Special Procedures
Special Procedures are examinations that are usually invasive. Some kind of contrast media (iodine) is used and a radiologist usually performs the procedure. Very little preparation is required for these tests that are available on an outpatient basis. Usually they require about an hour of the patient's time. In this section, we will explain some of these procedures and their preparations.
ARTHROGRAMS
Arthrograms are images made of the sac surrounding the joint space. This area cannot be visualized with x-ray without using a contrast media. In a knee arthrogram, a needle is placed under the knee cap in the joint space and iodine is injected into the space.
Meniscal tears can be detected. Other joints which are most commonly examined are the shoulder, ankle and the wrist.
Examination Time: 1 hour.
Precautions: Patients who have an allergy to iodine or local anesthesia should be premedicated to avoid an allergic reaction. Please check with the doctor or radiologist before scheduling.
Patient Instructions: Bring recent x-rays of area to be examined.
HYSTEROSALPINGOGRAM-HSG-TUBAL VISUALIZATION
Hysterosalpingography is used to examine the uterine cavity and fallopian tubes in the female. It will sometimes reveal the reason for female sterility because of obstructed fallopian tubes from pelvic inflammatory disease, surgery, etc. Occasionally, the examination itself will open the tubes and allow fertilization and implantation to occur.
Contrast material is injected into the mouth of the cervix and body of the uterus through an instrument placed in the vagina and cervical os. The exam may cause some discomfort and a little spotting. Antibiotics will be prescribed by a radiologist if necessary.
Examination Time: 30 minutes.
Precautions: Examination should be scheduled 7 to 10 days following the first day of menses. Menstrual bleeding should have ceased by then.
Patient Instructions: The patient should take 400 to 600 mg. Ibuprofen prior to the procedure.
VENOGRAM
Venograms are x-rays usually made of the vessels in the lower extremity including inferior vena cava, iliac veins, superficial and deep femoral veins and veins in the lower leg and ankle. Iodine is injected into a vein in the foot and is examined returning up the leg into the inferior vena cava. Varicosities and obstruction in the lower extremities are defined as to location.
Examination Time: 1 hour.
Precautions: Patients who have an allergy to iodine or local anesthesia should be premedicated to avoid an allergic reaction. Check with radiologist or doctor before scheduling.
**Note: Patients with a history of renal insufficiency should have creatinine levels drawn prior to scheduling.
Patient Instructions: Ideally, patients should be NPO 4 hours prior to examination. Diabetic patients may drink clear liquids with their morning insulin injection.