Diagnostics Visit Preparation
Thank you for visiting this page.
Make sure you are prepared for your visit so that it can go ahead as planned.
Find out your preparation advice below now.
- Cardiology Exams
- DEXA
- Endoscopy Exams
- MRI Exams (including MRA)
- Ultrasound (not injections)
- Ultrasound Guided Injections
- X-ray
This factsheet provides information about your forthcoming appointment so that you know exactly what to expect. We’ll go into more detail during your appointment and you’ll also be able to ask any questions that you may have.
Having a 12 lead Echocardiogram (ECG)
An electrocardiogram (ECG) records the electrical activity of the heart. The heart produces tiny electrical impulses which spread through the heart muscle to make the heart contract. These impulses can be detected by the ECG machine. You may have an ECG to help find the cause of symptoms such as the feeling of a ‘thumping heart’ (palpitations) or chest pain.
The ECG test is painless and harmless. (The ECG machine records electrical impulses coming from your body – it does not put any electricity into your body.)
Preparing for your test
You can take all your medications as usual and eat and drink as normal. If you would like to bring a chaperone with you, you’re welcome to bring a friend or relative. Alternatively, we can provide a chaperone for you upon your request.
At the appointment
Small metal electrodes are stuck on to your arms, legs and chest. Wires from the electrodes are connected to the ECG machine. You will be asked to remain very still whilst the machine detects the electrical impulses that occur at each heartbeat and records them on to a computer. The test takes about 10 minutes to complete and the recording of your heart will be reviewed by a cardiac physiologist.
Giving your consent for the procedure.
This information is intended to provide you with an overview of the heart monitor procedure. Prior to any medical examination being carried out, the Clinician will describe the nature of the examination. It is your right to be given sufficient information to be able to make any informed decision as to whether you wish to continue with the examination.
Results
Your results will be sent to the doctor who requested the test, which normally will be your GP. We advise you to contact the surgery 7 days after your examination.
This factsheet provides information about your forthcoming appointment so that you know exactly what to expect. We’ll go into more detail during your appointment and you’ll also be able to ask any questions that you may have.
Having a heart monitor
A heart monitor is used to assess your heart rate and rhythm for 24 hours or longer. It can be used to identify abnormal heart rates or rhythms, which may or may not be associated with particular symptoms. A heart monitor is also sometimes called an ‘ambulatory heart monitor’ or a ‘tape’.
Preparing for your test
The monitor will be worn for 24 hours and can be attached to your waistband using a clip or placed within a pouch which you can carry.
You can take all your medications as usual and eat and drink as normal. If you would like to bring a chaperone with you, you’re welcome to bring a friend or relative. Alternatively, we can provide a chaperone for you upon your request.
At the appointment
During your appointment stickers (called electrodes) will be put onto your chest to monitor your heart rate and rhythm. Some men may need to have a small area on their chest shaved in order for the electrodes to stick to the skin. These stickers are attached to the heart monitor.
Wearing the monitor
The heart monitor will record your heart rate and rhythm automatically so you won’t be required to do anything. It is important to carry on with your normal daily routine whilst you’re wearing the monitor. This includes any exercise you would normally do, as advised by your doctor (if applicable). You will be given a diary sheet to complete whilst wearing the monitor. Use this to make a note of the exact time and details of any symptoms you may experience.
The only restrictions whilst wearing the monitor are:
- Do not shower or take a bath
- Wear a loose fitting top
- Do not sleep with an electric blanket switched on
Giving your consent for the procedure.
This information is intended to provide you with an overview of the heart monitor procedure. Prior to any medical examination being carried out, the Clinician will describe the nature of the examination. It is your right to be given sufficient information to be able to make any informed decision as to whether you wish to continue with the examination.
Returning the monitor
You can remove the monitor yourself once the monitoring period has ended – we’ll show you how to do this. You’ll need to return the monitor and diary sheet to the GP reception. The recording will then be analysed and the results will be sent to your doctor. It’s very important that these devices are returned quickly so they’re available for other patients to use.
Results
Your results will be sent to the doctor who requested the test, which normally will be your GP. We advise you to contact the surgery 7 days after your examination.
This factsheet provides information about your forthcoming appointment so that you know exactly what to expect. We’ll go into more detail during your appointment and you’ll also be able to ask any questions that you may have.
Having a 24-hour blood pressure monitor
A blood pressure monitor is used to measure and record your blood pressure over a 24-hour period during your normal daily routine. It can be used to diagnose conditions such as high blood pressure (hypertension). It is sometimes used to diagnose a condition called white coat hypertension, which is when high blood pressure readings are caused by being in a clinical environment, such as a doctor’s surgery or a hospital. It can also be used to assess the use of medication for blood pressure control.
Preparing for your test
You’ll need to wear something with loose sleeves so that we can put a blood pressure cuff on your upper arm. The monitor itself will be attached to a belt around your waist. If possible, please wear your own belt. You can take all your medications as usual and eat and drink as normal. If you would like to bring a chaperone with you, you’re welcome to bring a friend or relative. Alternatively, we can provide a chaperone for you upon your request.
At the appointment
The first step is to record your blood pressure manually in both arms and then we’ll attach the blood pressure monitor and cuff to your upper arm. The cuff will usually be attached to your least dominant arm, for example to your left arm if you are right-handed. The arm cuff connects via a small tube to the monitoring device, which is a small box worn on a belt around your waist. The blood pressure cuff will be inflated during your appointment to check the device is recording correctly.
During your appointment we’ll ask you what time you get up and go to bed each day. We’ll then set-up the monitor to automatically record your blood pressure every 30 minutes during the day and every 60 minutes throughout the night. During a recording the blood pressure cuff around your arm will inflate.
Wearing the monitor
When you feel the cuff starting to inflate you should try to sit down with your arm rested and straight (only do this where possible and safe to do so). You will need to keep still and quiet during the recording. If the monitor is unable to record your blood pressure, which can happen for a number of reasons, then it will automatically retry five minutes later, re-inflating the cuff again. The device is automated so you won’t need to do anything.
It’s important that you carry on with your normal daily routine whilst you’re wearing the monitor. This includes any exercise you would normally do, as advised by your doctor (if applicable). You will be given a diary sheet to complete whilst wearing the monitor. Use this to make a note of the exact time and details of any symptoms you may experience. You won’t be able to have a bath or a shower whilst you’re wearing the monitor as it must stay dry.
Giving your consent for the procedure
This information is intended to provide you with an overview of the heart monitor procedure. Prior to any medical examination being carried out, the Clinician will describe the nature of the examination. It is your right to be given sufficient information to be able to make any informed decision as to whether you wish to continue with the examination.
Returning the monitor
At the same time the following day you will need to return to the GP surgery and we will remove the blood pressure monitor and review your diary sheet with you. The recording will then be analysed and the results will be sent to your doctor
Results
Your results will be sent to the doctor who requested the test, which normally will be your GP. We advise you to contact the surgery 7 days after your examination.
This factsheet provides information about your forthcoming appointment so that you know exactly what to expect. We’ll go into more detail during your appointment and you’ll also be able to ask any questions that you may have.
Having an echocardiogram
An echocardiogram or ‘echo’ is a scan that uses sound waves (ultrasound) to produce pictures of your heart. It’s a completely painless test that doesn’t have any side effects and doesn’t use radioactivity. An echocardiogram tells us how well your heart is pumping and whether your heart valves are working properly, but it doesn’t indicate whether or not you have angina.
Preparing for your test
You can take all your medications as usual and eat and drink as normal. If you would like to bring a chaperone with you, you’re welcome to bring a friend or relative. Alternatively, we can provide a chaperone for you upon your request.
