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What is a Fluoroscopy-Guided injection?

A fluoroscopic-guided injection is a diagnostic and therapeutic procedure that involves administering a medicine, usually a corticosteroid and numbing agent, directly into a joint through an injection to help identify or diagnose the source of pain, as well as relieve pain and discomfort caused by an inflamed joint.

What is Fluoroscopy?

Fluoroscopy is an imaging method to capture real-time moving pictures of the internal structures of an individual utilizing a fluoroscope – a special imaging device that creates viewable X-rays without capturing or developing X-ray images. During fluoroscopy, a continuous X-ray beam is passed through the part of the body being inspected and is transferred to a computer screen to visualize the body part and its motion.

Fluoroscopy is an advanced imaging technology that provides your surgeon with real-time and high-resolution X-ray images, thus allowing your physician to monitor the progress of the procedure at any point during surgery and make immediate corrections as be needed for the best outcome.

Indications for Fluoroscopy-Guided Injection

Fluoroscopy-guided injections can be recommended to diagnose and treat various orthopedic conditions such as:

  • Arthritis
  • Joint pain
  • Tendinopathy
  • Bursitis
  • Neck pain
  • Low back pain
  • Upper back pain
  • Muscle pain
  • Sciatica

Preparation for Fluoroscopy-Guided Injection

In general, pre-procedure preparation for fluoroscopy-guided injections will involve the following steps:

  • You will be asked if you have allergies to medications, anesthesia, contrast dye, or latex.
  • You should inform your doctor of any medications, vitamins, or supplements that you are taking.
  • You may need to refrain from vitamins, supplements, and medications such as blood thinners and anti-inflammatories a week prior to the procedure.
  • It is also important to inform your doctor if you are pregnant or might be pregnant, diabetic, asthmatic, or have any other medical conditions.
  • You should refrain from alcohol or tobacco at least a few days prior to the procedure.
  • You should not consume any solids or liquids at least 6 hours prior to the procedure.
  • You should remove all metal objects and accessories such as eyeglasses, jewelry, watch, etc. as they can interfere with the imaging.
  • You should arrange for someone to drive you home after the procedure.
  • A written consent will be obtained from you after the pros and cons of the procedure have been explained in detail.

Procedure for Fluoroscopy-Guided Injection

Fluoroscopy-guided injection is a minimally invasive procedure that is usually performed in an outpatient setting and takes about 30 minutes. In general, the procedure involves the following steps:

  • You will be asked to lie on the operating table in a specified position based on the area to be treated.
  • Your physician may administer sedative medicine to help you relax.
  • Your physician will clean the intended treatment site with iodine and cover it with a sterile drape.
  • Your physician will then administer a local anesthetic to numb the treatment area.
  • Under real-time x-ray (fluoroscopy) guidance, a small amount of contrast dye is injected to confirm the positioning of the needle.
  • This is followed by the administration of pain medicine (anesthesia and steroid mixture) through the needle into the treatment area under x-ray guidance.
  • The needle is then removed, and a bandage is applied over the injection site.

Post-Procedure Care

In general, post-procedure care instructions and recovery after fluoroscopy-guided injections will involve the following steps:

  • You will be transferred to the recovery area where you will be observed for an hour for any allergic/anesthetic reactions and discharged home thereafter.
  • You may experience some pain and soreness at the injection site for a few days. Pain and anti-inflammatory medicines are provided as needed. Administration of ice packs is also advised to mitigate pain and soreness.
  • Refrain from operating heavy machinery or driving for at least 24 hours.
  • Refrain from consuming alcohol for at least 24 hours.
  • Instructions on injection site area care and bathing will be provided. The bandage will stay on for a couple of days, but you may shower after 24 hours of the procedure.
  • You will be able to resume your normal activities within a couple of days but may have certain activity restrictions.
  • A follow-up visit will be scheduled to monitor your progress.

Risks and Complications

Fluoroscopy-guided injections are a relatively safe procedure; however, as with any procedure, some risks and complications may occur, such as:

  • Infection
  • Bleeding
  • Pain
  • Numbness
  • Damage to adjacent tissue
  • Soreness/bruising
  • Allergic/anesthetic reactions