condition of the teeth without opening them, clarify the number of root canals. X-ray is especially indispensable before dental implantation: the image allows you to assess the volume and examine the structure of bone tissue, which is necessary for the correct and high-quality placement of the implant.
Mild stages of tooth decay without severe enamel damage are not visible on X-rays. Caries can only be detected at a medium or deep stage or when complications develop:
- caries has the appearance of limited darkening on X-rays, with reduced density;
- Complicated caries appears as a disruption of the shape and anatomical structure of the tooth with numerous granulomas and denticles.
Pulpitis on X-rays is indicated by darkening in the central or lower part of the tooth. If it is a severe course of the disease, the image shows denticles - various amounts of compacted cavities in the root canal area.
Tooth cysts have the appearance of darkened foci localized in the area of the tooth root. Such foci have even boundaries and are not fused with nearby tissues. In some cases, cysts can affect two teeth at the same time.
Periodontitis is a purulent process in the root zone, which on X-rays looks like a darkening in the form of a small sac.
The darkening on the heart on the x-ray
During radiologic examination of the chest organs, it is possible to identify a cardiac shadow, which looks like an oval, located along the oblique line on the left side. The myocardium gives a dense darkening, homogeneous in structure, with clear and even outlines and an arc-shaped configuration. Each of the arcs displays a specific cardiac chamber, and when straightened, they speak of the presence of myocardial pathology.
In addition to darkening of the heart directly, X-rays may show:
- vascular or valve calcifications;
- changes in the pulmonary pattern;
- expansion of the pericardial bursa.
There are variations of the heart shadow like this:
- right-hand positioning;
- with a shift into the pleural cavity (due to effusion);
- displaced by a tumor or diaphragmatic hernia;
- with displacement due to pulmonary shriveling.
X-ray darkening is detected in inflammatory processes in the pericardial membrane (the presence of fluid around the heart, between the pericardial sheets), with calcium deposition on the walls of blood vessels (coronary artery calcinosis).
Cardiac X-rays can be performed in two ways: standard contrast-free or with contrast to better illuminate the left atrial border.
Darkening on X-rays can indicate both dangerous pulmonary and other pathologies and low-grade film. Therefore, in such a situation, do not panic, because the X-ray is only one of the diagnostic methods, and the doctor will never make a final diagnosis based on the image alone.
In general, the darkening on the X-ray has the appearance of a white spot (since a negative image is used), but its origin can be caused by a mass of reasons. To clarify the situation, a number of additional studies are necessarily prescribed, as well as, if necessary, an X-ray in a different projection.