At the appointment
The test will be performed by a Cardiac Physiologist, who may be male or female. A Cardiac Physiologist is a qualified specialist who operates ultrasound equipment and not a doctor. You will be asked to undress to the waist, but you’ll be covered up appropriately. You’ll need to lie on the couch on your left-hand side. We’ll attach stickers to your chest, which will be connected to the machine, and these will monitor your heart rate during the test. The lights in the room will be dimmed to make it easier for the specialist to see the images of your heart. An ultrasound probe covered by a small amount of gel is placed gently on the centre of your chest and will be moved to different positions throughout the test – beneath the left breast, beneath the rib cage and to the base of your neck. This enables us to see images of your heart from a number of different angles, which are then recorded.
During the echocardiogram
You will hear sounds coming from the machine, which represent blood flow through the heart. The echocardiogram will take approximately 30 minutes to complete. Once the echocardiogram is complete you can get dressed and leave. There aren’t any limitations as to what you can do after the scan so you can carry on as normal. You can drive to and from your appointment.
Giving your consent for the procedure
This information is intended to provide you with an overview of the Echo scan procedure. Prior to any medical examination being carried out, the Clinician will describe the nature of the examination. It is your right to be given sufficient information to be able to make any informed decision as to whether you wish to continue with the examination.
Results
Your results will be sent to the doctor who requested the test, which normally will be your GP. We advise you to contact the surgery 7 days after your examination.
- There is no preparation required for this examination.
- Please eat and drink normally prior to and after your scan.
- You can continue to take your usual medication.
- Please wear comfortable clothing with no metal fasteners or other metal parts such as an underwire bra.
- For more information on having a DEXA scan please follow the link to https://www.nhs.uk/conditions/dexa-scan/
What is a DEXA scan?
A DEXA scan uses X-ray equipment to measure bone density.
What is a DEXA scan used for?
DEXA scans can assist in looking for signs of fragile bones (osteoporosis) and help assess the risk of developing fractures. If a patient does have osteoporosis a DXA scan can also be used to monitor developments in the condition and effects of treatment.
What to expect during a scan?
Patients are asked to lie face up on a couch and the scanning arm passes over the body sending X-rays through the bones being tested, usually the hip and lower spine. THE SCANNER IS NOT A TUNNEL. The radiographer remains with the patient while the scanning is taking place which takes approximately 15 minutes. There is no contact with the scanner and patients do not feel anything.
After the scan patients can eat and drink normally and will be able to drive home.
When will I get my results?
Patients will not receive their results on the day of the scan. The images will be examined shortly after your visit and a report sent to your Doctor or Consultant, normally within one week.
Risks
DEXA scanning is very safe but it does use a small amount of radiation. Patients who have queries about the procedure should speak to the Radiographer prior to the scan.
All patients between the ages of 12-55 years will be asked if there is any chance of pregnancy before a DEXA examination
Why am I being asked if I may be pregnant?
Your healthcare professional/Doctor has requested a DEXA scan that requires an exposure to radiation. We have a legal responsibility and professional duty to ensure that we protect individuals from unnecessary exposures to radiation.
It also ensures that specialist Doctors reviewing your images are aware of your registered sex at birth and any natural physical variations you might have in your pelvic anatomy, as this may be relevant to your diagnosis.
Please inform your radiographer if you are aware that you were born with an intersex variation, also known as variations in sex characteristics (VSC) or diverse sex development (DSD). We acknowledge that you may wish to use a different term when informing the radiographer of this.
What do we do with this information?
The Ionising Radiation (Medical Exposure) Regulations 2017 legally requires us to document that a pregnancy status check has been performed for examinations that may result in a radiation exposure to the pelvis and so we will store an electronic copy of this form in your confidential records.
If you do not wish us to save this form, please let us know. The form will only be available for the radiographer looking after you today, and the specialist Doctor reviewing your images.
Endoscopy Exams
You will be invited to a endoscopy pre-assessment appointment with Healthshare.
As part of the appointment, you will be provided with preparation advice.
MRI is a very safe type of scan for most people, but as it involves going into a strong magnetic field it is important we ask you some questions to enable us to ensure that no risks to you are involved.
Please note:
- After your exam is scheduled, we will send you a link to the MRI Safety Questionnaire.
- You MUST complete the questionnaire before you attend your appointment.
These exams all require special patient preparation. The preparation advice is different for patients with diabetes than those without diabetes. Make sure you follow the correct advice for you.
Non-Diabetic Patients
- Please do not eat or drink anything (except sips of water) for 4 hours before your appointment time.
- You can continue to take your usual medication.
- Before entering the magnetic field, you will be required to remove all metallic objects, jewellery and items such as bank cards. These can be stored securely during your scan.
- You will also be required to remove any skin patches e.g., nicotine or hormone patches, and body piercings.
- If possible, wear clothing without any metal fasteners or zips – this may avoid having to change into a gown.
- It is safe to scan if you have any metal joint replacements such as a hip or knee replacement.
- For more information about having an MRI examination please follow the link to https://www.nhs.uk/conditions/mri-scan/
Diabetic Patients
- Please contact us on 0203 818 7777 if you are diabetic and we will book you in an early morning or afternoon appointment.
- Please do not eat or drink anything (except sips of water) for 4 hours before your appointment time.
- Have a starchy bedtime snack on the night before your appointment if you are concerned that you may become ‘hypo’
- Do not take your morning diabetic tablets or insulin, unless you take insulin glargine (Lantus) or detemir (Levemir) in the morning, then continue as normal. You may take other required mediations with water.
- Check your blood sugar levels at least hourly. If your sugar level is less than 4 or you feel ‘hypo’, have a sugary, non-fizzy drink, GlucoGel or glucose tablets to correct this
- Bring a drink and some biscuits or a sandwich with you for after your scan.
- If you have a continuous subcutaneous insulin pump you must contact your nurse contact specialist or care provider for specific advice. The information is intended to give standard advice to insulin and non-insulin dependent diabetic patients who have been asked to fast in preparation for an MRI scan under GP Care. However, every patient’s needs are different so if you have any doubts you are strongly advised to further seek the advice from your GP Practice or Diabetes Specialist Nurse.
This is for all MRI visits not listed in a Special Preparation section above:
- There is no preparation required for this examination.
- Please eat and drink normally prior to and after your scan.
- You can continue to take your usual medication.
- Before entering the magnetic field, you will be required to remove all metallic objects, jewellery and items such as bank cards. These can be stored securely during your scan.
- You will also be required to remove any skin patches e.g., nicotine or hormone patches, and body piercings.
- If possible, wear clothing without any metal fasteners or zips – this may avoid having to change into a gown.
- It is safe to scan if you have any metal joint replacements such as a hip or knee replacement.
- For more information about having an MRI examination please follow the link to https://www.nhs.uk/conditions/mri-scan/
What is an MRI scan?
Magnetic resonance imaging (MRI) is a type of scan that uses strong magnetic fields and radio waves to produce detailed images of the inside of the body. No radiation is involved.
What will I have to do before my scan?
Please remove all jewellery and wrist watches and if possible, wear clothing without any metal fasteners or zips. You will be greeted by a radiographer or health care assistant who will check your details, area that is being scanned and will confirm the answers to your safety questionnaire. You may be asked to change into a gown and your belongings will be securely locked away.
What to expect during a scan?
The MRI scanner is open at both ends and has a moveable couch which slides into the machine. You will be asked to lie on the couch and made comfortable. The part of the body being examined is placed in the middle of the scanner. You will be given a call button to gain the Radiographer’s attention if required. The scan takes approximately 30 minutes depending on the specific examination, during which time it is important to lie very still. The machine is noisy and will make knocking or buzzing sounds throughout the scan and you will be provided with earplugs or headphones to protect your ears.
Some examinations require a small quantity of contrast dye to be injected by a vein in your hand or arm in order to help with a diagnosis. The radiographer will discuss this with you at the time of your appointment and will place a small cannula (thin plastic tube) into a vein in your hand or arm. Side effects are unlikely and you can drive and continue as normal after the procedure.
