X-Ray Exam: Lower Leg (Tibia and Fibula)

What It Is

An X-ray of the tibia and fibula is a safe and painless test that uses a small amount of radiation to take a picture of the lower leg. During the examination, an X-ray machine sends a beam of radiation through the lower leg, and an image is recorded on a computer or special X-ray film. This image shows the bones (tibia and fibula) and soft tissues of the lower leg.

The X-ray image is black and white. Dense structures that block the passage of the X-ray beam through the body, such as the tibia and fibula, appear white on the X-ray image. Softer body tissues, such as the skin and muscles, allow the X-ray beams to pass through them and appear darker.

X-rays are performed by an X-ray technician in the radiology department of a hospital, a freestanding radiology center, or a health care provider's office. Two different pictures are taken of the lower leg: one from the front (anteroposterior view, or AP) and one from the side (lateral view).

Why It's Done

An X-ray of the tibia and fibula can help find the cause of common signs and symptoms such as pain, tenderness, swelling, or deformity of the lower leg. It can detect broken bones, and after a broken bone has been set, an X-ray can help determine whether the bones are in proper alignment and whether they have healed properly.

If surgery of the lower leg is required, an X-ray may be taken to plan for the surgery and, later, to see the results of the operation. Also, an X-ray can help to diagnose later stages of infections, as well as cysts, tumors, and other diseases in the bones of the lower leg.

Preparation

An X-ray of the tibia and fibula doesn't require any special preparation. Your child may be asked to remove some clothing, jewelry, or any metal objects that might interfere with the X-ray image.

Developing babies are more sensitive to radiation and are at more risk for harm, so if your daughter is pregnant, inform her doctor and the X-ray technician.

Procedure

This is a quick procedure. Although the tibia and fibula X-ray exam may take about 15 minutes, actual exposure to radiation is less than a second.

Your child will be asked to enter a special room that will most likely contain a table and a large X-ray machine hanging from the ceiling or the wall. Parents are usually able to accompany their child to provide reassurance and support.

The technician will position your child on the table, and will then step behind a wall or into an adjoining room to operate the machine. Two X-rays are usually taken (from the front and side), so the technician will return to reposition the leg for each X-ray.

Older kids will be asked to stay still for a couple of seconds while the X-ray is taken; infants may require gentle restraint. Keeping the leg still is important to prevent blurring of the X-ray image.

If your child is in the hospital and can't easily be brought to the radiology department, a portable X-ray machine can be brought to the bedside. Portable X-rays are sometimes used in emergency departments, intensive care units (ICUs), and operating rooms.

What to Expect

Your child won't feel anything as the X-ray is taken. The X-ray room may feel cool due to air conditioning used to maintain the equipment.

The positions required for the X-ray may feel uncomfortable, but they need to be held for only a few seconds. If your child has an injury and can't stay in the required position, the technician might be able to find another position that's easier on your child. Babies often cry in the X-ray room, especially if they're restrained, but this won't interfere with the procedure.

If you stay in the room while the X-ray is being done, you'll be asked to wear a lead apron to protect certain parts of your body. Your child's reproductive organs also will be protected with a lead shield.

After the X-rays are taken, you and your child will be asked to wait a few minutes while the images are processed. If they're blurred, the X-rays may need to be redone.

Getting the Results

The X-rays will be looked at by a radiologist (a doctor who's specially trained in reading and interpreting X-ray images). The radiologist will send a report to your doctor, who will discuss the results with you and explain what they mean.

In an emergency, the results of an X-ray can be available quickly for review by a doctor. Otherwise, results are usually ready in 1-2 days. In most cases, results can't be given directly to the patient or family at the time of the test.

Risks

In general, X-rays are safe. Although any exposure to radiation poses some risk to the body, the amount used in a tibia and fibula X-ray is small and not considered dangerous. It's important to know that radiologists use the minimum amount of radiation required to get the best results.

Developing babies are more sensitive to radiation and are at greater risk for harm, so if your daughter is pregnant, be sure to tell her doctor and the X-ray technician.

Helping Your Child

You can help your child prepare for an X-ray of the tibia and fibula by explaining the test in simple terms before the procedure. It may help to explain that getting an X-ray is much like posing for a picture.

You can describe the room and the equipment that will be used and reassure your child that you'll be right there for support. For older kids, be sure to explain the importance of keeping still while the X-ray is taken so it won't have to be repeated.

If You Have Questions

If you have questions about why the tibia and fibula X-ray is needed, speak with your doctor. You can also talk to the X-ray technician before the procedure.