A drill guide system is provided having a source for x-ray radiation along with a receiver to generate a visible image of the radiation. A bone with medical device or implant is located between the source and receiver. A drill with a passage transmits x-ray radiation from the source through a drill bit that then passes through the bone and implant. The source of the x-ray radiation is offset from the drilling axis and a system is used to combine multiple or varying images to reduce an occluded area generated by the drill bit. The user guides the drill bit using an image on the receiver. When the user lines up the drill with a hole in the nail, the alignment is visible on the receiver.