When will I get my results?
After your examination there will be many images which will need to be reviewed by a Consultant Doctor, so we will not be able to give you an instant result. You will need to make an appointment with the Clinician who requested your scan to discuss the results. Usually, this process takes approximately one week.
Inclusive Pregnancy Status
All patients between the ages of 12-55 years will be asked if there is any chance of pregnancy before an MRI examination
Why am I being asked if I may be pregnant?
Your healthcare professional/Doctor has requested an MRI that may potentially cause a mild heating effect to the pelvic region and exposure to radiofrequency and magnetic fields. We have a legal responsibility and professional duty to ensure that we are aware of a patient’s pregnancy status before a diagnostic procedure to ensure we provide care which is in the best interests of the patient.
It also ensures that specialist Doctors reviewing your images are aware of your registered sex at birth and any natural physical variations you might have in your pelvic anatomy, as this may be relevant to your diagnosis.
Please inform your radiographer if you are aware that you were born with an intersex variation, also known as variations in sex characteristics (VSC) or diverse sex development (DSD). We acknowledge that you may wish to use a different term when informing the radiographer of this.
What do we do with this information?
The Medicines and Healthcare products Regulatory Agency (MHRA) require us to document that a pregnancy status check has been performed for MRI examinations and so we will store an electronic copy of this form in your confidential records.
If you do not wish us to save this form, please let us know. The form will only be available for the radiographer looking after you today, and the specialist Doctor reviewing your images.
- Please wear loose clothing to enable the sonographer to easily access the part of your body that is being examined.
- For more information on having an ultrasound scan please follow the link to https://www.nhs.uk/conditions/ultrasound-scan/
- Please be aware that your clinician may be a male or female. If you require a specific gender clinician, please call us on the number above.
The preparation advice is different for patients with diabetes than those without diabetes. Make sure you follow the correct advice for you.
Non-Diabetic Patients
- Please arrive with a full bladder for this examination. Use the following instructions to achieve this:
- One and a half hours before your appointment time, go to the toilet and empty your bladder.
- Then drink 1½ pints (800ml) of water, or more to ensure your bladder is full.
- Finish drinking 800 ml of water 30 – 45 minutes before your exam time.
- Please DO NOT empty your bladder until after your examination.
- Please do not eat anything for a minimum of 6 hours before your appointment time.
- You may take required medications with water.
- Please wear loose clothing to enable the sonographer to easily access the part of your body that is being examined.
Diabetic Patients
Please do not eat or drink anything (except water and clear fluids) for 4 hours before your appointment time.
Please arrive with a full bladder for this examination. Use the following instructions to achieve this:
- One and a half hours before your appointment time, go to the toilet and empty your bladder.
- Then drink 1½ pints (800ml) of water, or more to ensure your bladder is full.
- Finish drinking 800 ml of water 30 – 45 minutes before your exam time.
- Please DO NOT empty your bladder until after your examination.
Furthermore:
- Please wear loose clothing to enable the sonographer to easily access the part of your body that is being examined.
- Have a starchy bedtime snack on the night before your appointment if you are concerned that you may become ‘hypo’.
- Do not take your morning diabetic tablets or insulin:
- Unless you take long lasting insulin, then continue as normal:
- Abasaglar® [insulin glargine]
- Humulin® I [isophane insulin]
- Insulatard® [isophane insulin],
- Insuman® Basal [isophane insulin]
- Lantus® [insulin glargine], Levemir® [insulin detemir]
- Semglee® [insulin glargine]
- Suliqua® [insulin glargine with lixisenatide]
- Tresiba® [insulin degludec]
- Toujeo® [insulin glargine],
- Xultophy® [insulin degludec with liraglutide].
- Or unless you take injectable GLP-1 receptor agonists, then continue as normal:
- Exenatide (Byetta, Bydureon)
- Dulaglutide (Trulicity)
- Liraglutide (Saxenda, Victoza)
- Lixisenatide (Lyxuma)
- Semaglutide (Ozempic, Wegovy)
- But you may take other required medications with water.
- Unless you take long lasting insulin, then continue as normal:
- Check your blood sugar levels at least hourly. If your sugar level is less than 4 or you feel ‘hypo’, have a sugary, non-fizzy drink, GlucoGel or glucose tablets to correct this.
- Bring a drink and some biscuits or a sandwich with you for after your scan.
- If you have a continuous subcutaneous insulin pump you must contact your nurse contact specialist or care provider for specific advice. The information is intended to give standard advice to insulin and non-insulin dependent diabetic patients who have been asked to fast in preparation for an ultrasound scan with GP Care. However, every patient’s needs are different so if you have any doubts you are strongly advised to further seek the advice from your GP Practice or Diabetes Specialist Nurse
The preparation advice is different for patients with diabetes than those without diabetes. Make sure you follow the correct advice for you.
Non-Diabetic Patients
- Please arrive with a full bladder for this examination. Use the following instructions to achieve this:
- One and a half hours before your appointment time, go to the toilet and empty your bladder.
- Then drink 1½ pints (800ml) of water, or more to ensure your bladder is full.
- Finish drinking 800 ml of water 30 – 45 minutes before your exam time.
- Please DO NOT empty your bladder until after your examination.
- Please do not eat anything for a minimum of 6 hours before your appointment time.
- You may take required medications with water.
- Please wear loose clothing to enable the sonographer to easily access the part of your body that is being examined.
For a female pelvic scan, in most cases, you will be offered a transvaginal (TV or internal) scan as this can often provide greater detail to aid diagnosis in the pelvic region. The Sonographer will place a narrow probe inside your vagina. This probe will have a latex-free cover over it. The probe is then gently moved to allow visualisation of the pelvic organs. The sonographer will discuss this examination with you, should it be required. You will be asked to empty your bladder before this procedure.
The examination can still be undertaken during your period, and will also be offered if you have not been sexually active in line with national guidelines.
If you have had a positive pregnancy test prior to your scan, please contact us on 0203 818 7777
Important
If you are unable to tolerate an internal scan you will be offered a transabdominal scan (TA) instead. Please follow Preparation instruction as outlined above.
Diabetic Patients
Please do not eat or drink anything (except water and clear fluids) for 4 hours before your appointment time.
Please arrive with a full bladder for this examination. Use the following instructions to achieve this:
- One and a half hours before your appointment time, go to the toilet and empty your bladder.
- Then drink 1½ pints (800ml) of water, or more to ensure your bladder is full.
- Finish drinking 800 ml of water 30 – 45 minutes before your exam time.
- Please DO NOT empty your bladder until after your examination.
Furthermore:
- Please wear loose clothing to enable the sonographer to easily access the part of your body that is being examined.
- Have a starchy bedtime snack on the night before your appointment if you are concerned that you may become ‘hypo’.
- Do not take your morning diabetic tablets or insulin:
- Unless you take long lasting insulin, then continue as normal:
- Abasaglar® [insulin glargine]
- Humulin® I [isophane insulin]
- Insulatard® [isophane insulin],
- Insuman® Basal [isophane insulin]
- Lantus® [insulin glargine], Levemir® [insulin detemir]
- Semglee® [insulin glargine]
- Suliqua® [insulin glargine with lixisenatide]
- Tresiba® [insulin degludec]
- Toujeo® [insulin glargine],
- Xultophy® [insulin degludec with liraglutide].
- Or unless you take injectable GLP-1 receptor agonists, then continue as normal:
- Exenatide (Byetta, Bydureon)
- Dulaglutide (Trulicity)
- Liraglutide (Saxenda, Victoza)
- Lixisenatide (Lyxuma)
- Semaglutide (Ozempic, Wegovy)
- But you may take other required medications with water.
- Unless you take long lasting insulin, then continue as normal:
- Check your blood sugar levels at least hourly. If your sugar level is less than 4 or you feel ‘hypo’, have a sugary, non-fizzy drink, GlucoGel or glucose tablets to correct this.
