What is fluoroscopy?

Fluoroscopy is a type of medical imaging that shows a continuous X-ray image on a monitor. It’s much like an X-ray "movie." It is often done while a contrast dye moves through the part of the body being examined. A continuous X-ray beam is passed through the body part and sent to a video monitor. The body part and its motion can then be seen in detail. Fluoroscopy lets healthcare providers look at many body systems. These include the skeletal, digestive, urinary, cardiovascular, respiratory, and reproductive systems.

Fluoroscopy may be used to look at certain parts of the body. These include the bones, bowel, muscles, heart vessels, and joints.

Why might I need fluoroscopy?

Fluoroscopy is used in many types of tests and procedures, including:

• Barium X-rays. In barium X-rays, fluoroscopy allows the healthcare provider to see any abnormalities in the GI tract, while watching the movement of the barium that is given through the mouth or rectum.

• Cardiac catheterization. In cardiac catheterization, fluoroscopy is used to help the healthcare provider see the flow of blood through the coronary arteries. It can diagnose heart problems and possibly treat them.

• Electrophysiologic procedures. During these procedures, fluoroscopy is used to treat people with heart rhythm problems (arrhythmias).

• Arthrography. This imaging test uses X-rays to see a joint or joints.

• Placement of IV (intravenous) or arterial catheters. Catheters are thin, hollow tubes. For catheter insertion, fluoroscopy is used to guide the catheter into a specific vessel inside the body.

• Hysterosalpingogram. This test is an X-ray of the uterus and fallopian tubes.

• Percutaneous vertebroplasty/kyphoplasty. This procedure treats compression fractures of the bones (vertebrae) of the spine.

• Retrograde urethrogram or micturating cystourethrogram. These tests assess problems of the urinary system.

• Fistulography. This test assesses an abnormal connection (fistula) between two organs.

Fluoroscopy may also be used for:

• Lumbar puncture

• Biopsies

• Locating foreign bodies

• Guided injections into joints or the spine

Fluoroscopy may be used alone. Or it may be used along with other diagnostic procedures.

There may be other reasons for your healthcare provider to advise fluoroscopy.

What are the risks of fluoroscopy?

You may want to ask your healthcare provider about the amount of radiation used during the procedure and the risks related to your particular situation. It is a good idea to keep a record of your radiation exposure, such as previous CT scans and other types of X-rays, so that you can tell your healthcare provider. Risks linked with radiation exposure may be related to the cumulative number of X-ray exams or treatments over a long time.

If you are pregnant or think you may be, tell your healthcare provider. Radiation exposure during pregnancy may lead to birth defects. There may be other health concerns with the use of contrast material, especially iodine, during pregnancy as well.

If contrast dye is used, there is a risk of allergic reaction to the dye. Tell your healthcare provider if you are allergic to or sensitive to medicines, contrast media, iodine, or latex. Also tell your healthcare provider if you have kidney failure or other kidney problems.

There may be other risks depending on your specific health problem. Be sure your healthcare provider knows about all your medical conditions.

Certain factors or conditions may interfere with the accuracy of a fluoroscopy procedure. For instance, a recent barium X-ray procedure may interfere with exposure of the stomach or lower back area. Make sure your healthcare provider knows about your medical history and any recent tests or treatments you have had.

How do I get ready for fluoroscopy?

• Your healthcare provider will explain the procedure to you and give you a chance to ask questions. Make a list of questions and concerns to discuss with your healthcare provider before the procedure. Consider bringing a family member or trusted friend to the appointment to help you remember your questions and concerns and to take notes.

• You will be asked to sign a consent form that gives your permission to do the procedure. Read the form carefully and ask questions if anything is not clear.

• The specific type of procedure or exam being done will determine whether you have to do any preparation before the procedure. Your healthcare provider will give you any pre-procedure instructions.

• Tell your healthcare provider, the radiologist, or the technologist if you have ever had a reaction to any contrast dye, or if you are allergic to iodine.

• Tell your healthcare provider if you are pregnant or think you may be.

• Tell your healthcare provider if you are breastfeeding and ask if you need to pump and save milk to use after the procedure.

• Make sure your healthcare provider has a list of all medicines (prescribed and over-the-counter) and all herbs, vitamins, and supplements that you are taking.

• Based on your health problem, your healthcare provider may give you other instructions on what to do before the procedure.

What happens during fluoroscopy?

Fluoroscopy may be done on an outpatient basis or as part of your stay in a hospital. Procedures may vary depending on your condition and your healthcare provider's practices.

Generally, fluoroscopy follows this process:

1. You will be asked to remove any clothing or jewelry that may get in the way of the body part to be examined. A bracelet with your name and an identification number may be put on your wrist. You may get a second bracelet if you have allergies.

2. If you are asked to remove your clothing, you will be given a gown to wear.

3. A contrast substance or dye may be given, depending on the type of procedure that is being done. You may get the contrast by swallowing it, as an enema, or in an IV (intravenous) line in your hand or arm. It's used to better see the organs or structures being studied.

4. You will be positioned on the X-ray table. Depending on the type of procedure, you may be asked to move into different positions, move a certain body part, or hold your breath for a short time while the fluoroscopy is being done.

5. For procedures that require catheter insertion, such as cardiac catheterization or catheter placement into another body part, a needle may be put into the groin, elbow, or other site.

6. A special X-ray machine will be used to make the fluoroscopic images of the body structure being looked at or treated.

7. If the healthcare provider is looking at the joint (arthrography), they may remove (aspirate) any fluid in the joint with a needle and syringe before injecting the contrast dye. After the contrast is injected, you may be asked to move the joint for a few minutes to spread the contrast throughout the joint.

8. The type of procedure being done and the body part being examined or treated will determine the length of the procedure.

9. If a catheter is placed, it will be removed after the procedure is finished.

Fluoroscopy itself is not painful. But the particular procedure being done may be painful, such as the injection into a joint or accessing of an artery or vein for angiography. In these cases, the radiologist will take all comfort measures possible. Depending on the procedure, that may include local anesthesia (numbing medicines), conscious sedation (medicines to make you sleepy), or general anesthesia (medicines to put you into a deep sleep and not feel pain).

What happens after fluoroscopy?

The type of care needed after the procedure will depend on the type of fluoroscopy that is done. Certain procedures, such as cardiac catheterization, will need a recovery period of several hours with immobilization of the leg or arm where the catheter was inserted. Other procedures may need less time for recovery.

If you notice any pain, redness, or swelling at the IV site after you go home, tell your healthcare provider. It may be a sign of infection or other type of reaction.

Your healthcare provider will give more specific instructions about your care after the procedure.

Next steps

Before you agree to the test or the procedure, make sure you know:

• The name of the test or procedure

• The reason you are having the test or procedure

• What results to expect and what they mean

• The risks and benefits of the test or procedure

• What the possible side effects or complications are

• When and where you are to have the test or procedure

• Who will do the test or procedure and what that person’s qualifications are

• What would happen if you did not have the test or procedure

• Any alternative tests or procedures to think about

• When and how you will get the results

• Who to call after the test or procedure if you have questions or problems

• How much you will have to pay for the test or procedure