Fluoroscopy

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What is fluoroscopy?

Fluoroscopy is an imaging test that uses X-rays to make “real-time” moving pictures of the body. Fluoroscopy allows your doctor to see your organs and tissues working on a video screen, similar to watching a movie. Fluoroscopy helps diagnose and treat many conditions of the blood vessels, bones, joints, and digestive, urinary, respiratory and reproductive systems.

A fluoroscopy is a noninvasive medical test and is generally painless. It makes images of any organ or body part. A contrast agent or dye is often necessary to create the fluoroscopy images. 

A radiologist will review your fluoroscopy images and discuss them with your doctor. Your doctor will then discuss the results with you. Together, you will decide what next steps, if any, you need to take based on the fluoroscopy results.

A fluoroscopy is only one method used to diagnose and treat many diseases, disorders and conditions. Your doctor will interpret your fluoroscopy results in relation to your physical exam, medical history, and other tests. Discuss all of your testing and treatment options with your doctor to understand which options are right for you.

Why is fluoroscopy performed? 

Your doctor may recommend a fluoroscopy to diagnose a disease and to guide invasive treatments. Doctors use fluoroscopy by itself or combine it with other procedures. The following common procedures use fluoroscopy:

  • Arthrogram shows joint structures including tendons, ligaments and cartilage. It diagnoses joint conditions such as arthritis and injuries.

  • Barium swallow shows the structure and function of the esophagus. It diagnoses narrowing or a tumor of the esophagus, and digestive symptoms such as burping, vomiting, regurgitation, and swallowing problems.

  • Cardiac catheterization makes images of your heart and coronary arteries. It diagnoses and treats coronary artery disease and other heart conditions.

  • Hysterosalpingogram shows the shape of the uterus and fallopian tubes, and fallopian tube blockages. It diagnoses the cause of infertility.

  • Intravenous pyleogram (IVP) shows the structure and function of the kidneys, ureters and bladder. It diagnoses kidney stones, pyelonephritis, polycystic kidney disease, and kidney abnormalities.

  • Lower GI series (barium enema) shows the structure of the colon (large intestine). It diagnoses polyps, diverticula, cancer, ulcers and inflammation.

  • Orthopedic procedures use fluoroscopy to guide orthopedic surgeries, proper realignment of bones, joint injections, joint aspirations, and percutaneous vertebroplasty (a minimally invasive procedure to treat vertebral compression fractures).

  • Upper GI series shows the structure of the esophagus, stomach, and a portion of the small intestine. An upper GI series with small bowel includes all of the small intestine and the beginning of the colon (large intestine). These tests diagnose ulcers, masses, narrowing of the digestive tract, diverticula, and esophageal varices.

  • Voiding cysto-urethrogram (VCUG) shows the size, shape and capacity of the bladder and urethra. It diagnoses urinary reflux, birth defects, and the cause of frequent bladder infections and difficulty emptying the bladder.

Who performs fluoroscopy?

Many types of doctors perform fluoroscopy to diagnose conditions and guide certain treatment procedures, such as a cardiac catheterization. Doctors who commonly use fluoroscopy include:

  • Cardiologists specialize in diagnosing and treating heart diseases. Many cardiologists are trained to perform nonsurgical, catheter-based procedures and specialized imaging techniques (interventional cardiology).

  • Gastroenterologists are internists or pediatricians who specialize in diagnosing and treating diseases, disorders and conditions of the gastrointestinal (GI) tract or digestive system.

  • Obstetricians-gynecologists (Ob/Gyns) specialize in the medical and surgical care of the female reproductive system.

  • Orthopedic surgeons specialize in diagnosing and treating injuries and diseases of the musculoskeletal system, including the muscles, joints, ligaments, tendons, nerves and bones.

  • Radiologists, sometimes called diagnostic radiologists, specialize in medical imaging. Your radiologist may be assisted by a radiologic technologist, a healthcare provider who performs imaging procedures and takes care of patients during the procedures.

  • Urologists and pediatric urologists specialize in diagnosing and treating diseases and conditions of the genitourinary tract.

How is fluoroscopy performed?

Your fluoroscopy will be performed in a hospital or outpatient setting. Fluoroscopy techniques vary depending on the particular procedure but generally include these steps:

  1. You will undress, remove any jewelry, and put on a patient gown.

  2. You will be positioned on a table to make the best images. You may need to change positions or hold your breath for a brief period during the fluoroscopy.

  3. You may have a contrast agent or dye through an IV, in an enema, or by drinking it. For catheter procedures, such as cardiac catheterization, your doctor will inject the contrast agent through the catheter.