- Bring a drink and some biscuits or a sandwich with you for after your scan.
- If you have a continuous subcutaneous insulin pump you must contact your nurse contact specialist or care provider for specific advice. The information is intended to give standard advice to insulin and non-insulin dependent diabetic patients who have been asked to fast in preparation for an ultrasound scan with GP Care. However, every patient’s needs are different so if you have any doubts you are strongly advised to further seek the advice from your GP Practice or Diabetes Specialist Nurse
For a female pelvic scan, in most cases, you will be offered a transvaginal (TV or internal) scan as this can often provide greater detail to aid diagnosis in the pelvic region. The Sonographer will place a narrow probe inside your vagina. This probe will have a latex-free cover over it. The probe is then gently moved to allow visualisation of the pelvic organs. The sonographer will discuss this examination with you, should it be required. You will be asked to empty your bladder before this procedure.
The examination can still be undertaken during your period, and will also be offered if you have not been sexually active in line with national guidelines.
If you have had a positive pregnancy test prior to your scan, please contact us on 0203 818 7777
Important
If you are unable to tolerate an internal scan you will be offered a transabdominal scan (TA) instead. Please follow Preparation instruction as outlined above.
The preparation advice is different for patients with diabetes than those without diabetes. Make sure you follow the correct advice for you.
Non-Diabetic Patients
- Please do not eat anything for a minimum of 6 hours before your appointment time.
- Please arrive with a full bladder for this examination.
- Use the following instructions to achieve this:
- One and a half hours before your appointment time, go to the toilet and empty your bladder.
- Then drink 1½ pints (800ml) of water, or more to ensure your bladder is full.
- Finish drinking 800 ml of water 30 – 45 minutes before your exam time.
- Please DO NOT empty your bladder until after your examination.
- You may take required medications with water.
- Please wear loose clothing to enable the sonographer to easily access the part of your body that is being examined
For a female pelvic scan, in most cases, you will be offered a transvaginal (TV or internal) scan as this can often provide greater detail to aid diagnosis in the pelvic region. The Sonographer will place a narrow probe inside your vagina. This probe will have a latex-free cover over it. The probe is then gently moved to allow visualisation of the pelvic organs. The sonographer will discuss this examination with you, should it be required. You will be asked to empty your bladder before this procedure.
The examination can still be undertaken during your period, and will also be offered if you have not been sexually active in line with national guidelines.
If you have had a positive pregnancy test prior to your scan, please contact us on 0203 818 7777
Important
If you are unable to tolerate an internal scan you will be offered a transabdominal scan (TA) instead. Please follow Preparation instruction as outlined above.
Diabetic Patients
Please do not eat or drink anything (except water and clear fluids) for 4 hours before your appointment time.
Please arrive with a full bladder for this examination. Use the following instructions to achieve this:
- One and a half hours before your appointment time, go to the toilet and empty your bladder.
- Then drink 1½ pints (800ml) of water, or more to ensure your bladder is full.
- Finish drinking 800 ml of water 30 – 45 minutes before your exam time.
- Please DO NOT empty your bladder until after your examination.
Furthermore:
- Please wear loose clothing to enable the sonographer to easily access the part of your body that is being examined.
- Have a starchy bedtime snack on the night before your appointment if you are concerned that you may become ‘hypo’.
- Do not take your morning diabetic tablets or insulin:
- Unless you take long lasting insulin, then continue as normal:
- Abasaglar® [insulin glargine]
- Humulin® I [isophane insulin]
- Insulatard® [isophane insulin],
- Insuman® Basal [isophane insulin]
- Lantus® [insulin glargine], Levemir® [insulin detemir]
- Semglee® [insulin glargine]
- Suliqua® [insulin glargine with lixisenatide]
- Tresiba® [insulin degludec]
- Toujeo® [insulin glargine],
- Xultophy® [insulin degludec with liraglutide].
- Or unless you take injectable GLP-1 receptor agonists, then continue as normal:
- Exenatide (Byetta, Bydureon)
- Dulaglutide (Trulicity)
- Liraglutide (Saxenda, Victoza)
- Lixisenatide (Lyxuma)
- Semaglutide (Ozempic, Wegovy)
- You may take other required medications with water.
- Unless you take long lasting insulin, then continue as normal:
- Check your blood sugar levels at least hourly. If your sugar level is less than 4 or you feel ‘hypo’, have a sugary, non-fizzy drink, GlucoGel or glucose tablets to correct this.
- Bring a drink and some biscuits or a sandwich with you for after your scan.
- If you have a continuous subcutaneous insulin pump you must contact your nurse contact specialist or care provider for specific advice. The information is intended to give standard advice to insulin and non-insulin dependent diabetic patients who have been asked to fast in preparation for an ultrasound scan with GP Care. However, every patient’s needs are different so if you have any doubts you are strongly advised to further seek the advice from your GP Practice or Diabetes Specialist Nurse
For a female pelvic scan, in most cases, you will be offered a transvaginal (TV or internal) scan as this can often provide greater detail to aid diagnosis in the pelvic region. The Sonographer will place a narrow probe inside your vagina. This probe will have a latex-free cover over it. The probe is then gently moved to allow visualisation of the pelvic organs. The sonographer will discuss this examination with you, should it be required. You will be asked to empty your bladder before this procedure.
The examination can still be undertaken during your period, and will also be offered if you have not been sexually active in line with national guidelines.
If you have had a positive pregnancy test prior to your scan, please contact us on 0203 818 7777
Important
If you are unable to tolerate an internal scan you will be offered a transabdominal scan (TA) instead. Please follow Preparation instruction as outlined above.
Non-Diabetic Patients
- Please do not eat or drink anything (except water) for a minimum of 6 hours before your appointment time.
- Please only drink clear fluids (i.e. water) before your appointment;
- You may take required medications with water.
- Please wear loose clothing to enable the sonographer to easily access the part of your body that is being examined.
Diabetic Patients
- Please do not eat or drink anything (except water and clear fluids) for 4 hours before your appointment time.
- Please wear loose clothing to enable the sonographer to easily access the part of your body that is being examined
- Have a starchy bedtime snack on the night before your appointment if you are concerned that you may become ‘hypo’
- Do not take your morning diabetic tablets or insulin:
- Unless you take long lasting insulin, then continue as normal:
- Abasaglar® [insulin glargine]
- Humulin® I [isophane insulin]
- Insulatard® [isophane insulin],
- Insuman® Basal [isophane insulin]
- Lantus® [insulin glargine], Levemir® [insulin detemir]
- Semglee® [insulin glargine]
- Suliqua® [insulin glargine with lixisenatide]
- Tresiba® [insulin degludec]
- Toujeo® [insulin glargine],
- Xultophy® [insulin degludec with liraglutide]
- Or unless you take injectable GLP-1 receptor agonists, then continue as normal:
- Exenatide (Byetta, Bydureon)
- Dulaglutide (Trulicity)
- Liraglutide (Saxenda, Victoza)
- Lixisenatide (Lyxuma)
- Semaglutide (Ozempic, Wegovy)
- But you may take other required medications with water.
- Unless you take long lasting insulin, then continue as normal:
- Check your blood sugar levels at least hourly. If your sugar level is less than 4 or you feel ‘hypo’, have a sugary, non-fizzy drink, GlucoGel or glucose tablets to correct this
- Bring a drink and some biscuits or a sandwich with you for after your scan.
- If you have a continuous subcutaneous insulin pump you must contact your nurse contact specialist or care provider for specific advice. The information is intended to give standard advice to insulin and non-insulin dependent diabetic patients who have been asked to fast in preparation for an ultrasound scan with GP Care. However, every patient’s needs are different so if you have any doubts you are strongly advised to further seek the advice from your GP Practice or Diabetes Specialist Nurse.
