Diagnostic Imaging - Radiography (X-ray)

Radiography (X-ray) Services at RIMA
• Arthrography
• Bone Densitometry
• Catheter Angiography
• Children’s (Pediatric) Voiding Cystourethrogram
• Galactography (Ductography)
• Hysterosalpingography
• Intravenous Pyelogram (IVP)
• Mammography
• Myelography
• Stereotactic Breast Biopsy
• X-ray (Radiography), Bone
• X-ray (Radiography), Chest
• X-ray (Radiography), Lower GI Tract
• X-ray (Radiography), Upper GI Tract

Arthrography
Conventional arthrography is the x-ray examination of a joint that uses a special form of x-ray called fluoroscopy and a contrast material containing iodine. Fluoroscopy makes it possible to see internal organs in motion. When iodine is injected into the joint space, it coats the inner lining of the joint structures and appears bright white on an arthrogram, allowing the radiologist to assess the anatomy and function of the joint. Arthrographic images help radiologists evaluate alterations in structure and function of a joint and help to determine the possible need for treatment, including surgery or joint replacement.

Much of conventional Arthrography today has been replaced by MR Arthrography. Instead of an iodine containing material being injected on fluoroscopic guidance, an MR sensitive material is injected and following the joint injection, the patient is scanned in an MRI machine. In most cases, MR Arthrography can provide more information then that available from conventional Arthrography.

Bone Densitometry
Bone density scanning, also called dual-energy x-ray absorptiometry (DXA) or bone densitometry, is an enhanced form of x-ray technology that is used to measure bone loss. DXA is today’s established standard for measuring bone mineral density (BMD).

DXA is most often performed on the lower spine and hips. In children and some adults, the whole body is sometimes scanned. Peripheral devices that use x-ray or ultrasound are sometimes used to screen for low bone mass. In some communities, a CT scan with special software can also be used to diagnose or monitor low bone mass (QCT). This is accurate but less commonly used than DXA scanning.

DXA is most often used to diagnose osteoporosis, a condition that often affects women after menopause but may also be found in men. Osteoporosis involves a gradual loss of calcium, as well as structural changes, causing the bones to become thinner, more fragile and more likely to break.

DXA is also effective in tracking the effects of treatment for osteoporosis and other conditions that cause bone loss.

The DXA test can also assess an individual’s risk for developing fractures. The risk of fracture is affected by age, body weight, history of prior fracture, family history of osteoporotic fractures and life style issues such as cigarette smoking and excessive alcohol consumption. These factors are taken into consideration when deciding if a patient needs therapy.

Bone density testing is strongly recommended if you:
• are a post-menopausal woman and not taking estrogen.
• have a personal or maternal history of hip fracture or smoking.
• are a post-menopausal woman who is tall (over 5 feet 7 inches) or thin (less than 125 pounds).
• are a man with clinical conditions associated with bone loss.
• use medications that are known to cause bone loss, including corticosteroids such as Prednisone, various anti-seizure medications such as Dilantin and certain barbiturates, or high-dose thyroid replacement drugs.
• have type 1 (formerly called juvenile or insulin-dependent) diabetes, liver disease, kidney disease or a family history of osteoporosis.
• have high bone turnover, which shows up in the form of excessive collagen in urine samples.
• have a thyroid condition, such as hyperthyroidism.
• have a parathyroid condition, such as hyperparathyroidism.
• have experienced a fracture after only mild trauma.
• have had x-ray evidence of vertebral fracture or other signs of osteoporosis.

Children’s (Pediatric) Voiding Cystourethrogram
A children’s (pediatric) voiding cystourethrogram (VCUG) is an x-ray examination of a child’s bladder and lower urinary tract that uses a special form of x-ray called fluoroscopy and a contrast material.

