Magnetic Resonance Imaging (MRI)MRI uses a strong magnet and radio waves to create detailed images of various parts of your body. MRI does notuse x-rays. An MRI is painless. Depending on the part of the body being examined, the test usually takes lessthan 45 minutes. There is no preparation before the exam, you may eat normally and take any prescribedmedication before your examination. Please arrive 15 minutes earlier than your appointment time.

v  Refrain from drinking or eating 2 hours before the MRI exam. You can have water and you should take yourregular medications on the day of testing.

v  Remove all metallic objects before MR examination including: keys, hair pins, barrettes, jewelry, watch,safety pins, paperclips, money clip, credit cards, coins, pens, belt, metal buttons, pocket knife, and clothingwith metal in the material.

v  Wear a 2 piece outfit (preferably sweat pants with elastic waistbands).

v  If sedated, you must have someone available to drive you home.

v  In menstruating women scheduling breast MRI exams, the MRI exam needs to be performed between days 5-12 of a menstrual cycle.

v  Earplugs are required and will be provided during the MRI examination.

v  Do not wear any powder, deodorant, or lotions on the upper half of your body, as certain deodorants cancause artifacts on the scans.

v  Please notify us if you have any of the following: pacemaker, artificial heart valve, implanted electrodes, removable dental work, hearing aid, implants/prosthesis, aneurysm clip, wig/hairclip/bobby pins, history of welding, grinding, or cutting of metal, metal in your eyes, allergic reactions to contrast for MRI, CT or XRAY, and any kidney problems, and any recent surgery within 6 weeks.

Computed Tomography (CT Scan)A CT scan is a special type of x-ray that lets the radiologist see detailed images of various parts of the body. CT scanning is painless. Depending on the part of the body being scanned, contrast (dye) may have to be given to you to drink or in the form of an injection. Administration of a contrast agent can improve the visibility of organsand structures otherwise obscured. CT examinations include: Abdomen, Pelvis, Brain, Chest, Extremities, Neck, Orbits, Sinuses, and Spine.

v  You cannot have a CT scan if you are pregnant or there is any possibility of pregnancy.

v  You cannot receive IV contrast if you are allergic to CT or XRAY contrast media or have known kidney problems resulting in renal failure. IV contrast may not be used in certain medical conditions, determined at the time of your visit.

v  Patients may take medications with a small amount of water.

v  CT Abdomen/Pelvis, Chest, Brain, & Neck (ordered with IV Contrast): Refrain from eating or drinking anything 6 hours before your scheduled examination time (except in diabetic patients who should only fast 2 hours before exam). Please allow approximately 2 hours for the examination for CT abdomen/pelvis and 30 minutes for all other examinations.

v  CT Spine, Orbit, Sinuses, & Exams not ordered with IV Contrast: No preparation is necessary. Please allow 30 minutes for the examination.

Diagnostic UltrasoundUltrasound uses sound waves instead of xray. Instructions will differ depending on the part of the body being scanned. Ultrasound examinations include: abdominal, pelvic, obstetrical, prostate/testicular, thyroid, breast, and vascular studies. v  Obstetrical & Pelvic examinations: You may eat normally. Your bladder must be full for these examinations.

v  Please drink at least 32 ounces of liquid one hour prior to your examination (four 8 oz. glasses of beverage).

v  Please do not empty your bladder before the examination. Allow 45 minutes to 1 hour for the examination.

v  Abdominal examinations: Refrain from eating or drinking anything after midnight the night before the examination, or at least 6 hours prior to your scheduled examination. Allow 30 minutes to 45 minutes for the examination.

v  Breast ultrasound: Do not wear any powder, deodorant, or lotions on the upper half of your body, as certain deodorants can cause artifacts on the scans. Allow 30 minutes to 45 minutes for the examination.

v  Other ultrasound examinations: No special preparation is required. Allow 45 minutes to 1 hour for theexamination.

Digital Mammography (Mammo)Digital mammography can detect breast abnormalities before they can be felt. The American Cancer Society recommends a self breast examination every month and a baseline mammogram between 35 to 39 years of age. In high risk women, the baseline examination can occur earlier. Women 40 years and over should have a mammogram and a breast examination by their doctor every year.

v  You cannot have a mammogram if you are pregnant or there is any possibility of pregnancy.

v  Please do not wear deodorant, body powder, or lotions, as these can potentially create artifacts on your examination. The examination should take approximately ½ hour.

v  Please have your previous mammograms available if not taken at our facility. The radiologist will compare your mammogram to previous mammography studies to ensure the most accurate results.

