X-rays can interact with matter through five main interactions:
1) Coherent scattering - X-rays change direction without energy loss.
2) Photoelectric effect - High energy photons eject tightly bound electrons.
3) Compton scattering - Photons collide with loosely bound electrons, losing some energy.
4) Pair production - High energy photons convert into electron-positron pairs in the nucleus.
5) Photodisintegration - Very high energy photons eject parts of the nucleus. Coherent scattering and the photoelectric effect are most relevant for medical and industrial X-ray applications.