What to Know About Fluoroscopy

Fluoroscopy is a type of imaging exam. It provides a real-time, moving X-ray image on a video screen. The result can look like detailed, X-ray moving images of a body part, instrument, or contrast dye inside your body.

This type of X-ray is used in many ways. It can help locate a disease or guide a healthcare provider's hand during the use of certain treatments like injections.

A fluoroscopy procedure carries many of the same risks for excess radiation as other types of X-rays. This risk can vary based on the type of method used. For most people, the risks of this type of radiation are outweighed by the benefits of the procedure.

This article describes the uses of fluoroscopy, its types, and what its results can reveal. It also explains what to expect during this type of procedure and who should not have it.

What Is a Fluoroscopy, and Why Do I Need This Test?

Fluoroscopy is an advanced imaging tool that delivers real-time X-ray "movies" of moving body structures. The moving images are captured while a constant X-ray beam is projected through the body over a period of time. X-rays are a form of ionizing radiation.

This procedure allows healthcare providers to see movement and function that can't be seen in fixed images.

In many cases, fluoroscopy is performed with the use of contrast dye (a solution used to highlight specific body structures during an imaging procedure). These substances appear opaque in an image and help highlight certain organs or structures.

Fluoroscopy is used in many types of diagnostic and therapeutic medical procedures. You may need a fluoroscopy exam for one of the following reasons:

• To examine how your stomach and intestines are working
• To follow how your food is swallowed and how the muscles of your mouth and throat are functioning
• To guide medical devices like catheters, stents, or other devices inside your body, such as in your heart or blood vessels
• To guide injections deep into your spine or joints
• To examine broken bones and whether surgery has fixed them in the proper position to heal
• To follow how your blood moves through blood vessels and to locate any blockages
  

Types of Fluoroscopy

Fluoroscopy is a form of radiology that can be used in many different ways. Some of the most common types of fluoroscopy include the following tests and procedures:

• Angiography: Uses fluoroscopy to identify and diagnose blood flow in the arteries (such as in your heart), often involving an angioplasty (a procedure used to open blocked arteries)
• Arthrography: Uses fluoroscopy to visualize a joint or joints
• Barium enema, or lower gastrointestinal (GI) series: Uses barium (a contrast substance) to examine the anatomy of your colon and the terminal ileum (the link between your small and large intestine)
  
• Barium esophagogram, or upper GI series: Uses barium to examine your esophagus, stomach, and the first part of your duodenum (small intestine)
• Barium swallow: Uses barium to look at your upper GI tract, including the back of your mouth, pharynx (throat), and esophagus (food tube)
• Cardiac catheterization: An invasive procedure used to evaluate and treat heart conditions by using a long, flexible tube inserted into your arm or groin, then guided to the blood vessels of your heart to diagnose a heart condition, deliver medication, or repair heart defects
• Hysterosalpingogram: Uses contrast dye to examine the fallopian tubes
• Myelography: Uses fluoroscopy and contrast dye to evaluate the spinal cord, nerve roots, and spinal lining
  
• Placement of intravenous (IV) or arterial catheters: Uses fluoroscopy to guide the placement of a catheter (a thin, hollow tube) inside the body
• Vertebroplasty: Uses of fluoroscopy to inject cement into your vertebrae (the bones that make up your spine)

Fluoroscopy can also be used to locate foreign bodies or assist in the following treatments:

• Biopsy: A medical procedure that involves the removal of a small sample of cells or tissue for examination under a microscope
• Guiding corticosteroid injections into your joints or spine, such as to treat arthritis and other diseases
• Spinal tap (lumbar puncture): Uses fluoroscopy to guide the insertion of a needle between the bones of the lumbar spine (lower back) to observe and collect cerebrospinal fluid (CSF) (the fluid that surrounds your brain and spinal cord)
  

Fluoroscopy Exam: What Happens

What happens during your fluoroscopy exam varies based on the type of procedure being performed and criteria such as your age, reason for fluoroscopy, and other medical conditions. Fluoroscopy may be done as an outpatient procedure or as part of a hospital stay.

