The hysterosalpingogram is an x-ray test that takes a picture after dye has filled the inside of the uterus and fallopian tubes. It is a useful test in helping determine the cause of infertility. It is sometimes also used to evaluate patients who have had several miscarriages or patients with an IUD (intrauterine device) that cannot be seen on regular examinations. This test can show areas of scarring inside a fallopian tube or changes in the uterine cavity, as might occur with a polyp or other growth in the uterus.

What do I need to do to prepare for this test?
Generally there is no special preparation needed for this test. However, depending upon your diagnosis, you may need to take antibiotics to guard against possible infection. To ensure that you are not pregnant, the study is done between Day 7 and 10 of your cycle. Prior to the procedure you may take an anti-inflammatory medication (Aleve or Motrin). A small catheter is placed into the cervix and the dye is injected. You may feel heavy cramping during, and for several hours following this procedure. Expect a sticky vaginal discharge for a few days as the dye is expelled from the uterus. Use a pad or panty liner during this time to allow fluid to escape. Any dye that remains will be absorbed without any ill effect.

NOTE: Be sure we are aware of any allergies you may have to Iodine, Betadine, or Novocaine prior to the procedure.

What happens when the test is performed?
This test takes place in the x-ray department. You lie on your back on a table with your knees bent and your feet in footrests, as you would for a pelvic examination. Most doctors feel your uterus to determine its size and shape by pressing inside your vagina with two fingers and pressing down on your lower abdomen with the other hand. A speculum (a device that looks like a duck-bill that can be opened and closed) is used to open the vagina so that your doctor can see inside. You may feel slight pressure from this.

Your vagina and cervix (the part of your uterus that the doctor can see inside your vagina) are cleaned with an antibacterial soap. A thin clamp might be clipped onto your cervix to hold it steady while the dye is put into your uterus. The doctor pushes a small bendable plastic tube gently through the opening in your cervix into your uterus. A tiny balloon on the end of the tube is filled with air to hold it temporarily in place.

The speculum is then removed, but the thin tube is left in place, with one end (about 6 inches of tubing) remaining outside of your vagina. Your doctor might have you change position at this time, so that you are lying more comfortably. A small amount of x-ray dye (about a tablespoon) is injected through the tube into your uterus, and several x-ray pictures are taken that may show up on a video screen for your doctor to see. Your doctor might ask you to move your pelvis slightly or roll from side to side to provide the clearest view of your uterus and tubes. When the x-rays are done, the balloon is emptied of air from the outside and the tube is gently pulled out.

What risks are there from the test?
It is common for patients to have a small amount of bleeding from the vagina and some pelvic cramping for a few days after the procedure. If you have heavy bleeding, fever, or increasing pain in the pelvis, you should call your doctor. Some women experience an allergic reaction the contrast dye. The most significant risk from this procedure is infection, which happens in close to 3 out of 100 patients. Most doctors use a water-soluble dye when they do this procedure; there are some risks associated with oil-based dyes that are still used in some centers, including rare scarring problems in the uterus or (rarely) breathing complications if the oil moves into a blood vessel.

As with x-rays, there is a small exposure to radiation. In large amounts, exposure to radiation can cause cancers or (in pregnant women) birth defects. The amount of radiation from a hysterosalpingogram is too small to be likely to cause any harm. However, since the x-ray exposure is directed right at the pelvis and ovaries, it is very important to be sure you are not pregnant at the time of the test.

Must I do anything special after the test is over?
You may be watched for 30 minutes or so to make sure you do not have an allergic reaction to the x-ray dye and do not have any worrisome bleeding.

What is the test?
The intravenous pyelogram (IVP) is an x-ray test that uses a dye to show your urinary organs (the kidneys, ureters, and bladder). The dye is injected through an IV (intravenous) line. Since your body clears away the dye by moving all of it into your urine, the organs that make and hold urine show up very brightly on the x-rays. This test is useful for finding kidney stones, tumors, or blockages in the urinary tract.

How do I prepare for the test?
Tell your doctor before the test if you have ever had an allergic reaction to x-ray dye (IV contrast dye). Also let your doctor know if you could be pregnant. If you have diabetes and take insulin, discuss this with your doctor before the test.

On the day before your test, you should drink plenty of fluids. This will help prepare your kidneys for the job of clearing out the dye the next day.

Your doctor will instruct you to eat a special diet the night before the test, so that you have less solid stool in your large intestine. (Large amounts of stool in the intestine can make it harder to interpret your x-rays.) Typical instructions might include using a laxative in the afternoon before your test and limiting your dinner the night before to clear liquids such as broth and juice.

