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General Diagnostic Radiology

The Program  |  Treatment Options  |  Patient Resources  |  Services

General Diagnostic Radiology includes evaluation of the chest, spine, skull, extremities, hips, pelvis and abdomen. General diagnostic radiology is often used to evaluate suspected fracture or other indications of injury or abnormality.

The Program

Chest imaging may be used to detect pneumonia, TB and enlargement of the heart. Abdominal images can reveal the size and shape of abdominal structures or the presence of fluid or air in the abdomen. Spinal images may be taken to evaluate scoliosis (curvature of the spine). Extremity images may indicate fracture or location of foreign bodies.

The General Diagnostic Radiology section’s staff consists of board certified radiologists and state licensed radiology technologists who provide a full range of radiology procedures for general diagnostic interpretation. As a trauma center, Hartford Hospital offers 24-hour coverage for emergencies. Flexible scheduling for outpatient services is available.

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Treatment Options

Arthrogram

Arthrograms have been commonly used to evaluate the shoulder, knee or wrist, but might also be used to evaluate the elbow or ankle. Arthrography has been largely replaced by non-invasive and more accurate MRI joints/extremities.

Patient Information
An arthrogram examination involves the injection of contrast into a joint to improve soft tissue visualization on these images. Though reactions to the contrast material are uncommon, patients may experience a tingling sensation or pressure in the joint as the contrast is injected. The exam will require patients to assume different positions as the images are acquired.

Before the Procedure
No preparation is usually required for arthrogram examination.

After the Procedure
Patients may experience some swelling or discomfort after the test. Rest the joint for 12 hours. Apply ice to the joint for swelling and take a mild analgesic such as Tylenol, Motrin, Advil or Aleve for pain.

Barium Enema Procedures

A Barium Enema exam is used to detect changes or abnormalities in the colon.

Patient Information
During the exam, liquid barium - and in some cases air - is instilled into the rectum and colon. This is done to improve the quality of the images. This test allows a doctor to examine the colon for: ulcers, narrowed areas (strictures), growths of the lining (polyps), small pouches in the wall (diverticula), cancer and other abnormalities. For the exam to be most accurate, it is important that the colon be thoroughly cleansed.

Before the Procedure
Adults:
Requires 24 hour prep. Drink clear liquids only (no food) 24 hours prior to exam. Purchase one (1) bottle of Magnesium Citrate, four (4) Dulcolax tablets, one (1) Fleet enema available at any pharmacy.

1 day (24 hours) before exam:
Take full bottle of Magnesium Citrate at 2 p.m. Drink plenty of clear liquids (no food) such as clear broth, clear juice (e.g. apple), water or Jell-O for the full 24 hours prior to the exam.

Night before exam:
Take two (2) Dulcolax tablets at 10 p.m.

Morning of exam:
Take two (2) Dulcolax tablets and administer Fleet enema when you wake up. Note: If you are or think you may be pregnant, please notify the technologist. If Bowel Obstruction or Ulcerative Colitis is suspected, the referring physician should consult with the radiologist prior to administration of bowel prep.

Children:
Special preparations are required depending on the child's age. For pediatric patients check with the Imaging Center at 860.545.2861

Bronchoscopy

Diseases of the lung can be analyzed with bronchoscopy by sampling the lung tissue through the use of a bronchoscope. Samples are sent to a laboratory for analysis, from which a physician can make a diagnosis.

Patient Information
The pulmonologist (a lung specialist trained to perform a bronchoscopy) sprays a topical or local anesthetic in the mouth and throat. This will cause coughing at first, which will stop as the anesthetic begins to work. When the area feels "thick," it is sufficiently numb. Medications may be given through an IV to help the patient relax.

If the bronchoscopy is performed via the nose, an anesthetic jelly will be inserted into one nostril. The scope will be inserted through the numbed nostril until it passes through the throat into the trachea and bronchi.

A flexible bronchoscope is used. The flexible tube is less than 1/2-inch wide and about 2 feet long. As the bronchoscope is used to examine the airways of the lungs, the physician doctor will obtain samples of lung secretions to send for laboratory analysis.

Saline solution is introduced to flush the area and collect cells to be analyzed by a pathologist or microbiologist. This part of the procedure is called a "lavage" or a bronchial washing. Usually, small amounts (5-10 cc, or 1-2 teaspoons) of saline are used.

In certain circumstances, a larger volume of saline may be used. In this procedure, called bronchoalveolar lavage, up to 300 cc of saline (20 tablespoons) are instilled into the airway after the bronchoscope has been advanced as far as possible and a small airway is temporarily blocked by the scope. Bronchoalveolar lavage is performed to obtain a sample of the cells, fluids, and other materials present in the very small alveoli (air sacs).

