Studying ultrasound imaging in Edmonton

Ultrasound in Edmonton

X-Ray, Ultrasound, and Interventional Pain Management services are embedded in our clinical ecosystem. We accept walk-ins for X-Ray. Please call us if you have a requisition for an Ultrasound and/or Pain Management procedure.

X-ray

Physiologix Diagnostic Imaging provides comprehensive X-ray services.

  • X-ray services are available at Physiologix on a walk-in basis (no appointment necessary).​

  • We accept all referral forms and perform all X-ray examinations.​

  • No special preparation is necessary for X-rays.

  • Please inform the staff if you are or might be pregnant.​

  •  We accept all referral forms and perform all X-ray examinations.

Kidney & Bladder Ultrasound

What is Kidney & Bladder Ultrasound?

Also known as a renal ultrasound, a kidney and bladder ultrasound is used to assess the kidneys, ureters, and bladder. Renal ultrasounds are useful in detecting cysts, tumors, abscesses, infection, and collections of fluid around the kidneys.

How do I prepare for a kidney ultrasound?

The preparation for this test will depend on the type of ultrasound procedure your healthcare provider has ordered. Some things you might need to do to get ready for your ultrasound could include:

  • Drinking a litre of water before the test to obtain better images.

  • Eating a fat-free dinner the night before the test.

  • Fasting (limiting or avoiding food for a period of time).

In some cases, you may not need to do anything before your ultrasound. Your healthcare provider will let you know exactly what you need to do before the test. If you have any questions leading up to your ultrasound appointment, call your provider’s office to learn more about how to prepare.

What happens on the day of my kidney ultrasound?

Unless told otherwise by your healthcare provider before the ultrasound, you can eat or drink as normal on the day of your test. If your provider needs a post void of your bladder, you will be required to drink a litre of water an hour before the exam and not use the restroom until after the ultrasound.

Your ultrasound test will be performed by a registered, specially trained, technologist and interpreted (read) by a board-certified radiologist.

What happens during the kidney ultrasound?

During the kidney ultrasound, you will be asked to lie on a padded examining table. The provider performing the ultrasound will apply a warm, water-soluble gel to your skin over the area that is being examined. This gel will not harm your skin or stain your clothes. A probe is then gently applied against your skin. You may be asked to hold your breath several times or roll on your side during the test. Typically, the ultrasound will take about 20 to 30 minutes to complete.

Pelvic Ultrasound

What is Ultrasound Imaging of the Pelvis?

Ultrasound imaging of the pelvis uses sound waves to produce pictures of the structures and organs in the lower abdomen and pelvis. There are three types of pelvic ultrasound: abdominal, vaginal (for women), and rectal (for men). These exams are frequently used to evaluate the reproductive and urinary systems. Ultrasound is safe, non-invasive and does not use ionizing radiation.

Female Pelvic Ultrasounds

In female pelvic ultrasounds, images are quickly captured allowing for the review of pelvic organs such as the uterus, cervix, vagina, fallopian tubes, and ovaries.

 

Female pelvic ultrasound may be performed using one or both of 2 methods:

  • Transabdominal (through the abdomen). A transducer is placed on the abdomen using the conductive gel.

  • Transvaginal (through the vagina). A long, thin transducer is covered with the conducting gel and a plastic/latex sheath and is inserted into the vagina.

  • The type of ultrasound procedure performed depends on the reason for the ultrasound. Only one method may be used, or both methods may be needed to provide the information needed for diagnosis or treatment.

Male Pelvic Ultrasounds

A male pelvic ultrasound allows for the review of male pelvic organs including the bladder, prostate gland, and surrounding blood vessels. This procedure requires little to no special preparation. You may be asked to drink water prior to the examination to fill your bladder. Leave jewelry at home and wear loose, comfortable clothing. You may be asked to wear a gown.

Musculoskeletal Ultrasound

What is Ultrasound Imaging of the Musculoskeletal System?

Ultrasound images of the musculoskeletal system provide pictures of muscles, tendons, ligaments, joints, nerves, and soft tissues throughout the body.

How should I prepare?

Wear comfortable, loose-fitting clothing. You may need to remove all clothing and jewelry in the area to be examined. You may need to change into a gown for the procedure. A clear, water based gel is applied to the skin during an ultrasound. It usually does not stain clothing and is hypoallergenic.

What are some common uses of the procedure?

