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Eremin Dmitry Sergeevich
Radiologist (CT)
Doctor
Radiologist
until September 30
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Chest radiography is a diagnostic method that allows you to obtain images of the organs of the chest cavity using X-ray irradiation. Different tissues of the body, depending on their density, transmit x-rays differently, and therefore appear differently in the image (x-ray).
A chest x-ray makes it possible to study bone structures (ribs, sternum, spine), lungs, pleura, bronchi and trachea, heart and mediastinum, as well as assess the condition of the soft tissues of this area.
First of all, chest x-ray is used to diagnose lung diseases.
The question often arises: what is better to do an X-ray of the lungs or fluorography? Each method has its own advantages. Typically, fluorography is used for a general assessment of the condition of the lungs: whether there are signs of pathology or not. X-ray of the lungs allows you to obtain a higher-quality image, which means its diagnostic value is higher. But fluorography is cheaper.
What does a chest x-ray show?
A chest x-ray can reveal:
- the presence of foci of inflammation in the lungs, including those characteristic of diseases such as pneumonia and tuberculosis;
- the presence of tumor formations and edema, which may be a consequence of heart failure;
- the presence of pathological accumulations of gases and liquids;
- accumulation of fluid in the pericardial sac, increase in the size of the heart, aorta and lymph nodes;
- foreign objects in the lungs, esophagus and respiratory tract.
Is it possible to sign up for fluorography without a doctor’s referral?
Many citizens are interested in one simple question: is it worth getting a referral from a therapist to sign up for fluorography. The Ministry of Health has issued a recommendation according to which you can perform chest X-rays no more than once or twice per calendar year. In this case, you can be accepted without problems, but in the clinic to which you are attached. Another hospital may require you to provide an official statement from a doctor.
On the territory of Russia, the following categories of the population are allowed to undergo the procedure without a therapist’s recommendation:
- Employees and workers of educational, children's institutions, representatives of companies and catering organizations and stores.
- Visitors who have been diagnosed with a chronic respiratory disease.
- Citizens with a confirmed diagnosis of diabetes mellitus.
- If you are undergoing radiation therapy.
Other consumers can order lung images without a referral no more than once. In practice, everything depends on the medical institution; in some institutions it is enough to provide a passport and a compulsory insurance policy to receive the service, but in others, on the contrary, they require a written recommendation from the attending physician.
As for paid appointments, consumers can book the procedure an unlimited number of times depending on their wallet capacity.
What diseases can a chest x-ray help diagnose?
A chest X-ray is prescribed for the purpose of diagnosing and assessing the condition of diseases such as:
- pneumonia. In complex cases, X-ray data of the lungs are basic for diagnosing acute pneumonia;
- tuberculosis;
- inflammatory diseases of the pleura (pleurisy, pleural empyema);
- tumor diseases of the lungs, bronchi, trachea;
- pulmonary embolism;
- occupational lung diseases caused by prolonged inhalation of dust and other small particles;
- pneumotrax (mechanical rupture of lung tissue);
- parasitic diseases of the chest (echinococcosis);
- diseases of the thoracic spine.
Sign up for fluorography through State Services
The unified portal of public services is a modern tool for processing documents and drawing up applications to almost all departments and government agencies. Currently, you can make an appointment with a doctor remotely from anywhere, without being geographically assigned to a specific region. It is enough to have access to the network and a mobile phone or computer.
The fluorography service is an additional highly specialized procedure, so it is impossible to obtain a coupon for the procedure using the electronic service. There is only one way, consisting of several successive steps. First, you need to make an appointment with a therapist in your clinic, and then get a referral and permission from him to conduct an X-ray of the respiratory organs.
First of all, you need to register on a single service.
In the authorization window, enter your first and last name, cell phone number and email address. Confirm your login using the security code, which will arrive in the form of an SMS alert. From now on, a simplified page is open for you; to get the maximum, enter your SNILS and passport data in the parameters of your personal account. The final stage is to visit the MFC department and activate your profile. The option of remote recording is now open to you. Below we consider a detailed list of actions.
Step-by-step instruction
An online appointment with a specialist in Moscow is as follows:
- Log in to your account and provide your password.
- In the main service window, select the services item at the top of the screen.
- Available categories of functions will appear in front of you, we need health.
- In the next window, select the option to make an appointment with a specialist.
- After this, you will see a detailed procedure for receiving an electronic service and its restrictions.
- The next step is to fill out the application. Please indicate your service region.
- Next, you need to choose for whom the number is issued.
- After this, you need to register personal information and information from documents. Be sure to write down the compulsory medical insurance policy number, which is a unique identifier and is located on the back of the card.