In addition, tiny brushes, needles, or forceps may be introduced through the bronchoscope to obtain tissue samples from the lungs. Occasionally, stenting and laser therapies can be performed through the bronchoscope. A rigid bronchoscope is less commonly used, and usually requires general anesthesia.

Before the Procedure
The night before your bronchoscopy, DO NOT eat or drink anything (not even water) after midnight. It is important that your stomach be empty. Your physician should tell you if you should take your medications with a sip of water on the morning of the procedure.

After the Procedure
When the procedure is finished, you will be observed by a nurse. It is normal to cough up a small amount of blood for 1-2 days after the procedure. The nurse will recheck your blood pressure, pulse and respiratory rate prior to your discharge. The IV needle will be removed, and a radiograph of the chest may be taken. You cannot eat or drink anything for 2 hours after the procedure. When you are ready to be discharged, the nurse will go over some instructions with you, such as what to do for a sore throat.

Enteroclysis

Enteroclysis is a diagnostic procedure performed to examine the small intestines. It is the most through means of confirming that the small bowel is normal. This test is especially useful for evaluating diseases such as Crohn’s disease, celiac sprue and other rare small bowel diseases.

Patient Information
This is a specialized examination which may require sedation. A barium-based liquid contrast material is infused through a tube from the nose or mouth, through the esophagus and then the stomach until the tip reaches the duodenum (beginning of the small intestine). The passage of the contrast material is monitored on a fluoroscopic monitor and pictures are taken in a variety of positions.

Before the Procedure
Day before exam:
The following medications should not be taken 24 hours prior to the exam: Morphine, Codeine, Demerol or Lomotil. A mild laxative (1 bottle of Magnesium Citrate or 3 tablets of Dulcolax available at any pharmacy) should be taken during the afternoon prior to the procedure. Follow a low residue diet (i.e., low fiber, Jell-O, toast, clear soup). Drink plenty of liquids.

Day of the exam:
Do not eat or drink anything the morning of the exam (except medications taken with a small amount of water).

After the Procedure
For the first 1-2 days after the imaging procedure, your bowel movements may appear white and chalky. This is normal. Ask your doctor if you should take a laxative and drink extra liquids to help clean out the barium and prevent constipation.

Epidural Steroid Injection (ESI)

An epidural is an injection that delivers steroids directly into the epidural space. The epidural space is the space inside the spine between a membrane and the vertebral wall and is filled with fat and small blood vessels. There are often inflammatory factors and other substances that generate pain and this inflammation can cause significant nerve root irritation and swelling.

Steroids (corticosteroids) have been shown to reduce inflammation by inhibiting the production of substances that cause inflammation, the epidural injection can be highly effective because it delivers the medication directly to the site of inflammation.

Patient Information
Proper placement of the injected medication is crucial, but it can be difficult. There are many different structures around a joint that can cause pain. Is there a torn tendon? An inflamed bursa? Or damaged cartilage from arthritis? Each of these problems require the medicine to be placed in a specific location.

The numbing agent included in most joint injections serves two purposes. In addition to making the injection itself less painful, the anesthetic can help verify proper placement of the needle. Your immediate relief of pain indicates the needle is in the right place.

A variety of substances have been used in trigger-point injections, including numbing agents, botulinum toxin (Botox), corticosteroids and other anti-inflammatory drugs. In some cases, pain relief occurs simply from the physical piercing of a trigger point with a needle — even when no medicine is injected.

Before the Procedure
No preparation is usually required for an ESI examination.

After the Procedure
The immediate effect after the injection is usually from the local anesthetic injected. This wears off in a few hours. The cortisone starts working in about 3 to 5 days and its effects can last for several days to a few months. Please arrange for transportation home.

ERCP - Endoscopic Retrograde Cholangiopancreatography

Endoscopic retrograde cholangiopancreatography (ERCP) enables the physician to diagnose problems in the liver, gallbladder, bile ducts, and pancreas. ERCP is used primarily to diagnose and treat conditions of the bile ducts including gallstones, inflammatory strictures (scars), leaks (from trauma and surgery), and cancer.

Patient Information
ERCP combines the use of radiographic imaging and an endoscope, which is a flexible, lighted tube. Through it, the physician can see the inside of the stomach and duodenum, and inject contrast into the ducts in the biliary tree and pancreas so they can be visualized on the images. ERCP takes 30 minutes to 2 hours.