Ultrasound images are typically used to help diagnose:

  • tendon tears or tendinitis of the rotator cuff in the shoulder, Achilles tendon in the ankle and many other tendons throughout the body.

  • muscle tears, masses or fluid collections.

  • ligament sprains or tears.

  • inflammation or fluid (effusions) within the bursae and joints.

  • early changes of rheumatoid arthritis.

  • nerve entrapments such as carpal tunnel syndrome.

  • benign and malignant soft tissue tumors.

  • ganglion cysts.

  • hernias.

  • foreign bodies in the soft tissues (such as splinters or glass). 

What are the limitations of Ultrasound Imaging of the Musculoskeletal System?

Ultrasound has difficulty penetrating bone and, therefore, can only see the outer surface of bony structures and not what lies within (except in infants who have more cartilage in their skeletons than older children or adults).

 

Doctors typically use other imaging modalities such as MRI to visualize the internal structure of bones or certain joints. There are also limitations to the depth that sound waves can penetrate; therefore, deeper structures in larger patients may not be seen easily. 

Breast Ultrasound

What is Breast Ultrasound?

Breast ultrasound is an imaging test that uses sound waves to look inside the breasts and can help your healthcare provider find breast problems. It also lets your healthcare provider see how well blood is flowing to areas in your breasts. This test is often used when a change has been seen on a mammogram or when a change is felt, but does not show up on a mammogram.

The sonographer moves a wand-like device called a transducer over the skin to make images of the breasts. The transducer sends out sound waves that bounce off the breast tissue. The sound waves are too high-pitched for you to hear. The transducer then picks up the bounced sound waves. These are made into pictures of the inside of the breasts.

The sonographer can add another device called a Doppler probe to the transducer. This probe lets the sonographer hear the sound waves the transducer sends out. He or she can hear how fast blood is flowing through a blood vessel and in which direction it is flowing. No sound or a faint sound may mean that you have a blockage in the flow.

Ultrasound is safe to have during pregnancy because it does not use radiation. It is also safe for people who are allergic to contrast dye because it does not use dye.

Why might I need a breast ultrasound?

A breast ultrasound is most often done to find out if a problem found by a mammogram or physical exam of the breast may be a cyst filled with fluid or a solid tumor.

Breast ultrasound is not usually done to screen for breast cancer. This is because it may miss some early signs of cancer. An example of early signs that may not show up on ultrasound are tiny calcium deposits called microcalcifications.

Ultrasound may be used if you:

  • Have particularly dense breast tissue. A mammogram may not be able to see through the tissue.

  • Are pregnant. Mammography uses radiation, but ultrasound does not. This makes it safer for the fetus.

  • Are younger than age 25.

 

Your healthcare provider may also use ultrasound to look at nearby lymph nodes, help guide a needle during a biopsy, or to remove fluid from a cyst.

Your healthcare provider may have other reasons to recommend a breast ultrasound.

What are the risks of a breast ultrasound?

A breast ultrasound has no risk from radiation. It poses no risk to pregnant women. Breast ultrasound may miss small lumps or solid tumors that are commonly found with mammography. Being obese or having very large breasts may make the ultrasound less accurate. You may have risks depending on your specific health condition. Be sure to talk with your healthcare provider about any concerns you have before the procedure.

How do I get ready for a breast ultrasound?

  • Your healthcare provider will explain the procedure to you. Ask any questions you have about the procedure.

  • You may be asked to sign a consent form that gives permission to do the test. Read the form carefully and ask questions if anything is not clear.

  • You do not need to stop eating or drinking before the test. You also will not need medicine to help you relax.

  • You should not put any lotion, powder, or other substances on your breasts on the day of the test.

  • Wear clothing that you can easily take off. Or wear clothing that lets the radiologist or technologist reach your chest. The gel put on your skin during the test does not stain clothing, but you may want to wear older clothing. 

  • Follow any other instructions your healthcare provider gives you to prepare for the test.

What happens during a breast ultrasound?

Generally, breast ultrasound follows this process:

  1. You will be asked to remove any jewelry and clothing from the waist up. You will be given a gown to wear.

  2. You will lie on your back on an exam table. You will be asked to raise your arm above your head on the side of the breast to be looked at. Or you may be placed on your side.

  3. The technologist will put a clear, warm gel on the skin over the breast area to be looked at.

  4. The technologist will press the transducer against the skin and move it over the area being studied.

  5. Once the test is done, the technologist will wipe off the gel.

What happens after a breast ultrasound?

