What is fluoroscopy?
The fluoroscopy procedure is an imaging technique that collects real-time moving images of internal structures in patients using a fluoroscope. A fluoroscope contains a fluorescent screen and an X-ray beam that passes through your body. It mimics an X-ray film, where continuous images are displayed on a monitor.
Fluoroscopy is very helpful for surgeons when performing surgical procedures. It allows physicians to see moving structures in the body and to help diagnose disease. Fluoroscopy offers enormous benefits over invasive surgical procedures because it requires a small incision, which significantly reduces the risk of infection and recovery time.
Purpose of fluoroscopy
Your doctor may recommend fluoroscopy to diagnose disease and guide invasive treatments. Doctors themselves use fluoroscopy or combine it with other procedures. The following common procedures use fluoroscopy:
- The arthrogram shows the joint structures, including tendons, ligaments, and cartilage. Diagnoses joint diseases such as arthritis and injuries.
- A barium swallow shows the structure and function of the esophagus. Confirm narrowing or tumor of the esophagus and digestive symptoms such as belching, vomiting, regurgitation, and swallowing.
- Hysterosalpingogram shows the shape of the uterus and fallopian tubes and the barriers of the fallopian tubes. Determine the cause of infertility.
- The intravenous pyelogram (IVP) shows the structure and function of the kidneys, ureters, and bladder. It can diagnose kidney stones, pyelonephritis, polycystic kidney disease, and kidney abnormalities.
- The lower GI series (barium enema) shows the structure of the colon (large intestine). Diagnoses polyps, diverticula, cancer, ulcers, and inflammation.
- Orthopedic procedures do fluoroscopy to lead orthopedic surgeries, including proper bone redesign, joint injections, joint aspirations, and percutaneous vertebroplasty (a minimally invasive method to treat vertebral compression fractures).
- The upper GI series shows a portion of the esophagus, stomach, and small intestine. The upper GI series with the small intestine includes the small intestine and the colon (large intestine). These tests can detect ulcers, masses, narrowing of the digestive system, diverticula, and esophageal variations.
- Voiding cysto-urethrogram (VCUG) confirms the size, shape, and size of the bladder and urethra. It can cause urinary reflux, birth defects, and frequent bladder infections, and difficulty emptying the bladder.
Risk factors for fluoroscopy
Fluoroscopy is a safe procedure. However, there are a few risks you should discuss with your doctor:
- Exposure to radiation, such as X-rays, increases the risk of cancer. Continuous exposure, such as fluoroscopy, will give you more radiation exposure than a single image from your doctor. However, the risk is small and many doctors find it worthwhile in lieu of a more accurate diagnosis or safer surgery. Modern X-ray equipment reduces the amount of radiation available to your body, and your doctor can work to get as little X-ray radiation as possible.
- Some tests require more X-rays than others. The more X-rays you receive, the greater your risk of cancer. If you are pregnant, you should inform your doctor because developing babies are more sensitive to X-rays.
- You may be allergic to iodine or another substance in the contrast material that your doctor gives you to help you take pictures. Allergies are very rare but can cause nausea or heart problems. Tell your doctor if you own an allergy to iodine.
Fluoroscopy can be used for many purposes, including the following:
- Epidural Steroid Injections
- Spine Procedures
- Facet injections
- Nerve Blocks
- Joint Injections & Aspirations
- Small joint (hand, wrist, foot, ankle)
- Large joint (hip, shoulder, knee)
- Ganglia (aspirations & injections)
- Plantar fascia
Procedure of fluoroscopy
During the procedure
Fluoroscopy can be performed on a patient basis or as part of your hospital stay. Policies may vary depending on your situation and the practices of your healthcare provider.
Generally, fluoroscopy follows this procedure:
- You will be asked to remove clothing or jewelry that comes in contact with the area of the body to be examined. You can put a bracelet with your name and identification number on your wrist. If you have allergies, you can get a second bracelet.
- If you are required to remove your clothing, you will be provided a gown to wear.
- Contrast or color material may be administered depending on the type of procedure being performed. You can do the opposite by taking an enema or by swallowing through the IV in your hand or arm. It is used to fully visualize the organs or structures being considered.
- You will be placed on an X-ray table. Depending on the type of procedure, you may be asked to move to a different position, move a specific part of your body, or hold your breath for a time while the fluoroscopy is being done.
- For procedures that require insertion of a catheter, such as cardiac catheterization or catheter placement, a needle may be placed in the groin, elbow, or another site.
- A special X-ray machine is used to examine or treat fluoroscopic images of the body structure.
- In the case of arthrography (visualization of the joint), any fluid can be expected in the joint before the contrast medium is injected (removed with a needle and syringe). After injecting the contrast, you may be asked to move the joint for a few minutes to spread the contrast through the joint.
- Examining or treating the type and body part of the procedure determines the length of the procedure.
- If the catheter is placed, it will be removed after the procedure is complete
Fluoroscopy is also not painful, but the specific procedure being performed can be painful, such as giving an injection into a joint or accessing an artery or vein for angiography. In these cases, the radiologist will take all possible comfort measures, including local anesthesia (medications for numbness), conscious anesthesia (sleeping pills), or general anesthesia (medications to help you sleep soundly and do not feel pain), depending on the specific procedure.
After the procedure
The type of care required after the procedure depends on the type of fluoroscopy. For some procedures, such as cardiac catheterization, a recovery period of several hours is required with stabilization of the leg or arm inserted by the cardiac catheter. Other policies require less recovery time.
If you notice any pain, redness, and/or swelling at the IV site after turning home from your procedure, you should tell your doctor, as this may show an infection or other type of reaction.
After the test or procedure, your doctor will give you more specific instructions about your care.