The pain medicine and sedative should keep you from feeling too much discomfort. After the procedure, you will need to stay at the hospital for 1 to 2 hours until the sedative wears off. The physician will make sure you do not have signs of complications before you leave.

Before the Procedure
Do not eat or drink anything after midnight the night before the procedure, or for 6 to 8 hours beforehand, depending on the time of your procedure.

After the Procedure
Please arrange for someone to take you home. You will not be allowed to drive due to the sedatives.

GI and/or Small Bowel Series

An Upper GI and/or Small Bowel Series is a set of images taken to examine the esophagus, stomach, and small intestine. Images are acquired after the patient has swallowed a barium suspension (contrast medium).

Patient Information
You will be sitting or standing up while your heart, lungs, and abdomen are examined with a fluoroscope (real-time images that projects images onto a TV-like screen. You may be given an injection of a medication that will temporarily slow bowel movement, so structures can be more easily seen with the fluoroscope. You will then be given a milk shake type drink that contains a barium mixture in it. You must drink 16 oz to 20 oz. for the examination.

The passage of the barium through the esophagus, stomach, and small intestine is monitored on the fluoroscope. Pictures are taken with you in a variety of positions (laying down, standing, sitting.) The test usually takes around three hours. However, in some cases, it may take up to six hours to complete.

Before the Procedure
Day before exam:
Do not eat or drink anything after midnight before the exam

Day of exam:
Do not eat breakfast or have any liquids. If you are or think you may be pregnant, please notify the technologist.

If you have had a barium enema or CT scan of the abdomen and/or pelvis within 72 hours prior to your exam please follow these instructions:

Day before exam:
At 3 p.m. drink 1 bottle of magnesium citrate (available at any pharmacy). This may be omitted only if directed by referring physician. If you are or think you may be pregnant, please notify the technologist.

Hysterosalpingogram

A Hysterosalpingogram allows the uterus and fallopian tubes to be visualized with imaging. The procedure is performed to evaluate narrowing of the fallopian tubes, scarring of the uterine lining and congenitally malformed uterus as a possible cause of infertility.

Patient Information
For this procedure, the patient is positioned as for routine pelvic exam and a speculum is inserted. A small tube is inserted (vaginally) through the cervix into the uterus. A contrast media (clear dye) is injected into the uterus. Under fluoroscopy, the uterus and fallopian tubes are visualized as they fill with contrast. Images are obtained. A cramping sensation during and after the procedure is common.

If proximal tubal occlusion (obstruction of a fallopian tube near its juncture/joining with the uterus) is confirmed by hysterosalpingogram procedure, fallopian tube recanalization may be recommended to open blocked fallopian tubes.

Before the Procedure
Hysterosalpingogram can be performed 3 to 5 days after the menstrual period. No other preparation is required. Tylenol, Motrin, Aleve or other non-aspirin (ibuprofen) pain reliever are recommended to relieve post procedural cramping.

Intravenous Pyelogram Procedure (IVP)

An intravenous pyelogram (IVP) is an imaging procedure which provides detailed pictures of the urinary tract. The test requires injection of a contrast agent, which circulates through the body and highlights the kidneys, ureters and bladder.

Patient Information
The patient is positioned on the table, and a contrast agent is injected, usually in a vein in the patient's arm. Contrast (iodine) excreted in the urine shows outlines of the kidneys and demonstrates the inner "collecting system" and ureters as well. The inner structures appear white in the image. Images are taken before and after the injection of the contrast material.

As the contrast material is processed by the kidneys, a series of images is captured to determine the actual size of the kidneys and to show the collecting system as it begins to empty. Some kidneys don't empty at the same rate and delayed films from 30 minutes to three or four hours may be requested. However, a typical IVP study usually takes about an hour.

Certain patients are at higher risk for experiencing side effects to intravenous (IV) contrast material. These include patients who have had previous reactions to contrast material or any other drug, as well as patients who have hay fever, allergies, asthma, emphysema, kidney disease, multiple myeloma, diabetes or heart disease. If you have any of these conditions, please inform the technologist or radiologist who is performing your examination.

Before the Procedure
Day before exam:
At 3 p.m. drink 1 bottle of magnesium citrate (available at any pharmacy).
Dinner - Begin liquid diet (Jell-O, soda, juice, and clear broth)

Day of exam:
Clear liquid diet, but then nothing by to eat or drink 4 hours prior to the exam.

Patients 70 years or older / Patient with a history of renal disease:
Requires additional bloodwork including BUN and creatinine prior to procedure.

