Fluoroscopy is an imaging system used by doctors to obtain a real time moving picture of the inside of the body. Using X-ray technology, fluoroscopy takes and displays several images of the inside of the body per second. This creates a live movie of the patient’s internal structures that doctors can use to look for signs and symptoms of a disease or condition, enabling them to make a diagnosis. In addition to diagnoses, physicians may also use this process to guide procedures such as injections into joints or minimally invasive surgeries.
Fluoroscopy is used to examine a wide range of internal structures, including bones, the lungs, heart, kidneys, bladder, digestive system, muscles, reproductive system, and joints. The device used in this procedure is called a fluoroscope or, sometimes, a C-arm. The fluoroscope consists of an X-ray machine and an image intensifier, between which the patient is positioned. After the X-ray source beams rays through the body, the image intensifier translates the X-rays into light, which appear as images. These images are then transferred to a monitor, much like a TV screen, on which the doctor can watch the shape and movement of the patient’s internal structures.
X-ray technology emits electromagnetic radiation to create images in which denser objects, such as bone, are highlighted and less dense objects, such as fat, appear in shades of gray. This technology may be used to determine whether the patient has broken or chipped bones, spinal injuries, bone or joint affecting diseases, heart or lung disease, a punctured lung, or scoliosis, the abnormal curving of the spine. X-ray may also be used to locate accidentally swallowed objects, evaluate causes of chest pain, detect blockages in blood vessels, inspect sinus infections, and evaluate dental problems. X-rays produce radiation, and dose reductions are often required for children. Patients should be sure to tell their doctor if they may be pregnant before using fluoroscopy.
Fluoroscopy procedures will vary based on the patient’s condition, the structures being examined, and the protocols of a given region. The process may begin an intravenous line, or IV, being injected into a vein, typically in the arm or hand. The patient may then be put under partial or general anesthesia, numbing the patient to any pain that might occur. He or she will then be positioned between the image intensifier and the X-ray source. If the patient cannot be moved, a mobile X-ray machine will be positioned around the patient.
In order to get a better visual aid, physicians may inject a harmless dye through the IV line to highlight desired structures. The next steps in fluoroscopy will depend on the patient’s case. If the gastrointestinal (GI) tract is being examined, the patient may be asked to swallow a barium sulfate solution so the physician can watch the muscles of the esophagus and stomach work through fluoroscopic imaging. Fluoroscopy is also commonly used to help a doctor guide a catheter, or tube, into the body. A catheter may be used to drain fluids from the body or administer fluids into the body and can be inserted into several locations, usually in the groin.
Fluoroscopy may also be used to guide minimally invasive surgeries. A minimally invasive surgery uses medical imaging to allow doctors to operate in the body without fully opening the patient. Fluoroscopy is used most frequently in percutaneous vertebroplasty, a minimally invasive surgery that strengthens weakened vertebrae in the spine. After undergoing a local anesthesia and being placed between a fluoroscope, the doctor injects a cement-like solution directly into the affected vertebra of the spine. This relieves pain and strengthens the spine.
