When a patient walks into a clinic with a broken rib or a severe cough, they want answers quickly. The technician hands them a flimsy paper gown and tells them to take off their shirt, their bra, and their necklace.
Patients often think this is just a hospital rule for modesty. It isn’t. It is strict physics.
An X-ray machine does not take a photograph of the skin. It measures density. It shoots a beam of radiation through the body, and whatever blocks that beam shows up as bright white on the final image. Bones block radiation, which is why they look white. Air in the lungs lets radiation pass through, which is why lungs look black. But bones are not the only dense objects in the room.
Common Radiographic Artifacts: Deodorant, Metal, and Graphic Tees
If a patient wears the wrong material during a scan, that material blocks the beam and creates a fake white shadow on the image. We call this an “Artifact.”
Artifacts ruin the diagnostic value of the image. That’s why the curriculum in a limited x ray tech school online spends significant time teaching you how to physically prep a patient before you ever turn the machine on. You have to know exactly what items cast a shadow, because if you miss one, the doctor cannot read the final image.
Why Antiperspirant Looks Like a Lung Tumor on an X-Ray
The most surprising artifact comes from a standard stick of deodorant.
Most clinical antiperspirants contain aluminum. Aluminum is a dense metal. If a patient comes in for a chest X-ray and they are wearing a thick layer of clinical deodorant, those aluminum particles gather in the armpit.
When you shoot the X-ray, that clump of aluminum absorbs the radiation. On the doctor’s screen, it looks exactly like a bright white mass or a calcified tumor sitting right next to the lung. What this means is a perfectly healthy patient might get a terrifying misdiagnosis. To prevent this, a technician must physically ask the patient to use a wet wipe and clean their underarms before standing against the chest board.
Removing Metal Underwires, Zippers, and Hair Ties
Metal is the ultimate blocker of radiation.
If you take a lower back (lumbar spine) X-ray while the patient is wearing jeans, the metal zipper and the metal button will cast a solid white block right over the exact vertebrae the doctor needs to check for a fracture.
And the rules apply to the upper body, too. A woman wearing a standard bra has two metal underwires and metal clasps on her back. If she leaves it on during a chest X-ray, those wires cut right across the lower lungs. Even a thick rubber graphic printed on a heavy cotton t-shirt can absorb enough radiation to look like fluid in the chest. You have to instruct the patient to remove everything from the waist up.
How Avoiding Artifacts Prevents Double Radiation Exposure
So, what happens if you forget to tell the patient to take off their necklace?
You take the image, look at your computer monitor, and see a giant white chain covering the patient’s throat. You cannot send that to the doctor. You have to make the patient take the necklace off and shoot the X-ray a second time.
Taking the picture twice means the patient gets double the dose of radiation. This violates a strict federal safety standard known as ALARA (As Low As Reasonably Achievable). Organizations like the American Society of Radiologic Technologists (ASRT) heavily enforce this principle.
Every time you hit the capture button, you expose a human being to radiation. An x ray tech fast track program trains you to get the shot perfect on the very first try. You do this by controlling the environment and ensuring the patient’s body is entirely free of artificial density.
The Verdict
Shooting an X-ray is easy; the machine does the heavy lifting. The hard part of the job is managing the human being in front of the machine. By mastering the physical preparation of the patient and learning to spot artifact traps before they happen, you protect the patient from unnecessary radiation and provide the doctor with a flawless, readable image.