Myelogram/Lumbar Puncture

A myelogram is an imaging study of the spinal cord, or, more specifically, the spinal canal which houses the various nerves which make up the spinal cord. A myelogram can be of the neck (a cervical myelogram), upper back (a thoracic myelogram), or the lower back (a lumbar myelogram). A myelogram is a thorough way to examine if a bone spur or arthritis is pinching a nerve. It also determines if a disk herniation is present.

Patient Information
A myelogram requires the injection of contrast into the fluid that surrounds the spinal cord and nerves that branch off of the spinal cord so that the nerves and spinal cord are outlined by this contrast on diagnostic images and CT scan images. The contrast is injected through a needle placed into the back or the neck using fluoroscopy to guide the needle through small spaces between the bones of the spine to get to the cerebral spinal fluid. After the contrast is injected, the needle is removed and diagnostic and CT images are taken of the section of the spine suspected of causing the problem.

Before the Procedure
It is preferable to have only fluids for 4 hours beforehand. Take your usual medicines except blood thinning agents, e.g., Aspirin, Warfarin. If you have diabetes and are on insulin, or suffer from epilepsy, please contact our Radiology Department to discuss the timing of your exam with us.

After the Procedure
Increase fluid intake and take a mild analgesic such as Tylenol, Motrin, Advil or Aleve for pain or as recommended by your physician.

Sialogram

A sialogram is a radiographic study of the salivary glands in your mouth. Most saliva is released into your mouth by three pairs of salivary glands. This exam looks at the largest pair called the parotid glands. These are located inside your mouth below your ear. Glands cannot be seen without the use of contrast material (x-ray dye).

Patient Information
The doctor will ask you to open your mouth wide so a very small tube can be placed gently in the opening of the gland near the back of your mouth. Once the tube is in the proper position, you may be asked to hold the tube in place while the doctor injects a small amount of contrast material. The contrast material fills the salivary gland and makes it show up on radiographic images. As images are taken you may be asked to turn your head in different positions and to hold your breath.

Before the Procedure
No preparation is usually required for sialogram examination.

After the Procedure
The contrast material will drain into your mouth. It may have a bitter taste. If you swallow some of the contrast material, it is not harmful. After your exam, you can return to your normal diet and activities.

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Patient Resources

General Preparations
Patients are asked to remove jewelry and metal objects that might obscure anatomic detail on the images. Holding one’s breath is necessary for some examinations. Most images are performed in two or more views such as front (AP), back (PA) and side (lateral).

Patients should expect to be placed in various positions and to hold still. Patient motion, positioning and body mass may affect the quality and usefulness of general diagnostic imaging. If test results do not correlate with clinical findings or if symptoms persist despite a negative imaging result, examination with other imaging techniques may be recommended.

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Services

  • MRI Scan

    Magnetic resonance imaging (MRI) technology is unrivaled in its ability to produce high resolution images of soft tissue and structural anatomy.

  • Revolution CT

    Volume Computed Tomography (VCT) offers an innovative way for physicians to obtain the information they need to diagnose disease and life threatening illness, including cardiovascular disease, stroke and chest pain.

  • General Diagnostic Radiology

    General Diagnostic Radiology includes evaluation of the chest, spine, skull, extremities, hips, pelvis and abdomen. General diagnostic radiology is often used to evaluate suspected fracture or other indications of injury or abnormality.

  • Ultrasound

    In an ultrasound procedure, high-frequency sound waves (ultrasound) are transmitted to tissues or organs and make echoes.

  • PET Scan

    PET/CT combines the functional information from a positron emission tomography (PET) exam with the anatomical information from a computed tomography (CT) exam into one single exam.

  • Mammography

    A mammogram is used to evaluate an abnormal clinical finding, such as a breast lump, that has been found by a woman or her physician.

  • CT Scans

    CT (computed tomography or CT scan) is an imaging technology that uses x-ray beams (radiation) and computers to create detailed, cross-sectional images of an area of the body.

  • Interventional Radiology

    The Department of Interventional Radiology and Neuroimaging’s staff physicians have all received specialized training and are all certified by the American Board of Radiology.

  • CT Virtual Colonoscopy

    Each year, approximately 150,000 Americans are diagnosed with a very common and serious disease - colon cancer.

  • 3D Mammography

    3D mammography is the latest and most advanced technology available for the early detection of breast cancer.

  • Nuclear Medicine

    Nuclear medicine is a safe and painless imaging technology that uses small amounts of specially-formulated radioactive materials (tracers) to help diagnose and treat a variety of diseases.

  • Breast MRI Scan

    Breast MRI is extremely helpful in evaluating mammogram abnormalities and identifying early breast cancer, especially in women at high risk.