Please arrive with a full bladder for this examination. Use the following instructions to achieve this:
- One and a half hours before your appointment time, go to the toilet and empty your bladder.
- Then drink 1½ pints (800ml) of water, or more to ensure your bladder is full.
- Finish drinking 800 ml of water 30 – 45 minutes before your exam time.
- Please DO NOT empty your bladder until after your examination.
- Please wear loose clothing to enable the sonographer to easily access the part of your body that is being examined.
For a female pelvic scan, in most cases, you will be offered a transvaginal (TV or internal) scan as this can often provide greater detail to aid diagnosis in the pelvic region. The Sonographer will place a narrow probe inside your vagina. This probe will have a latex-free cover over it. The probe is then gently moved to allow visualisation of the pelvic organs. The sonographer will discuss this examination with you, should it be required. You will be asked to empty your bladder before this procedure.
The examination can still be undertaken during your period, and will also be offered if you have not been sexually active in line with national guidelines.
If you have had a positive pregnancy test prior to your scan, please contact us on 0203 818 7777
Important
If you are unable to tolerate an internal scan you will be offered a transabdominal scan (TA) instead. Please follow Preparation instruction as outlined above.
Please arrive with a full bladder for this examination. Use the following instructions to achieve this:
- One and a half hours before your appointment time, go to the toilet and empty your bladder.
- Then drink 1.5 pints (800ml) of water, or more to ensure your bladder is full.
- Finish drinking 800 ml of water 30 – 45 minutes before your exam time.
- Please DO NOT empty your bladder until after your examination.
- You can continue to take any medication.
- Please wear loose clothing to enable the sonographer to easily access the part of your body that is being examined.
If you are known to the Renal Team, please contact us on 0203 818 7777 for further advice on how to prepare for your exam.
This is for all Ultrasound visits not listed in a Special Preparation section above.
- Please eat and drink normally prior to and after your scan.
- You can continue to take your usual medication.
- Please wear loose clothing to enable the sonographer to easily access the part of your body that is being examined.
What is an Ultrasound scan?
An ultrasound scan is a test that uses high frequency sound waves to create images of the organs and soft tissues in your body. It can provide accurate information about the size, shape and structure of these different parts. Ultrasound is a very commonly used method of imaging and has no known harmful effects on humans.
What to expect during a scan?
You will be called into the scan room and your identity will be checked. You will be asked to move or remove some clothing and then to lie down on an examination couch. The lights will be dimmed to allow the sonographer a clear view of the screen.
Gel will be spread on the area of your body being examined and the sonographer will place a hand-held probe onto your skin. By moving the probe, the sonographer will be able to see the necessary views of your anatomy to allow them to obtain the information needed. You may be asked to hold your breath at times to help them see more clearly. Selected images are saved as a record of the examination.
An ultrasound examination should not be painful, but some patients may occasionally find a little discomfort from the pressure of the probe over certain areas.
After your scan
After the examination you will be able to eat and drink as normal.
The sonographer will review the images and write a report of their findings and these results will be forwarded to your doctor. You should contact your doctor approximately one week after your appointment to get the results of the scan.
A corticosteroid (or ‘cortisone’) is an anti-inflammatory medicine, which can be injected directly into the soft tissues or joints that are causing your symptoms. It is a safer alternative to taking anti- inflammatory medication by mouth. It acts directly in the area injected and is not the same as the steroids taken by bodybuilders or athletes.
The injection can help to relieve swelling, pain and stiffness caused by inflammation. This may in turn help you to start your rehabilitation and return to normal activities sooner by ‘breaking the cycle’ of pain and inflammation. It can also be helpful to aid in the diagnosis of your condition if it is not clear which structures are responsible for your pain. You may also have a local anaesthetic injected at the same time, which allows for temporary pain relief.
Side effects of the injection are rare and however this includes:
- Flushing of the face for a few hours.
- Small area of fat loss or change in skin colour around the injection site.
- Post-injection pain: You may experience an increase in pain a few hours
- after your injection that can last a few days. You could continue you’re
- your pain killers or discuss this with your doctor or pharmacist.
- Diabetic patients may notice a temporary increase in blood sugar levels.
- Temporary bruising or bleeding if you are taking blood thinning tablets
- (such as aspirin or warfarin).
- Slight vaginal bleeding / menstrual irregularities.
- Allergic reaction (Anaphylactic shock):This is extremely rare but is a medical emergency and is associated with difficulty breathing (and other symptoms). It is most likely to happen in the first 15 minutes after an injection (usually involving analgesic) but can happen up to 6 hours after the procedure. For this reason, you will need to remain in the clinic / reception for 15 minutes after the injection. If you have any difficulty breathing or any unusual symptoms you must tell us immediately. If it happens after you have left you must seek medical help immediately. Treatment involves another injection and this must be administered quickly. However, please be assured this is extremely rare.
- Infection: if the area becomes hot, swollen and painful for more than 24 hours, or if you feel generally unwell, you should contact your physiotherapist or doctor immediately. If they are unavailable, you should seek advice from your GP or Accident & Emergency (A&E) department.
- Coronavirus: A side effect of corticosteroid injections is the increased risk of infection due to immunosuppression. This may increase the risk of contracting COVID 19 and the ability to fight a COVID 19 infection.
You SHOULD NOT have the injection carried out if you:
- Are in a high risk group of contracting coronavirus
- Have any infection in the area or anywhere else in your body.
- Are allergic to local anaesthetic or steroid.
- Feel unwell or due to have surgery in the treatment area soon.
- Are pregnant or breast feeding.
- Have poorly controlled diabetes.
- Do not want the injection or needle phobia
- Have Pancreatitis
- Lifestyle changes – rest activity modification
- Heat or cold packs, self-massage
- Pain relieving, anti-inflammatory gel application
- Use of anti-inflammatory medicines
- Physiotherapy
- Sometimes surgical opinion
Do I need any special preparation before an X-ray?
Usually there is no preparation required and you can continue to eat and drink as normal and take any medication.
What are X-rays?
X–rays are similar to light, except that they have a much higher frequency which makes them invisible to the naked eye. An X-ray is a widely used diagnostic test, used to examine the inside of the body by creating an image, like a photograph.
Why should I have an X-ray?
An X-ray will to help provide information that can assist your doctor to diagnose what may be wrong with you or can be used to monitor an existing condition.
What are the risks?
X-rays are a type of radiation known as ionising radiation. The dose that you get from a medical X-ray is very low and the associated risks are minimal. They are similar in strength to other sources of natural radiation that we are exposed to in everyday life. A dose from an X-ray is equivalent to just a few days natural back ground radiation. The Radiographer is responsible for keeping the dose as low as possible to ensure that the benefits outweigh any risks. For more information about the risks of having an X-ray please look at the following sites:
https://www.nhs.uk/conditions/x-ray/
What happens during an X-ray?
You will be taken to the X-ray room by the Radiographer; this person has had specialist training in taking X-ray images and the required qualifications to practice radiography. Your personal details will be checked and the examination will be explained to you. All patients between the ages of 12 and 55 will be asked if there is any possibility of them being pregnant before any examination can be performed.
You may be asked to stand, sit on a chair or lie on a bed, depending on the area being examined. The Radiographer will position the X-ray camera over the area to be examined and you will be asked to remain still during the procedure, as movement can affect the quality of the image and result in the process having to be repeated. For some examinations you may be asked to hold your breath whilst the X-ray is taken.
The radiographer will move behind a screen to take the image at a control panel, but will be able to see and hear you at all times. Often the radiographer will need to take two or more X-rays of the same area but from different angles to ensure maximum information is obtained for each examination. Once the X-ray is completed it will be viewed on a computer monitor and stored digitally.
Giving your consent to the X-ray
The Radiographer will ask you if you are happy for the X-ray to go ahead or if you have any questions. If you do not wish to have the X-ray, please inform a member of staff.
