Diagnostic X-Ray
Diagnostic X-rays are ordered by your provider to assist in the diagnosis of disease or injury of a specific part of your body. There are many different kinds of diagnostic X-ray procedures, ranging from a basic X-ray of an ankle to the introduction of contrast in a joint space or the digestive system.
X-ray equipment does emit radiation to produce images; however, our staff is trained to utilize the lowest radiation dose possible to produce the best quality images.
Our technologists have either an associate or bachelor’s degree from an AMA-approved school of radiologic technology. They are required to be registered with the American Registry of Radiologic Technicians (ARRT) and are certified in Basic Life Support. Our technologists complete continuing education requirements set by the ARRT, as well as annual competencies to ensure they are practicing with the highest standards.
Imaging exams are performed on risk versus benefit basis. The slight risk from the radiation is offset by the benefit of accurate diagnosis and proper treatment.
The following are descriptions of some of our common procedures that require scheduling.
To schedule an appointment, call 931-783-2222.
An arthrogram is a study used to evaluate a specified joint space (knee, hip, shoulder or wrist).
During an arthrogram, contrast is injected into the joint space. The exact site of injection will be determined by using X-rays. The area will be cleansed with a sterile soap and a sterile field will be created to prevent infection.
A local numbing agent will be introduced to obtain access into the joint space. Once access is obtained, a small amount of contrast will be injected. After the injection, the needle will be removed and a bandage placed. You will then be taken to MRI or CT at this time for additional images of the joint.
You may eat or drink without restriction prior to this exam.
Please bring a list of your current medications and allergy list. If you are taking a blood thinner, please check with your provider to determine how long it should be held prior to this exam.
Contrast agents (X-ray dye) are widely used in the radiology field today; however, if you have a history of contrast allergy, please alert the doctor ordering your exam. Pre-medication may be needed. A full medical/allergy history will be obtained prior to beginning the exam.
An arthrogram takes approximately one hour. Please note that if an MR arthrogram is ordered, this will add to the exam time.
You may resume a normal diet and your medications as needed after an arthrogram. You will not be placed on restrictions; however, you may experience soreness at the injection site.
A barium enema is a study that is used to evaluate the colon.
During a barium enema, barium and air (if applicable) is introduced into the colon via the rectum. The barium travels around the curves that naturally occur in the colon.
Barium enemas are performed very similarly to a cleansing enema that can be done at home; however, the X-ray images that are taken while the barium travels help the radiologist to see the many twists and turns that occur. After the barium has outlined the colon, several X-ray images are taken, and then the barium is relieved from the colon.
We do require a 24-hour bowel prep. Instructions will be given to you by the ordering provider.
Please note that if you do not complete your prep, your exam may not be done due to a non-cleansed colon.
Barium enema exams typically take one hour. If you have any questions, please contact the Imaging Department at Cookeville Regional or the Outpatient Imaging Center.
You may resume your normal diet and medications after a barium enema. We encourage you to increase your fluid intake for 24-48 hours to help prevent constipation.
A barium swallow (or esophagram) is a study that evaluates the esophagus. During a barium swallow or esophagram, you will be asked to drink barium while images are taken. This helps the radiologist see the size and shape of the esophagus and stomach.
We usually request that you have nothing to eat or drink for eight hours prior to this exam.
A barium swallow or esophagram usually takes 10-15 minutes.
You may resume your normal diet and medications after a barium swallow or esophagram. We encourage you to increase your fluid intake for 24-48 hours to help prevent constipation.
A modified barium swallow is a study that is used to evaluate swallowing difficulties that may be related to aspiration. This exam will be performed with a speech pathologist present.
During a modified barium swallow, various thicknesses from thin barium to a cracker covered with barium are ingested. This helps the radiologist see the swallowing mechanisms and helps the speech pathologist decide a recommended diet (liquids only, pureed foods, etc.).
There is no prep required prior for this exam; therefore, you can eat, drink and take any necessary medications.
A modified barium swallow takes approximately 15 minutes.
You may resume your normal diet (or as recommended by the speech pathologist) and medications after a modified barium swallow. We encourage you to increase your fluid intake for the next 24-48 hours or as directed by the speech pathologist.
