Fluoroscopy

What is fluoroscopy?

Fluoroscopy is a medical imaging procedure that uses X-rays to show internal organs and tissues working in real time. Providers use fluoroscopy to diagnose issues with your organs or help guide them while performing medical procedures.

Compared to plain X-rays, which get a snapshot of a part of your body, fluoroscopy gets images of what your body’s doing as it happens. Think of it like the difference between a still photograph of a moment in time versus recording an event so you can see how it unfolds.

What is fluoroscopy mainly used for?

Healthcare providers use fluoroscopy to help diagnose issues with specific body parts. They can also use it to help them guide procedures (like placing medical devices) inside your body or during injection or aspiration (known as interventional guidance).

Diagnostic fluoroscopy

Healthcare providers can use fluoroscopy to diagnose conditions in many parts of your body. Some examples include:

• Angiography. Providers use an angiogram to identify and diagnose narrowing or blockages in your arteries.
• Barium swallow (esophagogram). This test checks for problems in your upper gastrointestinal (GI) tract.
• Barium enema. This test checks for problems in your colon and rectum (parts of your large intestine).
• Cystography. Providers use cystography to help diagnose problems in your bladder. Voiding cystourethrogram (VCUG) is one type of cystography that checks how well your bladder drains.
• Hysterosalpingogram. In this procedure, a provider gets images of your uterus and fallopian tubes.
• Myelography. Myelography gets images of your spinal cord, nerve roots and spinal lining (meninges).
• Sniff test. This test checks how well your diaphragm is working.

Fluoroscopy for procedure guidance

Providers can use fluoroscopy during procedures to help them guide surgical instruments or medical devices. Examples include:

• Intravascular catheterization. In this procedure, fluoroscopy helps your provider see blood flowing through your arteries.
• Catheter insertion or adjustment. Fluoroscopy can help providers properly place catheters — thin tubes that help get fluids into your body or drain fluids from your body. Providers can place catheters through your urethra, blood vessels and bile ducts. For instance, fluoroscopy is often used in angioplasty procedures.
• Placement of stents. Fluoroscopy can help providers place stents, which are devices that help open narrow or blocked blood vessels.
• Orthopedic surgery. Your surgeon may use fluoroscopy to help guide orthopedic procedures, like joint replacement and fracture (broken bone) repair.

How does fluoroscopy work?

Fluoroscopy works by using a special camera that uses pulses (brief bursts) of X-ray beams to take pictures of your insides. This can be while your organs perform their normal tasks or while your provider performs a procedure.

Some procedures use a contrast agent to help the provider see your organs and structures better. You might hear it called a dye, but it isn’t the type of dye that can stain your clothes. Your provider might:

• Inject the dye into your vein
• Have you drink a liquid with the dye in it
• Apply the dye inside your rectum with an enema

How do I prepare for fluoroscopy?

Your preparation will depend on the type of fluoroscopy procedure and why you’re getting it. Some procedures don’t require any special preparations. For others, your provider may have you avoid certain medications and/or fast (not eat or drink anything) for several hours before the procedure. Ask your provider if you have questions about what you need to do before the procedure.

Let your provider know:

• If you’re allergic to contrast dye or if you’ve had any issues with it before
• If you’re pregnant or there’s a chance you may be pregnant (radiation from fluoroscopy can be harmful to a developing fetus)

What happens during a fluoroscopy test?

Depending on the type of procedure, you may have your fluoroscopy at an outpatient center or as part of your stay in a hospital. Right before the procedure, you may need to remove jewelry or change into a gown.

Your fluoroscopy may include the following steps:

• You’ll lay on a table or sit in a chair.
• An anesthesiologist will give you general anesthesia through a vein in your arm (if you’ll be asleep for the procedure).
• You’ll swallow contrast dye or a provider will give it to you with an injection or enema (if it’s part of the procedure).
• Depending on the type of procedure, your provider may ask you to move your body into different positions. They may also ask you to hold your breath for a short time.
• If your procedure involves getting a catheter, your provider will insert a needle in the appropriate body part. This may be your groin, elbow or another area.
• Your provider will use an X-ray scanner to take fluoroscopic images, which they’ll view on a computer screen.

Are you awake during this test?

Depending on the test, you might be awake or sedated (under anesthesia) for a fluoroscopic procedure. For instance, you’re more likely to be sedated if your provider is using it as imaging guidance during surgery or stent placement.

Other fluoroscopy tests are mostly painless and might require you to be awake during the procedure so that you can follow your provider’s instructions. Your provider will let you know if you’ll have anesthesia for your procedure or not.

What are the risks of fluoroscopy?

The main risk of fluoroscopy is radiation exposure. Fluoroscopy for diagnostic purposes uses very low levels of radiation. When providers use fluoroscopy during a surgery, you’re exposed to radiation for a longer period of time, which could:

• Damage your skin and underlying tissues (“burns”)
• Increase your risk of cancer later in life
• Cause damage to the fetus if you’re pregnant

The likelihood of experiencing these side effects is very small. If the procedure is medically necessary, the benefit outweighs the possible radiation risks.

If contrast dye is part of your fluoroscopy procedure, there’s also a small risk of an allergic reaction. Be sure to tell your provider if you have any allergies or if you’ve ever had a reaction to contrast material.

What are the benefits of fluoroscopy?

The main benefit of fluoroscopy is that providers can see how your organs are working or where structures are while they perform a procedure. It’s unlike many other forms of medical imaging (like a CT scan) where you can only see one moment in time.

What type of results will I get after a fluoroscopy test?

The kind of results you get from a fluoroscopy test will depend on the kind of test you had. If the results show that a part of your body isn’t working as it should, you may need additional diagnostic tests or treatment. Ask your provider what you can expect.

When should I know the results?

Depending on the type of fluoroscopy test you’re having and whether or not it’s part of a surgical procedure, you might know the results of the test:

• While your provider is performing it or right after
• After you wake up from surgery
• After a radiologist or your specialist has reviewed the images, which takes anywhere from a day to about a week

Ask your provider when you can expect to know the results.

When should I call my healthcare provider?

Contact your healthcare provider if you have any questions about how to prepare for the test or what the results mean.

Is a fluoroscopy test painful?

Fluoroscopy imaging itself is painless and noninvasive. But if your healthcare provider is using fluoroscopy as imaging guidance during a procedure like surgery or intervention, you may experience pain due to the procedure, not the fluoroscopy. Your provider will let you know what kind of pain levels you can expect during and after your procedure.