Remember, it is your decision. You can change your mind at any time and your wishes will be respected. This may however delay your diagnosis as the doctor may not have all the required information
How long will my X-ray take?
The examination will normally take 5-15 minutes depending on the area of the body being examined and the views required.
What happens after your X-ray?
You may be asked to wait while the X-rays are reviewed to ensure they meet with the requirements of your doctor/consultant. If no further images are required, you will be free to leave the clinic. A Consultant Radiologist, who specialises in interpreting X-rays will assess your images and write a report on the findings. The report will be forwarded to your clinician or GP to discuss with you during your follow up appointment.
All patients between the ages of 12-55 years will be asked if there is any chance of pregnancy when their pelvic area may be exposed to radiation.
Why am I being asked if I may be pregnant?
Your healthcare professional/Doctor has requested an X-ray that requires an exposure to radiation. We have a legal responsibility and professional duty to ensure that we protect individuals from unnecessary exposures to radiation.
It also ensures that specialist Doctors reviewing your images are aware of your registered sex at birth and any natural physical variations you might have in your pelvic anatomy, as this may be relevant to your diagnosis.
Please inform your radiographer if you are aware that you were born with an intersex variation, also known as variations in sex characteristics (VSC) or diverse sex development (DSD). We acknowledge that you may wish to use a different term when informing the radiographer of this.
What do we do with this information?
The Ionising Radiation (Medical Exposure) Regulations 2017 legally requires us to document that a pregnancy status check has been performed for examinations that may result in a radiation exposure to the pelvis and so we will store an electronic copy of this form in your confidential records.
If you do not wish us to save this form, please let us know. The form will only be available for the radiographer looking after you today, and the specialist Doctor reviewing your images.
This factsheet provides information about your forthcoming appointment so that you know exactly what to expect. We’ll go into more detail during your appointment and you’ll also be able to ask any questions that you may have.
Having a 12 lead Echocardiogram (ECG)
An electrocardiogram (ECG) records the electrical activity of the heart. The heart produces tiny electrical impulses which spread through the heart muscle to make the heart contract. These impulses can be detected by the ECG machine. You may have an ECG to help find the cause of symptoms such as the feeling of a ‘thumping heart’ (palpitations) or chest pain.
The ECG test is painless and harmless. (The ECG machine records electrical impulses coming from your body – it does not put any electricity into your body.)
Preparing for your test
You can take all your medications as usual and eat and drink as normal. If you would like to bring a chaperone with you, you’re welcome to bring a friend or relative. Alternatively, we can provide a chaperone for you upon your request.
At the appointment
Small metal electrodes are stuck on to your arms, legs and chest. Wires from the electrodes are connected to the ECG machine. You will be asked to remain very still whilst the machine detects the electrical impulses that occur at each heartbeat and records them on to a computer. The test takes about 10 minutes to complete and the recording of your heart will be reviewed by a cardiac physiologist.
Giving your consent for the procedure.
This information is intended to provide you with an overview of the heart monitor procedure. Prior to any medical examination being carried out, the Clinician will describe the nature of the examination. It is your right to be given sufficient information to be able to make any informed decision as to whether you wish to continue with the examination.
Results
Your results will be sent to the doctor who requested the test, which normally will be your GP. We advise you to contact the surgery 7 days after your examination.
This factsheet provides information about your forthcoming appointment so that you know exactly what to expect. We’ll go into more detail during your appointment and you’ll also be able to ask any questions that you may have.
Having a heart monitor
A heart monitor is used to assess your heart rate and rhythm for 24 hours or longer. It can be used to identify abnormal heart rates or rhythms, which may or may not be associated with particular symptoms. A heart monitor is also sometimes called an ‘ambulatory heart monitor’ or a ‘tape’.
Preparing for your test
The monitor will be worn for 24 hours and can be attached to your waistband using a clip or placed within a pouch which you can carry.
You can take all your medications as usual and eat and drink as normal. If you would like to bring a chaperone with you, you’re welcome to bring a friend or relative. Alternatively, we can provide a chaperone for you upon your request.
At the appointment
During your appointment stickers (called electrodes) will be put onto your chest to monitor your heart rate and rhythm. Some men may need to have a small area on their chest shaved in order for the electrodes to stick to the skin. These stickers are attached to the heart monitor.
Wearing the monitor
The heart monitor will record your heart rate and rhythm automatically so you won’t be required to do anything. It is important to carry on with your normal daily routine whilst you’re wearing the monitor. This includes any exercise you would normally do, as advised by your doctor (if applicable). You will be given a diary sheet to complete whilst wearing the monitor. Use this to make a note of the exact time and details of any symptoms you may experience.
The only restrictions whilst wearing the monitor are:
- Do not shower or take a bath
- Wear a loose fitting top
- Do not sleep with an electric blanket switched on
Giving your consent for the procedure.
This information is intended to provide you with an overview of the heart monitor procedure. Prior to any medical examination being carried out, the Clinician will describe the nature of the examination. It is your right to be given sufficient information to be able to make any informed decision as to whether you wish to continue with the examination.
Returning the monitor
You can remove the monitor yourself once the monitoring period has ended – we’ll show you how to do this. You’ll need to return the monitor and diary sheet to the GP reception. The recording will then be analysed and the results will be sent to your doctor. It’s very important that these devices are returned quickly so they’re available for other patients to use.
Results
Your results will be sent to the doctor who requested the test, which normally will be your GP. We advise you to contact the surgery 7 days after your examination.
This factsheet provides information about your forthcoming appointment so that you know exactly what to expect. We’ll go into more detail during your appointment and you’ll also be able to ask any questions that you may have.
Having a 24-hour blood pressure monitor
A blood pressure monitor is used to measure and record your blood pressure over a 24-hour period during your normal daily routine. It can be used to diagnose conditions such as high blood pressure (hypertension). It is sometimes used to diagnose a condition called white coat hypertension, which is when high blood pressure readings are caused by being in a clinical environment, such as a doctor’s surgery or a hospital. It can also be used to assess the use of medication for blood pressure control.
Preparing for your test
You’ll need to wear something with loose sleeves so that we can put a blood pressure cuff on your upper arm. The monitor itself will be attached to a belt around your waist. If possible, please wear your own belt. You can take all your medications as usual and eat and drink as normal. If you would like to bring a chaperone with you, you’re welcome to bring a friend or relative. Alternatively, we can provide a chaperone for you upon your request.
At the appointment
The first step is to record your blood pressure manually in both arms and then we’ll attach the blood pressure monitor and cuff to your upper arm. The cuff will usually be attached to your least dominant arm, for example to your left arm if you are right-handed. The arm cuff connects via a small tube to the monitoring device, which is a small box worn on a belt around your waist. The blood pressure cuff will be inflated during your appointment to check the device is recording correctly.
During your appointment we’ll ask you what time you get up and go to bed each day. We’ll then set-up the monitor to automatically record your blood pressure every 30 minutes during the day and every 60 minutes throughout the night. During a recording the blood pressure cuff around your arm will inflate.
Wearing the monitor
When you feel the cuff starting to inflate you should try to sit down with your arm rested and straight (only do this where possible and safe to do so). You will need to keep still and quiet during the recording. If the monitor is unable to record your blood pressure, which can happen for a number of reasons, then it will automatically retry five minutes later, re-inflating the cuff again. The device is automated so you won’t need to do anything.
It’s important that you carry on with your normal daily routine whilst you’re wearing the monitor. This includes any exercise you would normally do, as advised by your doctor (if applicable). You will be given a diary sheet to complete whilst wearing the monitor. Use this to make a note of the exact time and details of any symptoms you may experience. You won’t be able to have a bath or a shower whilst you’re wearing the monitor as it must stay dry.
Giving your consent for the procedure
This information is intended to provide you with an overview of the heart monitor procedure. Prior to any medical examination being carried out, the Clinician will describe the nature of the examination. It is your right to be given sufficient information to be able to make any informed decision as to whether you wish to continue with the examination.
