With fluoroscopy, x-ray images appear on a video screen  in real time, which allows the radiologist to see how well  the structure is functioning. FluoroscopyLinks:

Arthrography
Barium Enema
Barium Swallow
Myelogram

What is fluoroscopy?
Fluoroscopy is an imaging technique that takes live x-ray images of the body by passing a continuous x-ray beam through the structure being studied. The x-ray images appear on a video screen in real time, which allows the radiologist to see how well the structure is functioning. Fluoroscopy is used in many procedures including arthrography, barium enema (BE), and barium swallow.

How does fluoroscopy work?
For all fluoroscopic examination, a special x-ray scanner is used to take images of the body’s structures. This scanner sends the x-ray images to a monitor which shows the pictures in real time, just as if you were watching a video of the inside of your body.

ARTHROGRAPHY
Frequently Asked Questions

What is arthrography?
Is there preparation for arthrography?
What can I expect during arthrography?

What is arthrography?
Arthrography is a fluoroscopic procedure that takes x-ray images of joints after a contrast medium has been injected into the body. Contrast is a special substance that highlights the soft tissue and structures within the joints of the wrist, elbow, hip, knee, and ankle. Arthrography detects problems in the functioning of a joint.
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Is there preparation for arthrography?
No preparation is required if you are having arthrography.
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What can I expect during arthrography?
Before your study, you may be asked to change into an examination gown to make sure that you are not wearing any clothing with metal zippers or buttons. You will also be asked to remove jewelry if it will interfere with the images.

Next, you will be led into an examination room and positioned on a table by one of our registered radiologic technologists. Above the table, you will see a large metal box. This box contains the x-ray tubes and fluoroscopic equipment that will take the images of your body called arthrograms.

Before the arthrograms are obtained, regular x-ray images are taken of the joint. The radiologist will compare these images with the arthrograms. Next, a local anesthetic will be injected to numb the area around the joint. Then fluid from the joint will be removed with a syringe and replaced with contrast material and/or air. Allergic reactions to contrast are rare, but if you experience severe itching, burning, or nausea, tell the technologist immediately. Several arthrograms will be taken before the joint can absorb the contrast. Then more images will be taken of the joint as it is moved in different positions.

Arthrographic procedures usually take between 45 to 60 minutes. Following your procedure, the joint that underwent arthrography should be rested for 12 hours. You may experience some swelling or discomfort and hear cracking in the joint. Icing the joint should help reduce these symptoms, which usually disappear within two days.

Once all the arthrograms have been obtained, the radiologist will interpret the images. The findings will be sent in a report to your referring physician who will review these results with you and decide on a course of treatment.
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BARIUM ENEMA (BE)
Frequently Asked Questions

What is a barium enema?
What is the preparation like for a BE?
What can I expect during my BE procedure?
 barium enemaIs a barium enema safe?

What is a barium enema?
A barium enema (BE) is an x-ray examination of the lower intestine or colon and the rectum. A BE is typically performed on patients experiencing abdominal pain, constipation, diarrhea, or bleeding. Fluoroscopy is used to capture moving images of the colon while it is functioning to see if waste is moving normally through the lower gastrointestinal tract. BE is also used to detect ulcers, polyps (tumors), cancer, or inflammatory bowel disease.
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What is the preparation like for a BE?
At the time of scheduling, someone from our office will go over the preparation requirements for your BE. You will be instructed to pick up a bowel prep kit from our office at least three days before your examination. This kit will give you detailed instructions on taking a laxative to cleanse the bowel, as well as directions on following a diet of clear liquids such as tea, black coffee, and cola. Dairy products should be avoided. The night before your BE, nothing should be taken by mouth after midnight.
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What can I expect during my BE procedure?
Before your BE, you will be asked to change into an examination gown and to remove any jewelry or other metal objects that might interfere with the x-ray images. After changing, you will be brought into the fluoroscopy room where you will be positioned on a table. A large, metal box that houses the fluoroscopy equipment will be suspended above you. A preliminary film may be taken to make sure that the bowel is clean enough for the procedure.

Because the tissues of the colon have similar densities, a contrast material called barium is inserted into the colon with a small rectal tube. The barium coats the inside of the colon which helps highlight the tissue and provides a sharper image. After the radiologist has monitored the filling process, a few still x-ray images may be taken for later comparison. Air may also be pumped into the colon to inflate it. This helps the radiologist see the details of the walls of the colon better. Next, a series of live x-ray images will be taken of the colon. The technologist may ask you to change positions several times throughout the procedure so that the radiologist can see the intestine at various angles.

During the BE, you may feel some discomfort or mild cramping. You may even feel that you need to move your bowel. These sensations are completely normal, and are easily tolerated by most patients. However, if you feel that you are having trouble holding in the barium, please alert the technologist.

After the necessary images have been taken of the colon, most of the barium will be drawn back out of your bowel. The technologist will direct you to a bathroom so that you can expel the remaining barium and air. Some patients may be asked to return to the fluoroscopy room for additional images, but most are allowed to change back into their clothes at this point.

After your BE you will most likely be allowed to return to a normal diet and resume all medications. You should drink plenty of liquids. It is common for stool to appear white for a few days after the procedure as the body continues to expel the barium. Some patients experience constipation after a BE and may need to take a laxative.

The images from your BE will be interpreted by one of our board-certified radiologists. The results will be reported to your referring physician who will then review these findings with you.
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Is a barium enema safe?
A BE is a minimally invasive procedure that rarely has complications. In these rare cases, some patients experience inflammation in the bowel when barium leaks through an undetected perforation in the lining of the colon, or they may experience barium impaction (an obstruction of the intestinal tract).