  4. Children and adults who are anxious may have a light sedative to help them relax and stay still.

  5. A special X-ray scanner will take pictures of the specific body area and show the images instantly on a video screen. This is painless. The care team may let you view the images yourself if you are interested.

  6. Your doctor will complete other interventions and treatments as needed. For example, a cardiac catheterization may include angioplasty to open blocked coronary arteries.

  7. You may go home the same day or stay in the hospital for further observation and treatment as needed.

Will I feel pain?

Your comfort and relaxation is important to you and your care team. The fluoroscopy scanner itself never touches you and is not painful. Your positioning on the X-ray table should not cause pain or make it difficult to breathe.

If you need IV contrast, you may feel a brief stick or pinch during IV insertion. You may also feel a fleeting warm sensation when the contrast is injected. If you receive your contrast by enema, you may feel rectal pressure as the enema tube is inserted and the contrast is injected. 

Some procedures, such as a joint injection, may cause some brief pain or discomfort. Take a few long, deep breaths to help yourself relax. Tell your doctor or care team if any discomfort does not pass quickly, if you are anxious, or if your position makes it difficult to breathe.

Doctor often use sedation to keep patients relaxed and comfortable. Ask your doctor if sedation is an option for you.  

What are the risks and potential complications of fluoroscopy? 

Complications of fluoroscopy are not common, but any medical procedure involves risk and potential complications.

There is a small increase in the risk of cancer due to radiation exposure with fluoroscopy. Your care team follows strict standards for X-ray techniques and will use the smallest amount of radiation possible to produce the best images. 

Your doctor will generally not use fluoroscopy if you are pregnant because radiation can cause birth defects. It is important to tell your doctor and care team if there is any chance that you are pregnant.

Allergic reactions to contrast materials are rare, but can occur. Fluoroscopy teams are well prepared to handle allergic reactions. 

How do I prepare for my fluoroscopy?

You are an important member of your own healthcare team. The steps you take before your procedure can improve your safety and comfort and help obtain the most accurate results. Your doctor will give you instructions about how to prepare for your specific fluoroscopy procedure. 

You can generally prepare for fluoroscopy by:

  • Answering all questions about your medical history, allergies, and medications. This includes prescriptions, over-the-counter drugs, herbal treatments, and vitamins. It is a good idea to carry a current list of your medical conditions, medications, and allergies at all times.

  • Following instructions to clean stool out of your colon before a barium enema. This allows your doctor to get the most accurate results. Your doctor will give you directions if this is needed.

  • Leaving all jewelry and metal objects at home

  • Telling your doctor and your radiologic technologist if you feel nervous or anxious about lying still or having the fluoroscopy procedure

  • Telling your doctor if there is any possibility of pregnancy or if you are breastfeeding

Questions to ask your doctor

Preparing for any medical testing can be stressful. It is common for patients to forget some of their questions during a doctor’s office visit. You may also think of other questions after your appointment. Contact your doctor with concerns and questions before a fluoroscopy and between appointments.

It is also a good idea to bring a list of questions to your appointments. Common questions include:

  • Why do I need fluoroscopy? Are there any other options for diagnosing or treating my condition?

  • How will I receive the contrast for my fluoroscopy?

  • How long will the procedure take? When can I go home?

  • When and how will I receive the results of my test?

  • What other tests or treatments might I need?

  • How will you treat my pain?

  • When should I follow up with you?

  • How should I contact you? Ask for numbers to call during and after regular hours.

What can I expect after my fluoroscopy?

Knowing what to expect after fluoroscopy can help you get back to your everyday life as soon as possible.

How will I feel after the fluoroscopy?

How you feel after fluoroscopy will vary depending on your diagnosis and the type of procedure. Talk to your doctor about what to expect for your particular procedure and when you can return to normal activities.

You may have loose bowel movements that contain contrast for a day or two if you drank contrast or had a contrast enema. Tell a member of your care team or your doctor if unusual stools last longer or you have any pain or discomfort after your fluoroscopy.

When can I go home?

This varies depending on the type of fluoroscopy procedure. If you have your fluoroscopy during hospitalization, you will likely stay in the hospital for further evaluation and treatment. You may go home the same day if you are not acutely ill. 

For a cardiac catheterization, you may need to stay in the hospital, depending on your condition. Ask your doctor when you can go home based on your particular situation.

When should I call my doctor?

It is important to keep your follow-up appointments after a fluoroscopy. Contact your doctor for questions and concerns between appointments.

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2020 Nov 15
THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.
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