- A virtual map will appear below, where you need to select the department of the clinic to which you are attached. Please note that online booking is only available at the hospital where you are registered.
- Select the category of services and the doctor's specialty, for example, therapist.
- Select a suitable specialist from the list, and then mark the desired date on the calendar and select a free appointment time.
- Submit your application for consideration. If necessary, the coupon can be printed.
As soon as the time comes, come to the clinic and ask the therapist to write you a referral for a respiratory examination. Residents of Moscow can make a reservation using the Mos.ru website, which has a similar feature.
Required documents for passing
The opportunity to undergo fluorography will be provided at the place of registration; you must have 1) a passport with registration, 2) a compulsory medical insurance policy, 3) a ticket and 4) information about the expected dose. No payment required. No additional training or hygiene required.
To find out what dose you receive during fluorography using a modern digital device and compare the values with the natural background, go to “Dosimeter”.
In some medical institutions, it is enough to immediately go to a radiologist, explain the reason for the visit and immediately do a fluoroscopy.
If less than a year has passed since the last visit to the X-ray room and there are obvious symptoms of respiratory pathology, an earlier visit to a pulmonologist or therapist is necessary.
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Is the procedure harmful?
The main disadvantage is the presence of radioactive exposure. X-rays are radiation, but the amount of radiation received during diagnosis is comparable to the dose received by people under normal conditions in 2 weeks, which is safe for adult patients. It can only cause harm to a growing organism.
Pregnant women and children are diagnosed only in extreme cases. The study is also not recommended for persons under 17 years of age. You should not take x-rays frequently, as the effects of radiation can cause tissue damage.
Contraindications
This aspect deserves special attention. It is quite possible to do fluorography without a referral, but qualified specialists do not recommend doing this. This is due to x-ray radiation, which has a certain negative effect on the body. Undoubtedly, it is minimal, so it does not pose a serious threat to health. But it’s better not to take risks and consult with doctors first. As for contraindications, although there are few of them, they exist. You should refrain from X-ray examination in the following cases:
- age up to 14 years;
- pregnancy;
- lactation period;
- inability to hold your breath;
- inability to stand on your own feet;
- claustrophobia.
If you do not have any of the above problems, then you can safely undergo the examination. How to do fluorography in a clinic without a doctor’s referral? The answer to this question will be given in detail in one of the following sections. You will be able to find out how the whole process occurs, what documents you need to have with you, and also how long the test results are valid.
Responsibility for permission to work without a medical examination
For workers who work in hazardous conditions or in dangerous positions, undergoing a medical examination is mandatory - the obligation to conduct a medical examination according to Order 302n has been transferred to the new document. The provisions of Article 5.27.1 of the Code of Administrative Offenses of the Russian Federation will not change in this regard: they provide for serious sanctions for violators of this requirement:
- for the management of the company who violated order No. 302n - a fine of 15-25 thousand rubles for the first time, 30-40 thousand rubles or disqualification for up to 3 years - again;
- for individual entrepreneurs - a fine of 15-25 thousand rubles for the first time, 30-40 thousand rubles or suspension of work for up to 90 days - again;
- for legal entities - a fine of 110-130 thousand rubles for the first time, 100-200 thousand rubles or suspension of work for up to 90 days - again.
Possible complications
Many people do not want to undergo fluorography because they are afraid for their health. The fears are well founded, because X-rays affect all internal organs and systems. With strong radiation exceeding the permissible norm, there is a possibility of developing some serious pathologies. But if all rules and regulations are followed, any associated risks are extremely small. According to doctors themselves, the presence of hidden diseases is much more dangerous than the laboratory test itself. Therefore, there are no reasonable reasons for concern.
General tips and tricks
So, we already know that fluorography can be done without a referral. But to get accurate results, it is very important to do the examination correctly. First of all, this concerns smoking. Doctors recommend refraining from a bad habit if you plan to go to the hospital. Smoke can negatively affect the quality of the image, making it impossible to make an accurate diagnosis. In this case, you will be sent back for x-rays, so you will have to re-expose your body to harmful radiation.
In addition, there are some laboratory research methods that are not advisable to combine with fluorography. These include:
- radiography;
- mammography;
- metrosalpinography;
- fluoroscopy;
- irrigoscopy;
- irrigography;
- cholecystocholangiography;
- fluoroscopy;
- CT scan.
The use of several examination methods at once creates too high a radiation dose on the body, which can cause the development of serious diseases. If you plan to undergo a comprehensive examination, then it is better not to do fluorography without a doctor’s referral. A preliminary consultation will help you avoid many problems.
