Radiation in Healthcare: Fluoroscopy

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.

Find information on special considerations pregnant women and children.

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.
Medical professional in the operating room with c- arm fluoroscope.

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.

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Most people have had one or more medical imaging tests that use ionizing radiation. The type of imaging procedure that your doctor may suggest will depend on your health concern and the part of the body that is being examined. Some other common examples of imaging tests include:

If your doctor suggests x-rays or other medical imaging procedures  you should consider the following:

  • Medical imaging tests should be performed only when necessary.
  • The U.S. Food and Drug Administration (FDA) recommends discussing the benefits and risks of fluoroscopy with your doctor.
X-ray fluoroscopy instrument

Before the procedure

Ask your health care provider to explain the procedure and make sure you ask him/her if you still have additional questions. Some fluoroscopy procedures may use a “contrast dye” which allows doctors to see specific organ(s). The dye may be administered by swallowing, an intravenous (IV) line in your hand or arm, or an enema.

Make sure to let the doctor know if:

  • You have ever had a reaction to any contrast dye.
  • You are pregnant or suspect that you may be pregnant.

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 x-ray table, and depending on the type of procedure, you may be asked to do the following: assume different positions, move a specific body part, or hold your breath at intervals while the fluoroscopy is being performed.
  • A special x-ray machine will produce fluoroscopic views of the body structure being examined or treated.

Medical imaging tests such as fluoroscopy are non-invasive procedures that allow doctors to diagnose diseases and injuries.

These tests can help doctors:

  • Obtain a better view of organs, blood vessels, tissues and bones
  • Determine whether surgery is a good treatment option
  • Guide medical procedures involving placement of catheters, stents, or other devices inside the body, locate tumors for treatment and locate blood clots or other blockages
  • Guide joint replacement options and treatment for fractures

As in many areas of medicine, there are risks associated with the use of fluoroscopy, which uses ionizing radiation to generate images of the body. Risks from exposure to ionizing radiation include:

  • A small increase in the likelihood that a person exposed to radiation will develop cancer later in life.
  • Health effects that could occur after a large exposure to ionizing radiation such as acute skin reddening, and hair loss.
  • Possible allergic reactions associated with a contrast dye injected intravenously into the veins to better see body structures being examined.

While fluoroscopy itself is not painful, the particular procedure being performed may be painful, such as the injection into a joint or accessing of an artery or vein for angiography. In these cases, the radiologist will take all comfort measures possible, which could include local anesthesia, conscious sedation, or general anesthesia, depending on the particular procedure.

In the case of x-rays or other tests involving exposure to ionizing radiation, doctors and radiation experts can help reduce your exposure to and risk of harm from diagnostic ionizing radiation by:

  • Checking to see if you have had a similar test done recently that can provide them with the background information they need.
  • Checking to see if a test that does not use ionizing radiation can provide similar information.
  • Making certain the least possible amount of radiation needed to obtain a good quality image is used for your procedure.
  • Providing protective lead shielding to prevent exposing other areas of the body to radiation.

Radiation experts include the following:

  • Hospital radiation safety officer
  • Medical physicist
  • Radiation physicist
  • Diagnostic medical physicist

Talk to your physician about the potential risks and benefits from the medical procedures.  In many cases, the risk of an x-ray procedure to the mother and the unborn child is very small compared to the benefit of finding out about the medical condition of the mother or the child.

Many doctors use ultrasound to examine the abdomen, pelvic area, or heart. Ultrasound does not use ionizing radiation, so it does not expose women of childbearing age to radiation in the pelvic area. This is particularly important in pregnancy.  For more information, please see the Image Wiselyexternal icon website.

Risks that are considered small should not be taken if they’re unnecessary.  You can reduce risks from medical imaging procedures by telling your doctor if you are, or think you might be, pregnant whenever an abdominal x-ray is suggested by your doctor. Other options suggested by FDA that may be considered are as follows:

  • If you are pregnant, the doctor may decide that it would be best to cancel the medical imaging procedure, to postpone it, or to modify it to reduce the amount of radiation.
  • Depending on your medical needs, and realizing that the risk is very small, the doctor may feel that it is best to proceed with using a medical imaging procedure as planned.

In any case, you should feel free to discuss the decision with your doctor.  For more information on medical imaging and pregnancy, please see X-rays, Pregnancy and Youexternal icon.  Also, for more information on radiation safety in adult medical imaging, please visit the Image Wisely websiteexternal icon.

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It is important that x-rays and other medical imaging procedures performed on children use the lowest exposure setting needed to obtain a good quality image. The Image Gently Allianceexternal icon, part of the Alliance for Radiation in Pediatric Imaging, suggests the following for imaging of children:

  • Use imaging examinations when the medical benefit outweighs the risk.
  • Use the most appropriate imaging techniques, matched to the size of the child.
  • Use alternative imaging methods (such as ultrasound or MRI) when possible.

The U.S. Food and Drug Administration (FDAexternal icon) also provides information for parents, patients and healthcare providers to address concerns about the benefits and risks of medical imaging procedures for children.

There are also medical imaging procedures such as Magnetic Resonance Imaging (MRI) or ultrasound that do not use ionizing radiation to diagnose illnesses or injuries.

What is Magnetic Resonance Imaging (MRI)?

MRI procedures, which can lasts from 30-60 minutes, use magnetic fields and radio waves to produce images of specific parts of the body. MRI scans are often performed along with other medical imaging procedures to provide a more detailed view of the area of the body that is being examined. For more information on MRI, please see FDA’s website on MRI (Magnetic Resonance Imaging)external icon.

What is an Ultrasound?

Ultrasound imaging uses high-frequency sound waves to see inside the body. There is no ionizing radiation used and in most ultrasound examinations, no contrast is given.

Page last reviewed: October 20, 2021