Fluoroscopy makes it possible to see internal organs in motion. When the bladder is filled with and then emptied of a water-soluble contrast material, the radiologist is able to view and assess the anatomy and function of the bladder and lower urinary tract

A voiding cystourethrogram enables a radiologist, a physician specifically trained to supervise and interpret radiology examinations, to detect abnormalities in the flow of urine through the urinary tract.
This examination is often recommended after a urinary tract infection to check for a condition known as vesicoureteral (VU) reflux.

Urine is produced in the kidneys and flows through the ureter, the tube that carries urine from each kidney to the bladder. A valve mechanism prevents urine from backing up into the kidneys as the bladder gets full. Urine leaves the bladder through the urethra and is eliminated from the body during urination.

In some children, an abnormality in the valve or the ureters allows urine to flow backwards, a condition called VU reflux. In mild cases urine backs up into the lower ureter. In severe cases it can back up into a swollen kidney. Usually, children with this condition are born with it. Other causes include:
• blockage to the bladder
• abnormal urination with very high pressure within the bladder
• incomplete emptying of the bladder
• urinary tract infections.
Urinary tract infection may be the only symptom of the problem.

Hysterosalpingography
Hysterosalpingography, also called uterosalpingography, is an x-ray examination of a woman’s uterus and fallopian tubes that uses a special form of x-ray called fluoroscopy and a contrast material.

Fluoroscopy is a special x-ray technique that makes it possible to see internal organs in motion. When the uterus and fallopian tubes are filled with a water-soluble contrast material, the radiologist is able to view and assess their anatomy and function.

Hysterosalpingography is primarily used to examine women who have difficulty becoming pregnant by allowing the radiologist to evaluate the shape and structure of the uterus, the openness of the fallopian tubes, and any scarring within the peritoneal cavity.

The procedure can be used to investigate repeated miscarriages that result from congenital abnormalities of the uterus and to determine the presence and severity of these abnormalities, including:
• tumor masses
• adhesions
• uterine fibroids

Hysterosalpingography is also used to evaluate the openness of the fallopian tubes, and to monitor the effects of tubal surgery, including:
• blockage of the fallopian tubes due to infection or scarring.
• tubal ligation
• the closure of the fallopian tubes in a sterilization procedure and a sterilization reversal
• the re-opening of the fallopian tubes following a sterilization or disease-related blockage

X-ray (Radiography), Bone
An x-ray (radiograph) is a noninvasive medical test that helps physicians diagnose and treat medical conditions. Imaging with x-rays involves exposing a part of the body to a small dose of ionizing radiation to produce pictures of the inside of the body. X-rays are the oldest and most frequently used form of medical imaging.

A bone x-ray makes images of any bone in the body, including the hand, wrist, arm, foot, ankle, knee, leg or spine.
A bone x-ray is used to:
• diagnose broken bones or joint dislocation.
• demonstrate proper alignment and stabilization of bony fragments following treatment of a fracture.
• guide orthopedic surgery, such as spine repair/fusion, joint replacement and fracture reductions.
• look for injury, infection, arthritis, abnormal bone growths, bony changes seen in metabolic conditions.
• assist in the detection and diagnosis of bone cancer.
• locate foreign objects in soft tissues around or in bones.

X-ray (Radiography), Chest
The chest x-ray is the most commonly performed diagnostic x-ray examination. A chest x-ray makes images of the heart, lungs, airways, blood vessels and the bones of the spine and chest.

An x-ray (radiograph) is a noninvasive medical test that helps physicians diagnose and treat medical conditions. Imaging with x-rays involves exposing a part of the body to a small dose of ionizing radiation to produce pictures of the inside of the body. X-rays are the oldest and most frequently used form of medical imaging.

The chest x-ray is performed to evaluate the lungs, heart and chest wall.

A chest x-ray is typically the first imaging test used to help diagnose symptoms such as:
• shortness of breath
• a bad or persistent cough
• chest pain or injury
• fever

Radiologists use the examination to help diagnose or monitor treatment for conditions such as:
• pneumonia
• heart failure and other heart problems
• emphysema
• lung cancer
• other medical conditions.