Returning the monitor
At the same time the following day you will need to return to the GP surgery and we will remove the blood pressure monitor and review your diary sheet with you. The recording will then be analysed and the results will be sent to your doctor
Results
Your results will be sent to the doctor who requested the test, which normally will be your GP. We advise you to contact the surgery 7 days after your examination.
This factsheet provides information about your forthcoming appointment so that you know exactly what to expect. We’ll go into more detail during your appointment and you’ll also be able to ask any questions that you may have.
Having an echocardiogram
An echocardiogram or ‘echo’ is a scan that uses sound waves (ultrasound) to produce pictures of your heart. It’s a completely painless test that doesn’t have any side effects and doesn’t use radioactivity. An echocardiogram tells us how well your heart is pumping and whether your heart valves are working properly, but it doesn’t indicate whether or not you have angina.
Preparing for your test
You can take all your medications as usual and eat and drink as normal. If you would like to bring a chaperone with you, you’re welcome to bring a friend or relative. Alternatively, we can provide a chaperone for you upon your request.
At the appointment
The test will be performed by a Cardiac Physiologist, who may be male or female. A Cardiac Physiologist is a qualified specialist who operates ultrasound equipment and not a doctor. You will be asked to undress to the waist, but you’ll be covered up appropriately. You’ll need to lie on the couch on your left-hand side. We’ll attach stickers to your chest, which will be connected to the machine, and these will monitor your heart rate during the test. The lights in the room will be dimmed to make it easier for the specialist to see the images of your heart. An ultrasound probe covered by a small amount of gel is placed gently on the centre of your chest and will be moved to different positions throughout the test – beneath the left breast, beneath the rib cage and to the base of your neck. This enables us to see images of your heart from a number of different angles, which are then recorded.
During the echocardiogram
You will hear sounds coming from the machine, which represent blood flow through the heart. The echocardiogram will take approximately 30 minutes to complete. Once the echocardiogram is complete you can get dressed and leave. There aren’t any limitations as to what you can do after the scan so you can carry on as normal. You can drive to and from your appointment.
Giving your consent for the procedure
This information is intended to provide you with an overview of the Echo scan procedure. Prior to any medical examination being carried out, the Clinician will describe the nature of the examination. It is your right to be given sufficient information to be able to make any informed decision as to whether you wish to continue with the examination.
Results
Your results will be sent to the doctor who requested the test, which normally will be your GP. We advise you to contact the surgery 7 days after your examination.
- There is no preparation required for this examination.
- Please eat and drink normally prior to and after your scan.
- You can continue to take your usual medication.
- Please wear comfortable clothing with no metal fasteners or other metal parts such as an underwire bra.
- For more information on having a DEXA scan please follow the link to https://www.nhs.uk/conditions/dexa-scan/
What is a DEXA scan?
A DEXA scan uses X-ray equipment to measure bone density.
What is a DEXA scan used for?
DEXA scans can assist in looking for signs of fragile bones (osteoporosis) and help assess the risk of developing fractures. If a patient does have osteoporosis a DXA scan can also be used to monitor developments in the condition and effects of treatment.
What to expect during a scan?
Patients are asked to lie face up on a couch and the scanning arm passes over the body sending X-rays through the bones being tested, usually the hip and lower spine. THE SCANNER IS NOT A TUNNEL. The radiographer remains with the patient while the scanning is taking place which takes approximately 15 minutes. There is no contact with the scanner and patients do not feel anything.
After the scan patients can eat and drink normally and will be able to drive home.
When will I get my results?
Patients will not receive their results on the day of the scan. The images will be examined shortly after your visit and a report sent to your Doctor or Consultant, normally within one week.
Risks
DEXA scanning is very safe but it does use a small amount of radiation. Patients who have queries about the procedure should speak to the Radiographer prior to the scan.
All patients between the ages of 12-55 years will be asked if there is any chance of pregnancy before a DEXA examination
Why am I being asked if I may be pregnant?
Your healthcare professional/Doctor has requested a DEXA scan that requires an exposure to radiation. We have a legal responsibility and professional duty to ensure that we protect individuals from unnecessary exposures to radiation.
It also ensures that specialist Doctors reviewing your images are aware of your registered sex at birth and any natural physical variations you might have in your pelvic anatomy, as this may be relevant to your diagnosis.
Please inform your radiographer if you are aware that you were born with an intersex variation, also known as variations in sex characteristics (VSC) or diverse sex development (DSD). We acknowledge that you may wish to use a different term when informing the radiographer of this.
What do we do with this information?
The Ionising Radiation (Medical Exposure) Regulations 2017 legally requires us to document that a pregnancy status check has been performed for examinations that may result in a radiation exposure to the pelvis and so we will store an electronic copy of this form in your confidential records.
If you do not wish us to save this form, please let us know. The form will only be available for the radiographer looking after you today, and the specialist Doctor reviewing your images.
Endoscopy Exams
You will be invited to a endoscopy pre-assessment appointment with Healthshare.
As part of the appointment, you will be provided with preparation advice.
- Please wear loose clothing to enable the sonographer to easily access the part of your body that is being examined.
- For more information on having an ultrasound scan please follow the link to https://www.nhs.uk/conditions/ultrasound-scan/
- Please be aware that your clinician may be a male or female. If you require a specific gender clinician, please call us on the number above.
The preparation advice is different for patients with diabetes than those without diabetes. Make sure you follow the correct advice for you.
Non-Diabetic Patients
- Please arrive with a full bladder for this examination. Use the following instructions to achieve this:
- One and a half hours before your appointment time, go to the toilet and empty your bladder.
- Then drink 1½ pints (800ml) of water, or more to ensure your bladder is full.
- Finish drinking 800 ml of water 30 – 45 minutes before your exam time.
- Please DO NOT empty your bladder until after your examination.
- Please do not eat anything for a minimum of 6 hours before your appointment time.
- You may take required medications with water.
- Please wear loose clothing to enable the sonographer to easily access the part of your body that is being examined.
Diabetic Patients
Please do not eat or drink anything (except water and clear fluids) for 4 hours before your appointment time.
Please arrive with a full bladder for this examination. Use the following instructions to achieve this:
- One and a half hours before your appointment time, go to the toilet and empty your bladder.
- Then drink 1½ pints (800ml) of water, or more to ensure your bladder is full.
- Finish drinking 800 ml of water 30 – 45 minutes before your exam time.
- Please DO NOT empty your bladder until after your examination.
Furthermore:
- Please wear loose clothing to enable the sonographer to easily access the part of your body that is being examined.
- Have a starchy bedtime snack on the night before your appointment if you are concerned that you may become ‘hypo’.
- Do not take your morning diabetic tablets or insulin:
- Unless you take long lasting insulin, then continue as normal:
- Abasaglar® [insulin glargine]
- Humulin® I [isophane insulin]
- Insulatard® [isophane insulin],
- Insuman® Basal [isophane insulin]
- Lantus® [insulin glargine], Levemir® [insulin detemir]
- Semglee® [insulin glargine]
- Suliqua® [insulin glargine with lixisenatide]
- Tresiba® [insulin degludec]
- Toujeo® [insulin glargine],
- Xultophy® [insulin degludec with liraglutide].
- Or unless you take injectable GLP-1 receptor agonists, then continue as normal:
- Exenatide (Byetta, Bydureon)
- Dulaglutide (Trulicity)
- Liraglutide (Saxenda, Victoza)
- Lixisenatide (Lyxuma)
- Semaglutide (Ozempic, Wegovy)
- But you may take other required medications with water.
- Unless you take long lasting insulin, then continue as normal:
- Check your blood sugar levels at least hourly. If your sugar level is less than 4 or you feel ‘hypo’, have a sugary, non-fizzy drink, GlucoGel or glucose tablets to correct this.
