Intervention

Under this term are grouped all procedures that require an imaging technique to guide accurately the treatment required by your condition and prescribed by your treating physician.

There are indeed a multitude of pathologies which gain from being treated locally, guided with precision by various methods, whether it is fluoroscopy or ultrasound.

The main techniques performed under fluoroscopy are facet blocks, as well as intra-articular steroid (cortisone) or Synvisc injections. In some situations, the radiologist will inject a bit of iodine to ensure it is the right place in the articulation. The amounts used are minimal and kidney function issues do not apply in these cases. Allergies, however, could pose a problem. This will be verified with you at the time you make an appointment and confirmed again before performing the test. If necessary, another contrast medium (air or gadolinium) may be used.

The main techniques performed under ultrasound are aspirations of cysts in the breast or thyroid, as well as multiple infiltrations of the ducts, bursae (sacs) or tendons in the articulations.

Note that the radiologist will determine ultimately the best imaging method to use to obtain the desired result. It is therefore possible that an infiltration originally scheduled as an ultrasound is performed under fluoroscopy or vice versa.

Some calcifications are more likely to respond better to treatment than others. Only the radiologist can determine this when evaluating by ultrasound the structure of the latter. Calcifications said to be “soft” are generally easier to aspirate and respond better to treatment than organised calcifications said to be “hard”. In all cases, the test will be completed by a steroid injection into the bursa overlooking the shoulder tendons. Local anesthesia is given early in the process to ensure optimal comfort during the latter.

The test is generally interpreted within 24 hours following the acquisitions and the results are sent to your referring physician within 24 to 48 hours.

Upon arrival, you will need to register at reception and if it is your first visit here, open a file. You will need to bring with you a valid insurance card, as well as a medical prescription signed by your treating physician, containing your medical information (if it has not already been sent via Fax or internet). You are required to arrive 15 minutes before your appointment.

Our staff will accompany you to the pertinent area. If necessary, you may need to uncover the area to be treated and put on a jacket. You will then be called into the examination room where the technologist will position you and will proceed with the required technique.

The duration of this study varies between 5 and 15 minutes, depending on the technique to be performed. It may be somewhat longer in the case of washing of calcium deposits.

Most exams require no special preparation.

For people who have a phobia of needles, know that we generally use very small gauge needles and these exams are very well tolerated. If your anxiety is too severe, perhaps you might take an anxiolytic (Ativan) beforehand.

The taking of an anticoagulant (Coumadin, Xarelto, etc.) requires special attention. In most cases, no discontinuing of medication to “thin the blood” is required.

NOTE : in the case of cervical facet blocks, anticoagulants should be discontinued three days before the procedure. You will need to plan this stoppage with your treating physician. The radiologist cannot decide by him or herself to stop this medication as this involves a good knowledge of your medical file.

Some of these procedures are covered in part by RAMQ.The procedures performed in fluoroscopy are generally covered. In such a situation, you will simply pay a fee to cover the cost of the injected medication (in some cases you will bring the Synvisc yourself). Please refer to our list of rates for further details on the procedures performed under ultrasound guidance.