In any x-ray procedure, radiation exposure is a risk. However, with today’s fluoroscopy machines, the procedures are fast and the x-rays are targeted to the area of interest in a small beam, preventing scatter radiation to other parts of the body. The amount of radiation received from a BE is the same amount of radiation that the average person receives in approximately 16 months from naturally occurring background radiation.
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BARIUM SWALLOW
Frequently Asked Questions

What is a barium swallow?
What is the preparation like for a barium swallow?
What should I expect during my barium swallow?
 barium swallowIs a barium swallow safe?

What is a barium swallow?
A barium swallow, also called an upper gastrointestinal (GI) series, is a study of the esophagus, stomach, and upper portion of the small intestine using fluoroscopy and a contrast material called barium. Barium swallow detects abnormalities such as ulcers, tumors, and hernias. This procedure is usually performed on patients who have trouble swallowing and complain of chest pain or acid reflux.
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What is the preparation like for a barium swallow?
At the time of scheduling, you will be provided with the necessary preparation. Preparation usually involves fasting after midnight the night before the study. If your study is scheduled late in the day, you may only have to fast for four hours before your appointment. You will also be instructed not to smoke, chew gum, or take oral medications. These activities cause secretions in the stomach that will interfere with the images taken of your upper GI tract.
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What should I expect during my barium swallow?
Before your study, you will be asked to change into an examination gown and to remove any jewelry or other metal objects that might interfere with the x-ray images. After changing, you will be brought into the fluoroscopy room where you will be positioned on a table. A large, metal box that houses the fluoroscopy equipment will be suspended above you.

You will also be asked to drink some barium. Barium is a contrast material that makes the tissue in the intestine, esophagus, and stomach stand out on x-ray images. After drinking the barium, you may be asked to swallow baking soda crystals. These crystals create gas in the stomach, which improves the detail of the images. The crystals may give you the urge to belch, but it is important to hold in the gas for as long as possible. With the fluoroscopy equipment, the radiologist will study how the barium travels from the esophagus to the small intestine. The examination table may be tilted during the study so that the upper GI tract can be viewed from different angles. You will be asked to hold your breath during the study to prevent blurring of the x-ray images caused by motion of the chest during breathing. Once the barium has coated the upper GI tract, still x-rays will be taken.

After the barium swallow procedure is finished, you will be asked to wait while the radiologist quickly reviews the films to make sure that more images are not needed. If the images are adequate, you will be allowed to change into your clothes and leave the office. Following the procedure, you will be able to eat a regular diet and take oral medications. Bowel movements may appear gray or white for 48 to 72 hours as the barium passes through the digestive tract. You may also experience constipation, which can be treated with an over-the-counter laxative.

After reviewing the results of your study, the radiologist will send a report to your referring physician who will discuss the results with you.
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Is a barium swallow safe?
In any x-ray procedure, radiation exposure is a risk. However, with today’s fluoroscopy machines, the procedures are fast and the x-rays are targeted to the area of interest in a small beam, preventing scatter radiation to other parts of the body. The amount of radiation received from a barium swallow is the same amount of radiation that the average person receives in approximately 8 months from naturally occurring background radiation.
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MYELOGRAM
Frequently Asked Questions

What is a myelogram?
Is there any preparation for a myelogram?
What can I expect during my myelogram?
Where can I have my myelogram?

What is a myelogram?
A myelogram is an examination that uses x-rays to detect abnormalities in the spine, spinal cord, and surrounding structures.
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Is there any preparation for a myelogram?
At the time of scheduling, you will be provided with the preparation requirements for your myelogram. Be sure to tell your referring physician as well as our staff about any medical or nonmedical allergies and any prescriptions you are taking. Preparation usually involves fasting 6 hours before the procedure, with clear liquids allowed until 3 hours before the procedure. Typically, you will be able to take your daily medications, including pain relievers, on the day of the myelogram. Antidepressants containing MAO inhibitors must be stopped the day before the procedure.

Because you will not be able to drive yourself home after the myelogram, please make arrangements to have someone who is reliable drive you home.
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What can I expect during my myelogram?
Before you are taken back to the x-ray suite, you will be asked to change into an examination gown. Then a radiologic technologist will escort you to the examination room where you will be asked to lie on your side or stomach on the x-ray table. A small area of your back will be cleaned and then the radiologist will inject a local anesthetic to numb the area. Next, a needle containing contrast will be inserted into the spine. Contrast is a special dye that helps highlight the structures of the spine to make them show up on the x-rays. Dizziness or nausea from the contrast is rare, but alert the technologist if you experience these symptoms.

After the contrast has been injected, x-rays will be taken. The examination table may tilt so that images can be taken of the spine in different positions. After the necessary x-rays have been taken, you will be escorted to another examination room for a computed tomography (CT) scan, which will take approximately 10 minutes. The entire myelogram procedure will take about an hour.

Before being discharged, the technologist will give you an instruction sheet that tells you what to do at home. If you have no pain or serious discomfort, you will be allowed to leave our facility, provided that you have someone to drive you home. While in the car, it is best to lie down in the back seat until you arrive at home. At home, you should remain on your back for 24 hours. This will prevent headaches and take pressure off the injection site. You should drink plenty of fluids and refrain from drinking and smoking for 24 hours. If you have a headache, you may take Tylenol as instructed on the label. If headaches or nausea last for more than 24 hours, contact your referring physician.

The results of your myelogram will be interpreted by the radiologist and a report will be sent to your referring physician. Your physician will review the results of the study with you and determine the next course of action.
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Where can I have my myelogram?
Diagnostic Imaging Associates performs myelograms at our Omega, Pike Creek, Brandywine, and Glasgow locations. To schedule an appointment, please call our Central Scheduling Center at (302) 369-4342.
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