You do not need any special care after a breast ultrasound. Your healthcare provider may give you other instructions, depending on your situation.

Scrotal Ultrasound

What is Scrotal Ultrasound?

A scrotal ultrasound is a diagnostic test that obtains images of the testicles and the surrounding tissues in the scrotum. It is also known as a testicular sonogram.

An ultrasound is a safe, painless, and non-invasive procedure in which high-frequency sound waves produce images of organs inside your body

Why do I need a scrotal ultrasound?

A testicular ultrasound is the primary imaging method used to observe and diagnose abnormalities in the testicles. A doctor may recommend a scrotal ultrasound to:

  • Determine the outcome of trauma to your scrotum.

  • Verify whether a lump in your scrotum or testicles is solid (which indicates a tumor) or filled with fluid (which indicates a cyst).

  • Evaluate for possible testicular torsion, which is a twisted spermatic cord restricting blood flow to your testicle.

  • Identify sources of pain or swelling in your testicles.

  • Detect and evaluate varicoceles, which are varicose veins within the scrotum.

  • Find the location of an undescended testicle.

 

Ultrasound echoes can provide real-time still or moving images. Data from moving images is useful in examining blood flow to and from your testicles.

Are there risks involved with a scrotal ultrasound?

A testicular ultrasound does not put you at risk for any health problems. There is no radiation exposure during the procedure.

However, you may have increased pain or discomfort during the procedure if you have certain testicular issues, such as testicular torsion or an infection.

How do I prepare for a scrotal ultrasound?

Typically, there is no special preparation necessary for a testicular ultrasound. There is no need to make dietary changes, fast, or maintain a full bladder before the exam. You will not typically receive sedatives, anesthesia, or topical numbing agents.

Rarely, there is a need to interrupt or discontinue medication use before a testicular ultrasound. You should speak with your primary care physician about any prescription or over-the-counter (OTC) medications you take.

Abdominal Ultrasound

What is Abdominal Ultrasound?

Ultrasound imaging of the abdomen uses sound waves to produce pictures of the structures within the upper abdomen. It is used to help diagnose pain or distention (enlargement) and evaluate the kidneys, liver, gallbladder, bile ducts, pancreas, spleen and abdominal aorta. Ultrasound is safe, non-invasive and does not use ionizing radiation.

This procedure requires little to no special preparation. Your doctor will instruct you on how to prepare, including whether you should refrain from eating or drinking beforehand. Leave jewelry at home and wear loose, comfortable clothing. You may be asked to wear a gown.

Our Diagnostic Imaging team is fully integrated with our Medical Specialists and Allied Health team, so patients receive more than just a test result.

Pain Management

We offer a full range of image-guided interventional pain management procedures: 

  • Spinal Injections

  • Epidural Steroid Injections

  • Peripheral Injections

Epidural steroid injection

At the time of the procedure, you will be asked to sign consent forms, list medications you are presently taking, and advise us if you have any allergies to medications. The procedure may last 15-45 minutes, followed by a recovery period.

The goal is to inject the medication as close to the painful nerve as possible. The type of injection depends on your condition and if you have metal rods or screws from previous surgery. The doctor will decide which type is likely to produce the best results.

Step 1: Prepare the patient

The patient lies on an x-ray table. Local anesthetic is used to numb the treatment area so discomfort is minimal throughout the procedure. The patient remains awake and aware during the injection to provide feedback to the physician.  

Step 2: Insert the needle

With the aid of an x-ray fluoroscope, the doctor directs a hollow needle through the skin and between the bony vertebrae into the epidural space. Fluoroscopy allows the doctor to watch the needle in real-time on the x-ray monitor, ensuring that the needle goes to the desired location. Some temporary pain or discomfort, typically experienced as “pressure”, may occur.

There are several types of ESIs:

  • Cervical ESI (neck). The needle entry site is from the side of the neck to reach the neural foramen, just above the opening for the nerve root and outside the epidural space. Contrast dye is injected to confirm where the medication will flow.

  • Lumbar ESI (low back). The needle entry site is slightly off the midline of the back to reach the nerve canal. Contrast dye is injected to confirm where the medication will flow.

  • Caudal ESI (tailbone). The needle is placed in the sacral hiatus above the tailbone to reach the lowest spinal nerves. Contrast dye is injected to confirm where the medication will flow.

