How did Samara make those strange X-ray looking pictures?
The pictures are a nod toward the powers that Samara’s counterpart Sadako possessed in the original film. One of Sadako’s abilities was nensha, the focusing of will to produce an image on film or some other medium. It was through nensha that Sadako — and by extension, Samara — was able to create the cursed videotape. In Samara’s case file, we see nensha referred to as “projected thermography,” though it is more commonly called thoughtography (the term adopted by Fukurai Tomokichi, who coined the term nensha) or psychography. As for the needles appearing in the thermographic picture referenced above, they may be representative of the various injections and tests that Samara was subjected to during her time at Eola County Psychiatric Hospital.