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X-rays and Fluoroscopy

Diagnostic Imaging includes evaluation of the chest, spine, skull, extremities, hips, pelvis and abdomen using X-rays. General diagnostic radiology is often used to evaluate suspected fracture or other indications of injury of any of the bones in the body.

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X-rays and Fluoroscopy

Chest x-rays may be used to detect Pneumonia, Tuberculosis and enlargement of the heart. 
Abdominal x-rays can reveal the size and shape of intestines or the presence of fluid or air in the abdomen. 
Spinal x-rays may be used to evaluate scoliosis (curvature of the spine). 

Patients are asked to remove jewellery and metal objects that might obscure anatomic detail in the x-ray images. Holding one's breath is necessary for some examinations. Most x-rays are performed in two or more views such as front (AP), back (PA) and side (lateral). 
Patients should expect to be placed in various positions and to hold still. Patient motion, positioning and body mass may affect the quality and usefulness of general x-rays. If test results do not correlate with clinical findings or if symptoms persist despite a negative x-ray result, examination with other imaging techniques may be recommended. 
Specialised Procedures using X-rays are used to look at internal organs for signs of disease.

Specialist Procedures Performed: 
Barium Enema 
Barium Meal 
Intravenous Urogram (IVU) 
Hysterosalpingram 
Angiogram 
Venogram 
If Bowel Obstruction or Ulcerative Colitis is suspected, the referring doctor should consult with the radiologist prior to administration of bowel cleansing solutions

Barium Enema

  •  A Barium Enema — a distinct kind of colon X-ray — is used to detect changes or abnormalities in your colon.
  • How is it performed?
  • During the exam, liquid barium — and in some cases air — is instilled into your rectum and colon. This is done to improve the images of your colon made by the X-ray machine. This test allows your doctor to examine your colon for: Ulcers Narrowed areas (strictures) Growths of the lining (polyps) Small pouches in the wall (diverticula) Cancer Other abnormalities
  • For the exam to be most accurate, it is important that the colon be thoroughly cleansed.
How do I prepare for the exam? 
Adults: 
Requires 24 hour prep: 
       - Drink clear liquids only (no food) 24 hours prior to exam. 
       - Purchase one (1) bottle of Magnesium Citrate, four (4) Dulcolax tablets, one (1) Fleet enema available at any 
         pharmacy. 
1 Day (24 hours) before exam: 
      - Take full bottle of Magnesium Citrate at 2 p.m. Drink plenty of clear liquids (no food) such as clear broth, clear 
        juice (e.g. apple), water or Jell-O for the full 24 hours prior to the exam. 
Night before exam:
       - Take two (2) Dulcolax tablets at 10 p.m. 
Morning of exam: 
       - Take two (2) Dulcolax tablets and administer Fleet enema when you wake up.

Barium Meal

What is it?
A Barium Meal and/or Small Bowel Series is a set of X-rays taken to examine the esophagus, stomach, and small intestine. X-rays are taken after the patient has swallowed a barium suspension (contrast medium).

How is it performed?
You will be sitting or standing up while your heart, lungs, and abdomen are imaged with X-rays that projects onto a monitor.
You may be given an injection of a medication that will temporarily slow bowel movement, so structures can be more easily imaged. You will then be given a drink like a milk shake that has a barium mixture in it. You must drink 16 oz to 20 oz. for the examination.
The passage of the barium through the esophagus, stomach, and small intestine is monitored on the monitor. Pictures are taken with you in a variety of positions (laying down, standing, sitting.) The test usually takes around 1-2 hours. However, in some small bowel series, it may take up to 4 hours to complete.