What happens when the test is performed?
You need to have an IV (intravenous) line placed in a vein in your arm or hand. In the x-ray department, you lie on your back on a table and an x-ray camera takes some initial pictures from above. X-ray dye is injected through the IV. You might feel some warm tingling in your arm when the dye is injected. During the next 30–60 minutes, a new x-ray is taken every few minutes. These x-rays show the dye in different stages as it moves through your kidneys and ureters and into your bladder. Each time an x-ray is taken, you are asked to hold your breath. Before the last x-ray, you are sent to a bathroom to empty your bladder.

What risks are there from the test?
The dye used in the test can affect your kidneys, and sometimes they do not work as well after exposure to this dye. This effect is almost always temporary, but some people can have permanent damage. There is also a small chance of having an allergic reaction to the x-ray dye used in the test.

As with all x-rays, there is a small exposure to radiation. In large amounts, exposure to radiation can cause cancers or (in pregnant women) birth defects. The amount of radiation from x-ray tests is very small—too small to be likely to cause any harm. X-rays such as this kind in the pelvis area should be avoided in pregnant women, because the developing fetus is more sensitive to the risks from radiation.

Must I do anything special after the test is over?
It is a good idea to drink plenty of fluids after this test to help clear the last bit of dye out of your system.

How long is it before the result of the test is known?
It takes an hour or more for your pictures to be developed, and additional time for a radiologist to examine them and decide if your urinary tract appears normal. Your doctor will generally receive a report within a day or two of the test.



What is the test?
A myelogram is an x-ray test in which dye is injected directly into your spinal canal to help show places where the vertebrae in your back may be pinching the spinal cord. It is sometimes used to help diagnose back or leg pain problems, especially if surgery is being planned.

How do I prepare for the test?
Tell your doctor ahead of time if you have ever had an allergic reaction to lidocaine or the numbing medicine used at the dentist's office, or to x-ray dyes. You should also tell your doctor if you might be pregnant.

What happens when the test is performed?
Patients usually wear a hospital gown. Typically, you lie on your side with your knees curled up against your chest. In some cases, the doctor asks you to sit on the bed or a table instead, leaning forward against some pillows.

The doctor feels your back to locate your lower vertebrae and feels the bones in the back of your pelvis. An area on your lower back is cleaned with soap. Medicine is injected through a small needle to numb the skin and the tissue underneath the skin in the area. This causes some very brief stinging.

A different needle is then placed in the same area and moved forward until fluid can be injected through it into the spinal canal. This fluid is a type of dye that shows up on x-rays; this allows your doctors to get a clear picture of the fluid space around your spinal cord and to see places where the space is narrowed by bones around it. Because the needle must be placed through a small opening between two bones, the doctor must sometimes move the needle in and out several times to locate the opening. Because of the numbing medicine used in this area, most patients experience only a feeling of pressure from this movement. Occasionally some patients do get a sharp feeling in the back or (rarely) in the leg. Let your doctor know if you feel any pain.

Once the dye has been injected, the needle is removed and several x-ray pictures are taken of your back. Sometimes a CT (computed tomography) scan picture is taken instead.

What risks are there from the test?
Risks from this test are minimal. A few people have an allergic reaction to the dye used in the test. Some people have a headache or back soreness for a short time.

As with x-rays, there is a small exposure to radiation. In large amounts, exposure to radiation can cause cancers or (in pregnant women) birth defects. The amount of radiation from a CT scan is larger than from regular x-rays, but still very small—too small to be likely to cause any harm.

Must I do anything special after the test is over?
No. Usually a Band-Aid is the only dressing necessary for your back.

How long is it before the result of the test is known?
It takes about an hour to have your x-rays or CT scan developed and some time for the films to be reviewed by a radiologist. Usually your doctor can get the results within a day.


What is an Arthrogram?
An arthrogram (r-thro-gram) is also called a contrast arthrogram or arthrography (r-thah-gruh-fee). This is a test using x-rays and fluoroscopy (flor-oss-kuh-p) to look inside a joint, and a contrast media is used to more clearly visualize the joint. Fluoroscopy is a type of x-ray that shows moving pictures. An arthrogram can be done on the knee, shoulder, ankle, hip, or wrist joints.

Preparing for an Arthrogram
If the examination is scheduled for the morning, you may drink or eat clear liquids 2-3 hours before the scheduled time of the test. You should also take your regular medication at that time. If the exam is scheduled in the afternoon, you may eat a full breakfast and then have clear liquids two hours before the scheduled time of the test, and take your regular medications.

What to Expect During an Arthrogram
A preliminary film of the joint will be taken and the joint will be cleaned with a special solution. Your doctor will give you a local anesthetic before placing a needle into the joint area. A contrast media will then be injected. You may feel some pressure during the injection. X-rays pictures will then be taken of the joint.