Step 3: Inject the medication

When the needle is correctly positioned, the anesthetic and corticosteroid medications are injected into the epidural space around the nerve roots. The needle is then re­moved. Depending on your pain location, the procedure may be repeated for the left and right sides. One or several spinal levels may be injected.

What happens during treatment?

Who performs the procedure?

Physicians who perform epidural steroid injections include physiatrists (PM&R), radiologists, anesthesiologists, neurologists, and surgeons.

What is an epidural steroid injection (ESI)?

Epidural steroid injection (ESI) is a minimally invasive procedure that can help relieve neck, arm, back, and leg pain caused by inflamed spinal nerves due to spinal stenosis or disc herniation.

 

Medicines are delivered to the epidural space, which is a fat-filled area between the bone and the protective sac of the spinal nerves.

 

Pain relief may last for several days or even years. The goal is to reduce pain so that you may resume normal activities and a physical therapy program.

A steroid injection includes both a corticosteroid (e.g., triamcinolone, methyl-prednisolone, or dexamethasone) and an anesthetic numbing agent (e.g., lidocaine or bupivacaine). The drugs are delivered into the epidural space of the spine, which is the area between the bony vertebra and the protective dural sac surrounding the spinal nerves and cord. 

 

Corticosteroid injections can reduce inflammation and can be effective when delivered directly into the painful area. The injection does not make a herniated disc smaller; rather, it works on the spinal nerves by flushing away the irritants that cause swelling and neutralizing the inflammation.

 

The pain relief can last from days to years, allowing your spinal condition to improve with physical therapy and an exercise program.

Who is a candidate for epidural steroid injection (ESI)?

Patients with pain in the neck, arm, low back, or leg (sciatica) may benefit from ESI. Specifically, those with the following conditions:

  • Spinal stenosis: A narrowing of the spinal canal and nerve root canal can cause back and leg pain, especially when walking.

  • Spondylolisthesis: If the vertebra slips forward, it can compress the nerve roots, causing pain.

  • Herniated disc: The gel-like material within the disc can bulge or rupture through a weak area in the surrounding wall (annulus). Irritation, pain, and swelling occur when this material squeezes out and comes in contact with a spinal nerve.

  • Degenerative disc: A breakdown or aging of the intervertebral disc causing collapse of the disc space, tears in the annulus, and growth of bone spurs.

  • Sciatica: Pain that radiates from the back down the leg(s). It is usually caused by compression of the 5th lumbar or 1st sacral spinal nerve.

ESI has proven helpful for some patients in the treatment of painful inflammatory conditions. ESI can also help determine whether surgery might be beneficial for pain associated with a herniated disc. When symptoms interfere with rehabilitative exercises, epidurals can ease the pain enough so that patients can continue their physical therapy.

ESI should NOT be performed on people who have an infection or have bleeding problems. The injection may slightly elevate the blood sugar levels in patients with diabetes. It may also temporarily elevate blood pressure and eye pressure for patients with glaucoma. You should discuss this with your physician.

If you think you may be pregnant, tell the doctor. Fluoroscopy x-rays may be harmful to the baby.

What happens before treatment?

The doctor who will perform the procedure reviews your medical history and previous imaging studies to plan the best approach for the injections. Be prepared to ask any questions at this appointment.

Patients who take blood thinning medication (Coumadin, Plavix, Xarelto, etc.) may need to stop taking it several days before the ESI. Discuss any medications with your doctors, including the one who prescribed the medication and the doctor who will perform the injection.

The procedure is performed in our fluoroscopy suite. Make arrangements to have someone drive you to and from the Clinic the day of the injection.

What happens after treatment?

You should be able to walk around immediately after the procedure. After being monitored for a short time, you will be able to leave the Clinic. Rarely, temporary leg weakness or numbness can occur; therefore, someone should drive you home.

Typically, patients resume full activity the next day. Soreness around the injection site may be relieved by using ice and taking a mild analgesic (eg. Tylenol).

You will be asked to record your levels of pain during the next couple of weeks in a pain diary provided by the Clinic. You may notice a slight increase in pain, numbness, or weakness as the numbing medicine wears off and before the corticosteroid starts to take effect.

Patients should schedule a follow-up appointment with the referring physician after the procedure to document the efficacy and address any concerns the patient may have for future treatments and expectations.