A cystogram or voiding cystourethrogram (VCUG) is a study used to evaluate UTIs, painful urination, history of ureteral reflux. During a cystogram or VCUG, a small, flexible catheter is introduced into the bladder. The catheter is used to deliver contrast (X-ray dye) to the bladder. This contrast agent is seen on the X-ray images and helps the radiologist to see the size, shape and sometimes the function of the bladder.
Once the contrast has filled the bladder, several X-ray images will be taken and then the contrast is relieved from the bladder.
There is no prep for this exam; therefore, you may eat, drink and take any necessary medications.
Please bring a list of current medications and allergy list.
Contrast agents are widely used in today’s radiology field; however, if you have a history of contrast allergy, please alert the doctor ordering the exam. Pre-medication may be necessary. A full medical/allergy history will be performed prior to beginning the exam.
A cystogram or VCUG typically takes one hour.
You may resume your normal diet, activities and medications; however, increased fluid intake may be encouraged.
A hysterosalpingogram (or HSG) is a study used to evaluate the uterus and fallopian tubes for help in diagnosing causes for infertility, permanent birth control placements. During a hysterosalpingogram, a speculum will be used to visualize the cervix in a similar fashion to an annual pap smear. A small catheter is placed into the cervix, and a contrast agent (often referred to as X-ray dye) is injected into the uterus and fallopian tubes. X-ray images are taken just after and during the injection of contrast. The contrast agent helps the radiologist to see the size and shape of the uterus as well as the patency of the fallopian tubes (if applicable).
Please ensure that your hysterosalpingogram is scheduled to be performed after the last day of bleeding and no later than 12 days after the start of a normal menstrual period.
Please do not have any sexual activity five to seven days prior to your exam.
There is no dietary prep for a hysterosalpingogram; therefore, you may eat and drink as necessary.
Contrast agents are widely used in the radiology field today; however, if you have a history of contrast allergy, please alert the doctor ordering the exam. Pre-medication may be needed. A full medical/allergy history will be performed prior to beginning the exam.
A hysterosalpingogram takes approximately one hour.
You may resume your normal diet and medications (or as directed by your OB/GYN).
Please do not use tampons for 24 hours after your exam.
Please note that you may experience spotting and/or cramping after your exam. Please plan to wear appropriate undergarments to accommodate a sanitary pad. You may use over-the-counter medications as needed for cramping (or as directed by your OB/GYN).
An Intravenous Pyelogram (IVP) is a study used to evaluate for kidney stones, ureteral stones or UTIs. During an IVP, an IV will is started in an accessible vein, and a contrast agent (X-ray dye) is injected into the bloodstream. The contrast agent travels through the blood and is filtered by the kidneys. This allows the radiologist to see the size, shape and functioning of the kidneys, ureters and bladder on the X-ray images that are performed at specific time intervals.
We request that you have nothing to eat or drink four hours prior to the exam.
Please bring a list of current medications and allergy list.
Contrast agents are widely used in today’s radiology field; however, if you have a history of contrast allergy, please alert the doctor ordering the exam and schedule accordingly. Pre-medication will be needed prior to the exam. A full medical/allergy history will be performed prior to beginning the exam.
An IVP typically takes one hour; however, additional delayed X-ray images may be necessary as decided by the radiologist.
You may resume your normal diet and activities; however, we encourage increased fluid intake for the next 24-48 hours.
A percutaneous nephrostogram is a study used to evaluate for a blockage in the kidney or ureter. During a percutaneous nephrostogram, the tube that has been placed in the kidney will be used to introduce a contrast agent (X-ray dye). The contrast agent will be injected through the tube and will help the radiologist to see if there is a blockage in the kidney or ureter.
We request that you have nothing to eat or drink four hours prior to the exam.
Please bring a list of your current medications and allergy list.
Contrast agents are widely used in today’s radiology field; however, if you have a prior history of contrast allergy, please alert the doctor ordering the exam and schedule accordingly. Pre-medication may be needed. A full medical/allergy history will be performed prior to beginning the exam.
A percutaneous nephrostogram typically takes 15-30 minutes; however, it can take longer depending on the outcome of the injection.
You may resume a normal diet; however, increased fluid intake may be encouraged.
A lumbar puncture is performed to remove a sample of cerebrospinal fluid (CSF) to send for testing.
