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"Can an X-Ray detect gallstones?"


Do gallstones show up in an x-ray? I recently had an x-ray to look for problems in my liver, and now I'm having digestive troubles. So I'm wondering if, instead of running another scan, the doctor could just examine my old x-rays.


The vast majority of gallstones will not show up on an x-ray, as most stones are composed primarily of cholesterol. Cholesterol is not radio-opaque, meaning that an x-ray will penetrate through the cholesterol and hence will not show up as white on an x-ray (as opposed to bones, for example). A much less common type of gallstone is formed by a mixture of pigments, typically calcium and bilirubin salts.

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While calcium is radio-opaque when large and dense enough (like a bone), the amount in a gallstone may not be enough to show up on an x-ray; even if it is, it would be very difficult to get an idea of how large the stone is. The most helpful initial way to image the gallbladder and the liver is by ultrasound, which has the extra advantage of being cheap and not exposing you to any further radiation. Ultrasound can detect the presence of stones, look at the wall of the gallbladder, the texture of the liver, detect most abnormalities of the biliary tract, and detect any masses in the liver. Classically, gallstones can cause symptoms of right upper abdominal pain after meals (especially if they are fatty). If these symptoms sound familiar, then ultrasound would be a first step in making the diagnosis.

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