Fluoroscopy is a medical procedure that makes a real-time video of the movements inside a part of the body by passing x-rays through the body over a period of time. X-rays are a form of ionizing radiation. Fluoroscopy can be used for diagnosing (finding out the cause of) a health problem such as heart or intestinal disease. It also can be used to guide treatments such as implants or injections, or in orthopedic surgery. It helps the healthcare provider look inside organs, joints, muscles, and bones.

Although we all are exposed to ionizing radiation every day from the natural environment, added exposures like those from fluoroscopy procedures can slightly increase the risk of developing cancer later in life.

What You Should Know

Your healthcare provider may recommend a fluoroscopy procedure to diagnose disease or guide treatment procedures for a particular health concern.

Fluoroscopy is commonly used to:

• Check how the stomach and intestines are working.
• Check if food is being properly swallowed and how the muscles of the mouth and throat are working.
• Guide medical procedures to place catheters, stents, or other devices inside the body, such as in the heart or blood vessels.
• Guide injections (shots) deep into the spine or joints.
• See broken bones and whether surgery has fixed them in proper position to heal.

Coronary angiography is an example of a fluoroscopy procedure. A small tube (catheter) is inserted into an artery of the heart. Contrast dye moves through the catheter into the blood vessels. The fluoroscopy shows how the blood moves through the vessels and allows the healthcare provider to locate any blockages.

Your healthcare provider will recommend fluoroscopy when the benefits to your health outweigh the risk.
Talk to your healthcare provider if you have any questions or concerns or to decide on the best options for you.

What To Expect

Before the procedure

Some fluoroscopy procedures may use a contrast dye which allows medical provider to see specific organ(s). You will be asked to either drink the dye or you will receive it in an intravenous (IV) line in your hand or arm.

Make sure to let your healthcare provider or radiologist (medical professional specially trained in radiation procedures) know if:

• You have ever had a reaction to any contrast dye.
• If you have kidney disease or poor kidney function.
• You are pregnant or think you could be pregnant.

You may be asked to take a pregnancy test before the procedure.

During the procedure

• You will be asked to remove any clothing and jewelry that may interfere with the procedure.
• You will be positioned on the procedure table and, depending on the type of procedure, you may be asked to get in different positions, move a specific body part, or hold your breath at intervals while the fluoroscopy is being performed.
• Anesthesia or sedation may be used depending on the procedure.

Benefits and Risks of Fluoroscopy Procedures

Benefits:

• Allows healthcare providers to see movement and function (like in a movie) that cannot be seen in other fixed imaging studies (like a photograph).
• Guides sometimes life-saving surgical treatments.

Risks:

• Radiation doses are usually higher than in common imaging like x-rays. This means these procedures are slightly more likely to increase the possibility you may get cancer later in life.
• Some fluoroscopy procedures are longer and use more radiation than others. These could cause skin reddening and hair loss.
• Contrast dye, if used, can produce an allergic reaction in some people.

While fluoroscopy itself is not painful, the procedure being performed may be painful, such as the injection into a joint or accessing of an artery or vein for angiography.

The radiologist will take all comfort measures possible, which could include local anesthesia, conscious sedation, or general anesthesia, depending on the procedure.

Fluoroscopy is like a real-time x-ray movie. It can show the movement of a body part (like the heart) or the course that a medical instrument or dye (contrast agent) takes as it travels through the body.

Unlike a regular x-ray, during fluoroscopy an x-ray beam is passed continuously through the body. The image is transmitted to a monitor so that doctors can see the body part and its motion in detail.

Fluoroscopy is used in many types of examinations and procedures. Some examples include:

• Barium x-rays and enemas (to view movement through the GI tract).
• Catheter insertion (to direct the placement of a catheter during angioplasty or angiography).
• Blood flow studies (to visualize blood flow to organs).
• Orthopedic surgery (to help doctors see broken bones and to set the fractures in good alignment).

Fluoroscopy is a type of medical imaging that shows a continuous X-ray image on a monitor, much like an X-ray movie. During a fluoroscopy procedure, an X-ray beam is passed through the body. The image is transmitted to a monitor so the movement of a body part or of an instrument or contrast agent (“X-ray dye”) through the body can be seen in detail.

Benefits/Risks

Fluoroscopy is used in a wide variety of examinations and procedures to diagnose or treat patients. Some examples are:

• Barium X-rays and enemas (to view the gastrointestinal tract)
• Catheter insertion and manipulation (to direct the movement of a catheter through blood vessels, bile ducts or the urinary system)
• Placement of devices within the body, such as stents (to open narrowed or blocked blood vessels)
• Angiograms (to visualize blood vessels and organs)
• Orthopedic surgery (to guide joint replacements and treatment of fractures)

Fluoroscopy carries some risks, as do other X-ray procedures. The radiation dose the patient receives varies depending on the individual procedure. Fluoroscopy can result in relatively high radiation doses, especially for complex interventional procedures (such as placing stents or other devices inside the body) which require fluoroscopy be administered for a long period of time. Radiation-related risks associated with fluoroscopy include:

• radiation-induced injuries to the skin and underlying tissues (“burns”), which occur shortly after the exposure, and
• radiation-induced cancers, which may occur some time later in life.

The probability that a person will experience these effects from a fluoroscopic procedure is statistically very small. Therefore, if the procedure is medically needed, the radiation risks are outweighed by the benefit to the patient. In fact, the radiation risk is usually far less than other risks not associated with radiation, such as anesthesia or sedation, or risks from the treatment itself. To minimize the radiation risk, fluoroscopy should always be performed with the lowest acceptable exposure for the shortest time necessary.

Information for Patients

Fluoroscopy procedures are performed to help diagnose disease, or to guide physicians during certain treatment procedures. Some fluoroscopy procedures may be performed as outpatient procedures while the patient is awake – for example, upper gastrointestinal series to examine the esophagus, stomach and small intestine, or a barium enema to examine the colon.

Other procedures are performed as same-day hospital procedures or sometimes as inpatient procedures, typically while the patient is sedated – for example, cardiac catheterization to examine the heart and the coronary arteries that supply blood to the heart muscle. Still other fluoroscopy procedures may be performed under general anesthesia during surgery – for example to help align and fix fractured bones.

The clinical benefit of a medically appropriate X-ray imaging exam outweighs the small radiation risk.

The total radiation exposure depends on the length of the fluoroscopy procedure and the dose of the materials used. An interventional fluoroscopic procedure may expose the patient to the radiation equivalent of 75-3,000 chest x-rays. Examples of fluoroscopic procedures and approximate exposures are:

Barium swallow: 1.5 mSv (150 mrem)

Barium enema: 7.0 mSv (700 mrem)

Coronary angiogram: 4.6-15.8 mSv (460-1,580 mrem)

Angioplasty (heart study): 7.5-57 mSv (750-5,700 mrem)

Fluoroscopic procedures expose patients to a greater amount of radiation than other medical imaging procedures, such as x-rays. It’s important to discuss the necessity of the procedure with your medical professional. Medical imaging can provide life-saving information, so the benefits of the procedure generally far outweigh the risks from radiation exposure.