Generally, you can expect the following during a fluoroscopy exam.

Before Your Fluoroscopy

Your preparation will vary based on the type of procedure being performed. Before the procedure, inform your healthcare provider about the following:

• Past reactions to any kind of contrast dye
• Presence of kidney disease or poor kidney function
• Pregnancy, breastfeeding, or the possibility of pregnancy
• Any prescription or over-the-counter (OTC) medications you take

You may be instructed to stop eating and drinking at midnight before the procedure, although some procedures may not require preparation.

You may be asked to drink a contrast dye before your procedure. Sometimes, you will receive the contrast dye via an intravenous (IV) line in your hand or arm, or as an enema.

During Your Fluoroscopy

During your procedure, you will be positioned on a special table that can move you from a horizontal to an upright position. Your procedure time can vary from 30 to 120 minutes.

You may be able to remain awake during your procedure. Depending on your procedure, you may be asked to do the following:

• Change into a hospital gown and remove any jewelry.
• Receive local anesthesia (medication that numbs the targeted area), general anesthesia (medication to put you into a deep sleep so you won't feel pain), or conscious sedation (medicine that makes you sleepy) depending on the type of procedure being performed.
  
• Change positions to lie on your back, side, or stomach.
• Hold your breath at certain times during the test.

A fluoroscopy procedure typically does not cause pain. However, depending on the type of procedure being performed, you may have discomfort from that treatment.

After Your Fluoroscopy

The care you require after fluoroscopy depends on your overall health, the type of fluoroscopy performed, and whether you received anesthesia or sedation.

Some procedures may require a recovery period that involves immobilization of the arm or leg where a catheter was inserted. Other types of fluoroscopy require less time for recovery.

You may experience side effects involving constipation, an impacted stool, or changes in stool color if your procedure involves barium. You may be instructed to follow a special diet of extra fluids and fiber to help any remaining barium leave your body.

Contact your healthcare provider immediately if you experience any of the following symptoms after fluoroscopy:

• Constipation or an inability to pass gas
• Abdominal pain or swelling
• Fever
• Pain, redness, or swelling at an IV site
  

Who Shouldn't Have a Fluoroscopy?

While fluoroscopy can provide valuable diagnostic data and assistance during certain procedures, pregnancy or the possibility of pregnancy is usually a contraindication for fluoroscopy and any type of X-rays.

The exposure to radiation that occurs during fluoroscopy can harm fetal cells. These changes can increase the risk of congenital (present at birth) anomalies and cancer later in life. The degree of risk depends on the dose of radiation involved and the gestational age of the fetus at the time of exposure.

The level of radiation exposure that occurs during fluoroscopy is highly variable depending on the type of study. It is usually higher than the radiation exposure from an abdominal or chest X-ray. It may not be as high as a more complex examination, such as a multiphase CT.

Some of the potential side effects of fluoroscopy include the following:

• Slightly higher risk of radiation-induced cancer later in life
• Allergic reaction to contrast dye
• Other risks depending on specific health problems

Results From Fluoroscopy

Images from your fluoroscopy are sent for analysis by a radiologist. After the radiologist interprets the images, a report is sent to your referring physician.

The process for receiving your results may take about two to three business days. Your referring healthcare provider will deliver the results.

Depending on the type of procedure used, you may receive results immediately after your fluoroscopy. This may be the case when your procedure involves fluoroscopy for guidance during surgery, stent implantation, or injections.

Summary

Fluoroscopy is a type of imaging that can provide key data needed to find disease. It can also serve as a useful tool to guide certain treatments and surgeries.

This approach differs from other types of imaging because it provides a detailed X-ray of a body system or moving body part. The moving pictures are cast on a screen in real time during the process. Contrast dye is sometimes used to highlight certain organs or body systems.

While the process can produce higher levels of radiation than other methods, its benefits often outweigh the risks. Your healthcare provider can offer advice on whether this option is right for you and your needs.