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A fluoroscope uses X-rays at a rate of 25 to 30 images per second to create a continuous flow of pictures or video of a bodily function, comparable to the way television and film displays moving images.
*Source: International Atomic Energy Agency
 

Understanding Fluoroscopy

Fluoroscopy is a real-time X-ray imaging method used to diagnose or treat patients by displaying the movement of a body part or an instrument or a contrast agent through the body. Instead of taking a single X-ray image, fluoroscopy often requires a large series of X-ray images to make it possible to see internal organs in motion.


Fluoroscopy is used in many types of examinations and procedures. Some of the more common ones include:


  • Barium swallows and enemas to view evaluate the gastrointestinal tract
  • Angiograms to direct the placement of a catheter, assess blood flow, and perform angioplasty
  • Hysterosalpingograms to assess fallopian tube patency for infertility
  • During orthopedic surgery to view fractures and optimize repair

Because X-rays and fluoroscopy involve exposure to radiation, concerns arise about the risks, especially if you have X-rays regularly. WellStar technologists and radiologists always use the smallest possible dose of radiation necessary. Protective lead aprons and shields are used to protect parts of the body outside the region of interest when multiple X-rays are necessary.


WellStar Resources and Support

WellStar uses state-of-the-art equipment and innovative digital systems integrated into all of its X-ray and fluoroscopy technologies to ensure quality images at minimum dose levels. With improved equipment positioning and examination accuracy, we can ensure maximum patient comfort and reduced need to reposition patients or take repeat images.


Fluoroscopy is available at all WellStar hospitals and most imaging centers.


Fluoroscopy Procedures

A number of imaging examinations fall under the category of fluoroscopy and each require their own specific preparations, procedures and post-examination requirements. For each examination, you will be asked to provide your medical history, review it with a technologist and asked to put on a gown before undergoing the fluoroscopic examination.


As with any examination involving X-rays, you may be required to remove clothing and any jewelry or other objects from the area of your body to be examined. You should also inform your radiologist or another WellStar physician if you believe you might be pregnant or if you are allergic to barium or other contrasts.


Barium Swallow/Upper Gastrointestinal Tract (UGI)

For a barium swallow alone, no special preparation is needed. For a barium swallow with an upper gastrointestinal tract (UGI) exam, you will need to eat a light dinner the day before your exam, and then refrain from drinking or eating after midnight. Pediatric patients must not have anything to eat or drink four hours before the exam.


For this exam, you will most likely begin from a standing position. A radiologist will give you some carbon dioxide crystals (such as Alka-Seltzer®) to swallow, immediately followed with a cup of barium. As you drink, the radiologist will take several films of you drinking. The radiologist will then lie you down on the examination table and take more pictures.


This exam takes about 30 minutes.


After the examination, you will need to drink plenty of fluids to flush the barium out of your system. You may have a white stool for a few days after your procedure. If you experience constipation, ask your WellStar physician if you should take a laxative. Otherwise, you may resume normal activities after the examination.


Small Bowel Series

For a small bowel series examination, you will need to eat a light dinner the day before your exam, and then refrain from drinking or eating after midnight. Pediatric patients must not have anything to eat or drink four hours before the exam.


At the start of this procedure, a radiologist will take a preliminary image of your abdomen. As you drink a large amount of barium, the radiologist will take images throughout your exam to trace the barium’s flow into your small bowel system. Once your small bowel is filled, the radiologist will take more images.


This exam takes between one to four hours.


After the examination, you will need to drink plenty of fluids to flush the barium out of your system. You may have a white stool for a few days after your procedure. If you experience constipation, ask your WellStar physician if you should take a laxative. Otherwise, you may resume normal activities after the examination.


Colon Barium Enema (BE)

For a colon barium enema (also known as a lower gastrointestinal (GI) examination), you will receive a special preparation kit designed to thoroughly cleanse the large intestine, a requisite before conducting this examination. The prep starts a full day before your examination so be sure to have the kit in time to follow the necessary steps. As part of this prep, you will be asked to follow a special diet leading up to the examination, and will need to fast before the test.


At the start of the procedure, the technologist will take a preliminary image of your abdomen to ensure your colon is adequately cleansed, as this is critical for a successful test. An enema tip will then be inserted into your rectum so that barium can be passed through the device and into your colon. During this process, you will be asked to turn in various positions so the radiologist can take pictures of different areas of the colon.


When the radiologist is finished administering the barium, the technologist will take additional images of your colon.


After the tip is removed, you will be allowed to go the restroom. A final set of images will be taken before the examination is complete.


This exam takes about an hour.


After the examination, you will need to drink plenty of fluids to flush the barium out of your system. You may have a white stool for a few days after your procedure. If you experience constipation, ask your WellStar physician if you should take a laxative. Otherwise, you may resume normal activities after the examination.