How do I prepare for the exam?
Adults: 
Day before exam:      
- Do not eat or drink anything after midnight before the exam 
Day of exam:      
- Do not eat breakfast or have any liquids       
- If you have had a barium enema or CT scan of the abdomen and/or pelvis within 72 hours prior to your exam please follow these instructions:
Day before exam:       
- At 3 p.m. drink 1 bottle of magnesium citrate (available at any pharmacy). This may be omitted only if directed by referring physician.
Children: 
2-12:      
- Nothing to eat or drink 8-12 hours prior to the exam.
Younger than 2:      
- Hold last feeding (preferably nothing to eat or drink 3-4 hours prior to the exam)

Intravenous Urogram (IVU)

What is it?
  • An intravenous urogram (IVU) is an x-ray procedure which provides detailed pictures of the urinary tract. The test requires injection of a contrast agent, which circulates through the body and highlights the kidneys, ureters and bladder.
  • Certain patients are at higher risk for experiencing side effects to intravenous (IV) contrast material. These include patients who have had previous reactions to contrast material or any other drug, as well as patients who have hay fever, allergies, asthma, emphysema, kidney disease, multiple myeloma, diabetes or heart disease.
  • If you have any of these conditions, please inform the technologist or radiologist who is performing your examination.

How is it performed?
  • The patient is positioned on the table, and a contrast agent is injected, usually in a vein in the patient's arm. Contrast (iodine) excreted in the urine shows outlines of the kidneys and demonstrates the inner "collecting system" and ureters as well. The inner structures appear white in the image. Images are taken before and after the injection of the contrast material. As the contrast material is processed by the kidneys, a series of images is captured to determine the actual size of the kidneys and to show the col lecting system as it begins to empty. Some kidneys don't empty at the same rate and delayed films from 30 minutes to three or four hours may be requested. However, a typical IVP study usually takes about an hour.

How do I prepare for the exam?
Adults: Day of exam:
  •  Clear liquid diet, but then nothing by to eat or drink 4 hours prior to the exam.

Hysterosalpingogram (HSG)

What is it?
  •     Hysterosalpingogram (HSG) allows the uterus and fallopian tubes to be visualized on x-rays. The proce dure is performed to evaluate narrowing of the fallopian tubes, scarring of the uterine lining and congenitally malformed uterus as a possible cause of infertility.
  •     How is it performed?
  •     For this procedure, the patient is positioned as for routine pelvic exam and a speculum is inserted. A small tube is inserted (vaginally) through the cervix into the uterus. A contrast media (clear dye) is injected into the uterus. Under fluoroscopic x-ray, the uterus and fallopian tubes are illuminated and visualized as they fill with contrast. X-ray images are obtained. A cramping sensation during and after the procedure is common.
How do I prepare for the exam?
  •     HSG can be performed 3 to 10 days after the menstrual period.
  •     No other preparation is required.
  •     Tylenol, Motrin, Aleve or other non-aspirin (ibuprofen) pain reliever are recommended to relieve post proce dural cramping.

Angiogram

What is it?
  •     An Angiogram allows the arterial circulation to be visualized on x-rays. The procedure is performed to evaluate narrowing of the circulation carrying blood with oxygen to various tissues throughout the body. Frequently, the blood vessels to the legs, brain, or heart are examined. How is it performed?
  •     For this procedure, needle is placed in either the artery in the groin, or for other types, it may be placed in a vein in the arm. The contrast media (clear dye) is injected into the circulation. Under x-ray, blood vessels are illuminated and visualized as they fill with contrast. X-ray images are obtained.
  •     If there is a blockage of the blood vessels taking blood to that part of the body is seen by the angiogram.
How do I prepare for the exam?
  •     Have a light early breakfast.
  •     If you take Metformin for Diabetes, you should omit this the day before your test.
  •     No other preparation is required.

Venogram

What is it?
  •     A Venogram allows the veins to be visualized on x-rays. The procedure is performed to evaluate blockage of the veins carrying blood back to the heart from throughout the body. Frequently, the veins in the legs are examined to look for clots.
  •     How is it performed?
  •     For this procedure, needle is placed in a vein and the contrast media (clear dye) is injected into the circu lation. Under fluoroscopic x-ray, blood vessels are illuminated and visualized as they fill with contrast. X-ray images are obtained.
  •     If there is a blockage of the vein, it is seen by venogram.
How do I prepare for the exam?
  •     Have a light early breakfast.
  •     If you take Metformin for Diabetes, you should omit this the day before your test.
  •     No other preparation is required.