Many patients experience some pain relief benefits from ESI. For those who experience only mild pain relief, serial injections may be performed to achieve full effect. Duration of pain relief varies, lasting for weeks or years. Injections are done in conjunction with a physical therapy and/or home exercise program to strengthen the core and back muscles and prevent future pain episodes.

What are the results?

With few risks, ESI is considered an appropriate nonsurgical treatment for some patients. The potential risks associated with inserting the needle include spinal headache from a dural puncture, bleeding, infection, allergic reaction, and nerve damage / paralysis (rare).

Corticosteroid side effects may cause flushing (hot flashes), mood swings or insomnia, and elevated blood sugar levels in people with diabetes. Any numbness or mild muscle weakness usually resolves within 8 hours in the affected arm or leg (similar to the facial numbness experienced after dental work).

 

Patients who are being treated for chronic conditions (e.g., heart disease, diabetes, rheumatoid arthritis) or those who cannot temporarily discontinue anti-clotting medications should consult their personal physician for a risk assessment.

What are the risks?

Facet Injections

What are facet injections?

A facet joint injection may be done to help diagnose the facet joints as the source of the patient's pain, as well as to provide pain relief.

Facet joints are pairs of small joints in between the vertebrae in the back of the spine. These joints have opposing surfaces of cartilage, which limits friction between the bones. The joint is surrounded by a capsule filled with a small amount of synovial fluid. The synovial fluid acts as an additional lubricant to reduce friction between adjacent bones.

Healthy facet joints support the spine while also allowing a wide range of twisting and bending motion. These joints may become inflamed and painful due to a variety of conditions, such as osteoarthritis, degenerated discs, spinal stenosis, or from a trauma such as a car accident.

How do I get ready for Facet Injections and what can I expect?

Prior to your procedure, all medical history is examined, diagnostic images are reviewed to determine the placement of injection, and the procedure is outlined to the patient. Patients that are taking blood thinners or antibiotics may be asked to discontinue prior to treatment. Please consult with your doctor prior to treatment if you have questions.

A facet joint injection procedure begins with the patient positioned face down on a table, while a small area of skin and tissue over the facet joint is treated with a local anesthetic to numb the area.

The physician uses X-ray guidance, called fluoroscopy, to direct a small needle into the facet joint. Contrast dye is injected to confirm that the needle is positioned correctly in the facet joint and that medication is contained inside the joint.

Following this confirmation, a mixture of anesthetic, such as lidocaine, and anti-inflammatory medication, such as cortisone, is then slowly injected into the joint.

As with many spinal injection procedures, facet joint injections work better for some patients than for others. Often, a facet joint injection is combined with physical therapy to rehabilitate the back.

What are the risks associated with my facet injection?​

As with all invasive medical procedures, there are potential risks and complications associated with facet joint injections. However, in general, the risk is low and complications are rare.

Potential risks and/or complications that may occur from a facet joint injection include:

  • Allergic reaction.

Usually, the allergy is to the X-ray contrast or steroid; rarely to local anesthetic. Life threatening or severe allergies are rare.

  • Bleeding.

Bleeding severe enough to cause problems is extraordinarily rare even in patients with underlying bleeding disorders or in patients on blood thinners.

  • Infection.

Minor infections are very rare. Severe infections are extraordinarily rare.

  • Discomfort at the point of the injection or worsening of pain symptoms.

These symptoms are usually mild and short-lived. Long lasting increases in pain are rare.

  • Damage to surrounding structures.

It is extremely rare for the nearby blood vessels, spinal cord, nerves, or bones to be damaged by these types of injections.

In addition to risks from the injection, some patients will experience side effects from the steroid medication, such as:

  • Transient flushing with a feeling of warmth ('hot flashes') for several days.

  • Transient blood sugar level changes in people with diabetes.

Nerve Block Injection

The day of the injection the doctor who will perform the procedure reviews your medical history and previous imaging studies to plan the best location for the injections. Be prepared to ask any questions you may have at this appointment.

Patients who take aspirin or a blood thinning medication may need to stop taking it several days before the procedure. Discuss any medications with your doctors, including the one who prescribed the medication and the doctor who will perform the injection.

The procedure is usually performed in an outpatient special procedures suite that has access to fluoroscopy. Make arrangements to have someone drive you to and from the office or outpatient center.

What happens before treatment?

Who is a candidate?