Bone Densitometry/DEXABone densitometry provides a way to measure the calcium content of bones to detect osteoporosis. Please avoid taking calcium supplements for at least 24 hours prior to the examination. You cannot have a bone density or DEXA scan if you are pregnant or there is any possibility of pregnancy.

Diagnostic Radiography/Xray

v  Diagnostic xrays require no special preparation.

v  You cannot have an xray if you are pregnant or there is any possibility of pregnancy.

FluoroscopyFluoroscopy examinations include: Barium swallow, Upper GI Series, Small Bowel Series, Arthrograms, andMyelograms. Kidney xrays (IVP) are performed administering a contrast (dye) through a vein in your arm and taking a series of xray films. Injection of contrast is necessary to see details of the kidney structure and follow the passage of urine into the bladder. Barium studies are performed for examination of the stomach, small bowel or colon. Barium is administered by mouth or an enema. Using a special xray machine called a fluoroscope, the passage of barium is monitored and xrays are taken of the stomach and bowel. Barium and IVP studies require special preparation before the scheduled exam.

v  Barium Enema: Please obtain a bowel prep kit at our facility 2 days prior to your scheduled examination and follow the instructions on the prep kit. Make sure you stay on a clear liquid diet the day before your examination. Clear liquids include: fruit juices without pulp, clear broth or bouillon, water, coffee and tea without milk products, unsweetened drink mixes, plain/unsweetened Jello®, and popsicles.

v  Upper GI Series: Refrain from any milk or milk products after your noon meal the day before the examination; nothing by mouth after midnight; and no breakfast before your exam. The examination time is approximately ½ hour. If you are having a small bowel exam following your GI series, discontinue medications for diarrhea 24 hours before your exam. The small bowel exam could take anywhere from 1 to 6 hours and is highly variable in each patient based on the underlying medical condition.

v  IVP Test: Eat your regular diet the day before the examination. Please obtain a bowel prep kit at our facility 2 days prior to your scheduled examination and follow the instructions on the prep kit. Avoid eating any solid food after midnight. You may have one glass of water between midnight and the examination the next day. Avoid eating breakfast or fluids in the morning of your exam except for the one allowed glass of water. Arthrogram: No special preparation is required by the patient. An arthrogram is a diagnostic study of a joint space (e.g., shoulder, knee, wrist, etc.) using iodinated contrast material and occasionally air. Arthrograms are typically performed to demonstrate a tear in the joint. The joint is then anesthetized using a local anesthetic. After the initial needle stick and numbing of the skin, you should feel little pain. A needle is positioned inside the joint and contrast material is injected into the space. Once the contrast material is in the joint the needle is removed and radiographs are taken. The exam, depending on which joint is being studied, generally takes less than 45 minutes. You cannot have an arthrogram if you are pregnant or there is any possibility of pregnancy. You cannot receive iodinated contrast if you are allergic to CT or XRAY contrast media or have known kidney problems resulting in renal failure. Patients may take medications with a small amount of water.

FluoroscopyMyelogram: The purpose of a myelogram is to evaluate the spinal cord and nerve roots for suspected compression. Pressure on these delicate structures causes pain or other symptoms. A myelogram is performed when precise detail about the spinal cord is needed to make a definitive diagnosis. In most cases, myelography is used after other studies, such as magnetic resonance imaging (MRI) or a computed tomography scan (CT), have not provided enough information to be certain of the diagnosis. Sometimes myelography followed by CT scan is an alternative for patients who cannot have an MRI scan, because they have a pacemaker or other implanted metallic device. Refrain from eating solid foods at least 3 hours prior to exam but are encouraged to drink liquids (i.e., water, soft drinks, juices, coffee, tea, etc.). You may be required to stop taking certain medications prior to the exam. We will review your current medications and instruct you on which medication must be discontinued at the time of your examination.

v  For your safety and comfort you must have someone accompany you during the procedure and drive you home.

v  For 24 hours following the exam, you will be on strict bed rest.

v  You cannot have a myelogram if you are pregnant or there is any possibility of pregnancy.

v  You cannot receive iodinated contrast if you are allergic to CT or XRAY contrast media or have known kidney problems resulting in renal failure.

v  Patients may take medications with a small amount of water.