Intravenous Pyelogram (IVP)

For an intravenous pyelogram to examine your urinary system, you should refrain from eating or drinking after midnight before your exam. If you are taking Metformin-Glucophage®, Glucovance®, Metaglip®, Avandamet® or generics of these medications, you will need to discontinue the medication before or at the time of the exam. Do not resume your medication without physician approval.


At the start of the procedure, a technologist will take a preliminary image of your abdomen. A needle will be placed in your arm to administer a contrast. After the contrast (X-ray dye) is injected, images will be taken at timed intervals.


This exam takes about an hour.


You will be given discharge instructions after the examination.


Hysterosalpingogram

A hysterosalpingogram, an exam to study the inside of the uterus and fallopian tubes and the surrounding area, is usually scheduled between Day 6 and Day 10 after the onset of your menstrual cycle. You must refrain from any sexual intercourse from the day you start your menstrual cycle to the day of your exam. This helps ensure that there is no chance of pregnancy during the examination.


For this procedure, a technologist will assist you into the proper position on the exam table, similar to one in a gynecologist’s office. After the radiologist cleans and drapes your lower pelvis, a speculum will be inserted into your vagina followed by a catheter placed into the uterus. A small amount of contrast (X-ray dye) will be injected through the catheter. After images are taken, the catheter and speculum will be removed.


This exam takes about an hour.


After the exam, you will be given special discharge instructions. You may want someone to drive you home. If you experience some spotting and cramping, an extremely common occurrence, you may take ibuprofen as directed. You should refrain from inserting anything in the vagina for 48 hours post procedure to minimize your risk of infection. This includes avoiding any sexual activity for 48 hours. In the case of spotting, please use an external pad and not a tampon.


Cystogram

A cystogram, which obtains images of the urinary tract, requires no initial preparation.


For this procedure, a urinary catheter is inserted into your bladder to administer a contrast (X-ray dye). When your bladder is full of the contrast material, the radiologist will take images and then remove the catheter. For some exams, you may be asked to empty your bladder as images are taken. Additional images will be taken after you have finished urinating.


This exam takes about an hour.


You may resume normal activities after the exam.


Venogram

A venogram obtains images of vessels and muscles in the legs and arms. If the exam has been ordered for your legs, you should wear comfortable shoes due to possible soreness after the contrast is injected.


If you are taking Metformin-Glucophage®, Glucovance®, Metaglip®, Avandamet® or generics of these medications, you will need to discontinue the medication before or at the time of the exam. Do not resume your medication without physician approval.


For this procedure, a small needle is placed in the hand or top of the foot so that a contrast (X-ray dye) may be injected into your legs or arms to visualize your veins. Once all images are completed, the needle is removed, and you may resume normal activities.


This exam takes about an hour.


Arthrogram

An arthrogram, which examines your joints, does not require special preparation before the examination. But you should notify your WellStar physician if you are claustrophobic because you may be scheduled for a computerized tomography (CT) scan or magnetic resonance imaging (MRI) upon completion of this exam.


For this procedure, a technologist will take preliminary images of the area under examination. The radiologist will numb the joint, insert a needle and inject the contrast into the joint. The radiologist removes the needle and takes images of the joint.


This exam takes about 45 minutes.


After the exam, you will be given special discharge instructions. You will need to relax for the remainder of the day and may need a warm compress for the examined area.


Myelogram

A myelogram is an exam designed to detect disorders of the spinal cord and spinal nerves and requires an extended outpatient and, sometimes, an inpatient visit to the hospital.


The day before the exam you will be prescribed a liquid diet. You should refrain from taking tricyclics, phenothiazines or thioxanhenes for 48 hours before and for 48 hours after the examination.


You should refrain from taking anti-platelet medications, such as aspirin and Plavix®, and anti-coagulant medications, such as Coumadin®, heparin or Lovenox®, before the myelogram. Please call your physician for instructions on stopping these medications.


On the day of the exam, you will check into the hospital, where you will need to provide your medical history, have your vitals, such as blood pressure taken, and have an IV access line started.


For the procedure itself, you will lie on your stomach on the examination table. A radiologist will numb an area of your lower back and insert a needle. A contrast (X-ray dye) will be injected through the needle and into your spinal cord. The radiologist will remove the needle and take images of your spine. After the myelogram, you will have a computerized tomography (CT) scan for more detailed images.


After the myelogram and the CT scan, you will be taken back to your hospital room for four to six hours for observation. It is important for you to lie in bed with your head and upper body elevated at approximately 40 to 45 degrees during this period to minimize the risk of headache. You should be still as possible, but you may go to the bathroom.


In regards to food and drink intake, you should drink as many fluids as possible, and you may eat solid foods.


You should make arrangements for someone to drive you home upon discharge and refrain from driving or operating dangerous machinery for at least 24 hours. You should refrain from heavy lifting for 48 hours.