If you have pain stemming from a joint or peripheral nerve, then you may benefit from a nerve block injection. Typically, the procedure is recommended for those who do not respond to other conservative treatments, such as oral anti-inflammatory medication, rest, or physical therapy.

If a steroid joint injection confirms that the joint is the likely source of pain, then a diagnostic nerve block test may be recommended to determine if a radiofrequency ablation would provide more lasting pain relief.

A nerve block injection is done using fluoroscopic (x-ray) guidance and should NOT be performed on people who have an infection, are pregnant, or have bleeding problems.

What is Block Nerve Injection?

A nerve block injection, also called a pain receptor block injection, is a minimally invasive procedure that can temporarily relieve joint or nerve pain. The cause of peripheral nerve or joint pain (arthritis, injury, degeneration) is not well understood. The procedure is used as a diagnostic test to determine if the pain is actually coming from the nerve or joint.

 

The effects of a nerve/pain receptor block tend to be temporary and are rarely long term. If the block is successful, then a radiofrequency ablation or other procedure may be recommended.

What is a nerve / pain receptor block?

A nerve block is an injection of anesthetic on or near the nerve/pain receptor connected to a specific nerve or joint. The injection temporarily "blocks" the pain in the same way a dentist uses an anesthetic injection to block pain in your jaw before working on your teeth. Nerve blocks can be made in the following areas:

  • facet joints of the spine

  • hip joint, sacroiliac joint, and coccyx

  • shoulder, elbow, and hand

  • knee, ankle and foot

  • occipital, saphenous, pudendal nerves

  • other peripheral nerves

 

A nerve block injection may be done one or two times or in conjunction with a steroid joint injection, depending on the physician and patient preference.

Who performs the procedure?

The types of physicians who administer nerve block injections include physiatrists (PM&R), radiologists, anesthesiologists, neurologists, and surgeons.

What happens during treatment?

At the time of the procedure, you will be asked to sign consent forms, list medications you are presently taking, and if you have any allergies to medication. The procedure may last 15-45 minutes, followed by a recovery period.

Step 1: Prepare the patient

The patient lies on an x-ray table. Local anesthetic is used to numb the treatment area. The patient experiences minimal discomfort throughout the procedure. The patient remains awake and aware during the procedure to provide feedback to the physician. A low dose sedative, such as Valium or Versed, is usually the only medication given for this procedure.

Step 2: Insert the needle

With the aid of a fluoroscope (a special X-ray), the doctor directs a hollow needle through the skin and into the region responsible for pain. Fluoroscopy allows the doctor to watch the needle in real-time on the fluoroscope monitor to make sure that the needle goes to the desired location. Contrast material may be injected to confirm correct needle location. Some discomfort occurs, but patients typically feel more pressure than pain.

 

Step 3: Inject the medication

When the needle is in the correct position, the anesthetic is injected (Fig. 2). The needle is then removed. One or several blocks may be performed depending on the location of the pain.

Most patients can walk around immediately after the procedure. After being monitored for a short time, you can usually leave the office or suite. Someone must drive you home.

Typically patients resume full activity the next day. Soreness around the injection site may be relieved by using ice and taking a mild analgesic (Tylenol).

You may be asked to perform activities that normally cause pain to determine if the procedure was effective. You may want to record your levels of pain during the next couple of hours in a diary. You may notice a slight increase in pain as the numbing medicine wears off.

What happens after treatment?

The physician will recommend further treatment based on the patient's pain relief after the block. If the patient experiences marked pain relief immediately after the injection, then the block would be considered successful and indicate that the joint is the source of pain.

 

In this case, a radiofrequency ablation may be recommended for longer-term pain relief. A radiofrequency ablation is a procedure that uses a radiofrequency current to deaden the nerves surrounding the joint and prevent pain signals from reaching the brain.

What are the results?

A nerve block injection is a relatively safe procedure with minimal risk of complications. The complications reported in the literature include: temporary increase in nerve pain, neuritis, neuroma, localized numbness, infection, allergic reaction to medications used during the procedure, and/or lack of pain relief (in less than 30% of patients).

What are the risks?

Radiofrequency Ablation

At the time of the procedure, you will be asked to sign consent forms, list medications you are presently taking, and advise us if you have any allergies to medications. The procedure may last 15-45 minutes, followed by a recovery period.