During a lumbar puncture, you will be placed on an X-ray table on your abdomen. X-ray will be used to locate the exact site to remove the CSF. The area will be cleansed with sterile soap and a sterile field will be created to prevent infection.
A local numbing agent will be used to numb the skin and surrounding tissues. A longer needle then will be introduced into the space where the CSF is located.
Once access is obtained, the CSF will be collected. The needle then will be removed and bandage placed on the site. The collected CSF will be taken to the lab where tests that your provider have ordered will be performed.
We request that you have nothing to eat or drink four hours prior to the exam.
Bring a list of current medications and allergy list.
You must bring someone with you to your appointment to drive you home.
If you are taking a blood thinner, please check with your provider to determine how long it should be held prior to the exam.
A lumber puncture takes approximately an hour and a half. You will be monitored by an imaging nurse approximately one hour after the fluid is collected.
You may resume your normal diet and medications after your procedure. You will be asked to have limited activity for the remainder of the day. Complete after care instructions will be given to you by an imaging nurse.
A small bowel series is a study that is used to evaluate for stomach pain, bowel (or intestinal) obstruction, diarrhea, Crohn’s disease. During a small bowel series, barium is ingested, and X-ray images of the abdomen are performed on a timed schedule. This helps the radiologist see the stomach and intestines and also the amount of time it takes to travel through the small intestine.
We require you to have nothing to eat or drink for four hours prior to this exam.
Small bowel series exams can take anywhere from one to four hours. Since this exam is based on the time it takes for the barium to travel from the stomach to the end of the small intestine, a more accurate time frame is difficult to quote.
You may resume your normal diet and medications after a small bowel series. We encourage you to increase your fluid intake for the next 24-48 hours to help prevent constipation.
A sniff test is an exam used to evaluate the diaphragm for paralysis and/or movement. During a sniff test, you will be instructed to “sniff” and different variations of breathing may be requested while images are taken.
There is no prep for a sniff test; therefore, you may take your medication, eat and drink as needed.
A sniff test takes approximately 10 minutes.
There are no restrictions after a sniff test. You may resume all normal activity, diet and medications.
A Myelogram is performed using contrast (X-ray dye) to look for problems in the spinal canal. During a Myelogram, you will be placed on an X-ray table on your abdomen. X-rays will be used to locate the exact site of injection. The area will be cleansed with sterile soap and a sterile field will be created to prevent infection. A local numbing agent will be used to numb the skin and surrounding tissues. A longer needle will then be introduced to obtain access. Once access is obtained, a small amount of contrast will be injected into the spinal canal. The needle will then be removed and a bandage placed on the injection site. Multiple images will be taken while in the X-ray department. You will then be taken to CT for additional images.
We request that you have nothing to eat or drink four hours prior to the exam.
Bring a list of your current medications and allergy list.
You must bring someone with you to your appointment to drive you home.
If you are taking a blood thinner, please check with your provider to determine how long it should be held prior to this exam.
Contrast agents (X-ray dye) are widely used in the radiology field today. If you have a history of contrast allergy, please alert the doctor ordering your exam. Pre-medication may be needed. A full medical/allergy history will be obtained prior to beginning the exam.
A Myelogram takes approximately one hour. After completion of the CT portion, you will be monitored by an imaging nurse for approximately 15 minutes.
You may resume your normal diet and medications. You will be asked to have limited activity for the remainder of the day. Complete after care instruction will be given to you by an imaging nurse.
An upper GI (also referred to as AC UGI or SC UGI) is a study that can be used to help evaluate for stomach pain, hiatial hernia, belching, reflux or GERD. During an upper GI, various liquids are ingested, including thin and thick barium. Barium is a white, chalky liquid that is seen on an X-ray image as it is being ingested. This helps the radiologist see the size and shape of the stomach.
We request that you have nothing to eat or drink eight hours prior to this exam.
An upper GI (or UGI) takes approximately 15 minutes.
You may resume your normal diet and medications after an upper GI. We encourage you to increase your fluid intake for 24-48 hours to help prevent constipation.
An interpreting physician (usually a radiologist) will read your exam and make a final diagnosis. Your provider should present the findings of your exam to you. You may also sign up for a patient portal account at mycrmchealth.org to read your results online.