Step 1: Prepare the patient

The patient lies on an x-ray table. Local anesthetic is used to numb the treatment area so discomfort is minimal throughout the procedure. The patient remains awake and aware during the injection to provide feedback to the physician.  

Step 2: Insert the needle

The technique for nerve ablation is similar to that used for diagnostic blocks. With the aid of a fluoroscope (a special x-ray), the doctor directs a thin hollow needle into the region responsible for the pain. Fluoroscopy allows the doctor to watch the needle in real-time on the fluoroscope monitor to make sure that the needle goes to the desired location. Contrast may be injected to confirm correct needle location. Some temporary pain or discomfort, typically experienced as “pressure”, may occur.

Step 3: Deliver heating current

Once the needle is in place, the patient receives a numbing medication. Then a radiofrequency current is passed through the hollow needle to create a small and precise burn, called a lesion, about the size of a cotton swab tip. The current destroys the portion of the nerve that transmits pain and disrupts the pain-producing signal. The burn takes approximately 90 seconds for each site, and multiple nerves can be burned at the same time.

What happens during treatment?

Who performs the procedure?

The types of physicians who perform radiofrequency ablation include physiatrists (PM&R), radiologists, anesthesiologists, neurologists, and surgeons.

What is radiofrequency ablation?

Radiofrequency ablation, also called rhizotomy, is a nonsurgical, minimally invasive procedure that uses heat to reduce or stop the transmission of pain. Radiofrequency waves ablate, or "burn," the nerve that is causing the pain, essentially eliminating the transmission of pain signals to the brain.

This procedure is most commonly used to treat chronic pain and conditions such as arthritis of the spine (spondylosis) and sacroiliitis. It is also used to treat neck, back, knee, pelvic and peripheral nerve pain. The benefits of radiofrequency ablation include: avoiding surgery, immediate pain relief, little to no recovery time, decreased need for pain medication, improved function, and a quicker return to work and other activities.

Who is a candidate?

Radiofrequency ablation is a treatment option for patients who have experienced successful pain relief after a diagnostic nerve/pain receptor block injection.

Radiofrequency ablation is done using fluoroscopic (x-ray) guidance and should NOT be performed on people who have an infection, are pregnant, or have bleeding problems.

What happens before treatment?

The doctor who will perform the procedure reviews your medical history and previous imaging studies to plan the best location for the ablation. Be prepared to ask any questions you may have at this appointment.

Patients who are taking aspirin or a blood thinning medication may need to stop taking it several days before the procedure. Discuss any medications with your doctors, including the one who prescribed the medication and the doctor who will perform the injection.

The procedure is usually performed in an outpatient special procedure suite that has access to fluoroscopy. Make arrangements to have someone drive you to and from the office or outpatient center the day of the ablation.

What happens after treatment?

You should be able to walk around immediately after the procedure. After being monitored for a short time, you will be able to leave the Clinic. Rarely, temporary leg weakness or numbness can occur; therefore, someone should drive you home.

Typically, patients resume full activity the next day. Soreness around the injection site may be relieved by using ice and taking a mild analgesic (eg. Tylenol).

Patients may experience pain from the procedure for up to 14 days, but this is generally due to the residual effects of the nerve ablation or muscle spasm. Patients are typically up and around immediately and back to work 24 to 72 hours after the procedure. Significant pain relief is often experienced within 10 days; for some patients, pain relief may be immediate and for others it may take up to three weeks.

Patients should schedule a follow-up appointment with the referring physician after the procedure to document the efficacy and address any concerns the patient may have for future treatments and expectations.

Pain relief may last from 9 months to more than 2 years. It is possible the nerve will regrow through the burned lesion that was created by radiofrequency ablation. If the nerve regrows, it is usually 6-12 months after the procedure. Radiofrequency ablation is 70-80% effective in people who have successful nerve blocks. The procedure can be repeated if needed. Results can be improved with a physical therapy program.

What are the results?

Radiofrequency nerve ablation is a relatively safe procedure with minimal risk of complications. The complications reported in the literature include: temporary increase in nerve pain, neuritis, neuroma, localized numbness, infection, allergic reaction to medications used during the procedure, and/or lack of pain relief (in less than 30% of patients).

What are the risks?

Ultrasound

Physiologix Diagnostic Imaging offers Musculoskeletal, Vascular, Abdominal, Kidney and Bladder, Thyroid, Breast, Pelvic and Scrotal Ultrasound services.