- Bring a drink and some biscuits or a sandwich with you for after your scan.
- If you have a continuous subcutaneous insulin pump you must contact your nurse contact specialist or care provider for specific advice. The information is intended to give standard advice to insulin and non-insulin dependent diabetic patients who have been asked to fast in preparation for an ultrasound scan with GP Care. However, every patient’s needs are different so if you have any doubts you are strongly advised to further seek the advice from your GP Practice or Diabetes Specialist Nurse
The preparation advice is different for patients with diabetes than those without diabetes. Make sure you follow the correct advice for you.
Non-Diabetic Patients
- Please arrive with a full bladder for this examination. Use the following instructions to achieve this:
- One and a half hours before your appointment time, go to the toilet and empty your bladder.
- Then drink 1½ pints (800ml) of water, or more to ensure your bladder is full.
- Finish drinking 800 ml of water 30 – 45 minutes before your exam time.
- Please DO NOT empty your bladder until after your examination.
- Please do not eat anything for a minimum of 6 hours before your appointment time.
- You may take required medications with water.
- Please wear loose clothing to enable the sonographer to easily access the part of your body that is being examined.
For a female pelvic scan, in most cases, you will be offered a transvaginal (TV or internal) scan as this can often provide greater detail to aid diagnosis in the pelvic region. The Sonographer will place a narrow probe inside your vagina. This probe will have a latex-free cover over it. The probe is then gently moved to allow visualisation of the pelvic organs. The sonographer will discuss this examination with you, should it be required. You will be asked to empty your bladder before this procedure.
The examination can still be undertaken during your period, and will also be offered if you have not been sexually active in line with national guidelines.
If you have had a positive pregnancy test prior to your scan, please contact us on 0203 818 7777
Important
If you are unable to tolerate an internal scan you will be offered a transabdominal scan (TA) instead. Please follow Preparation instruction as outlined above.
Diabetic Patients
Please do not eat or drink anything (except water and clear fluids) for 4 hours before your appointment time.
Please arrive with a full bladder for this examination. Use the following instructions to achieve this:
- One and a half hours before your appointment time, go to the toilet and empty your bladder.
- Then drink 1½ pints (800ml) of water, or more to ensure your bladder is full.
- Finish drinking 800 ml of water 30 – 45 minutes before your exam time.
- Please DO NOT empty your bladder until after your examination.
Furthermore:
- Please wear loose clothing to enable the sonographer to easily access the part of your body that is being examined.
- Have a starchy bedtime snack on the night before your appointment if you are concerned that you may become ‘hypo’.
- Do not take your morning diabetic tablets or insulin:
- Unless you take long lasting insulin, then continue as normal:
- Abasaglar® [insulin glargine]
- Humulin® I [isophane insulin]
- Insulatard® [isophane insulin],
- Insuman® Basal [isophane insulin]
- Lantus® [insulin glargine], Levemir® [insulin detemir]
- Semglee® [insulin glargine]
- Suliqua® [insulin glargine with lixisenatide]
- Tresiba® [insulin degludec]
- Toujeo® [insulin glargine],
- Xultophy® [insulin degludec with liraglutide].
- Or unless you take injectable GLP-1 receptor agonists, then continue as normal:
- Exenatide (Byetta, Bydureon)
- Dulaglutide (Trulicity)
- Liraglutide (Saxenda, Victoza)
- Lixisenatide (Lyxuma)
- Semaglutide (Ozempic, Wegovy)
- But you may take other required medications with water.
- Unless you take long lasting insulin, then continue as normal:
- Check your blood sugar levels at least hourly. If your sugar level is less than 4 or you feel ‘hypo’, have a sugary, non-fizzy drink, GlucoGel or glucose tablets to correct this.
- Bring a drink and some biscuits or a sandwich with you for after your scan.
- If you have a continuous subcutaneous insulin pump you must contact your nurse contact specialist or care provider for specific advice. The information is intended to give standard advice to insulin and non-insulin dependent diabetic patients who have been asked to fast in preparation for an ultrasound scan with GP Care. However, every patient’s needs are different so if you have any doubts you are strongly advised to further seek the advice from your GP Practice or Diabetes Specialist Nurse
For a female pelvic scan, in most cases, you will be offered a transvaginal (TV or internal) scan as this can often provide greater detail to aid diagnosis in the pelvic region. The Sonographer will place a narrow probe inside your vagina. This probe will have a latex-free cover over it. The probe is then gently moved to allow visualisation of the pelvic organs. The sonographer will discuss this examination with you, should it be required. You will be asked to empty your bladder before this procedure.
The examination can still be undertaken during your period, and will also be offered if you have not been sexually active in line with national guidelines.
If you have had a positive pregnancy test prior to your scan, please contact us on 0203 818 7777
Important
If you are unable to tolerate an internal scan you will be offered a transabdominal scan (TA) instead. Please follow Preparation instruction as outlined above.
The preparation advice is different for patients with diabetes than those without diabetes. Make sure you follow the correct advice for you.
Non-Diabetic Patients
- Please do not eat anything for a minimum of 6 hours before your appointment time.
- Please arrive with a full bladder for this examination.
- Use the following instructions to achieve this:
- One and a half hours before your appointment time, go to the toilet and empty your bladder.
- Then drink 1½ pints (800ml) of water, or more to ensure your bladder is full.
- Finish drinking 800 ml of water 30 – 45 minutes before your exam time.
- Please DO NOT empty your bladder until after your examination.
- You may take required medications with water.
- Please wear loose clothing to enable the sonographer to easily access the part of your body that is being examined
For a female pelvic scan, in most cases, you will be offered a transvaginal (TV or internal) scan as this can often provide greater detail to aid diagnosis in the pelvic region. The Sonographer will place a narrow probe inside your vagina. This probe will have a latex-free cover over it. The probe is then gently moved to allow visualisation of the pelvic organs. The sonographer will discuss this examination with you, should it be required. You will be asked to empty your bladder before this procedure.
The examination can still be undertaken during your period, and will also be offered if you have not been sexually active in line with national guidelines.
If you have had a positive pregnancy test prior to your scan, please contact us on 0203 818 7777
Important
If you are unable to tolerate an internal scan you will be offered a transabdominal scan (TA) instead. Please follow Preparation instruction as outlined above.
Diabetic Patients
Please do not eat or drink anything (except water and clear fluids) for 4 hours before your appointment time.
Please arrive with a full bladder for this examination. Use the following instructions to achieve this:
- One and a half hours before your appointment time, go to the toilet and empty your bladder.
- Then drink 1½ pints (800ml) of water, or more to ensure your bladder is full.
- Finish drinking 800 ml of water 30 – 45 minutes before your exam time.
- Please DO NOT empty your bladder until after your examination.
Furthermore:
- Please wear loose clothing to enable the sonographer to easily access the part of your body that is being examined.
- Have a starchy bedtime snack on the night before your appointment if you are concerned that you may become ‘hypo’.
- Do not take your morning diabetic tablets or insulin:
- Unless you take long lasting insulin, then continue as normal:
- Abasaglar® [insulin glargine]
- Humulin® I [isophane insulin]
- Insulatard® [isophane insulin],
- Insuman® Basal [isophane insulin]
- Lantus® [insulin glargine], Levemir® [insulin detemir]
- Semglee® [insulin glargine]
- Suliqua® [insulin glargine with lixisenatide]
- Tresiba® [insulin degludec]
- Toujeo® [insulin glargine],
- Xultophy® [insulin degludec with liraglutide].
- Or unless you take injectable GLP-1 receptor agonists, then continue as normal:
- Exenatide (Byetta, Bydureon)
- Dulaglutide (Trulicity)
- Liraglutide (Saxenda, Victoza)
- Lixisenatide (Lyxuma)
- Semaglutide (Ozempic, Wegovy)
- You may take other required medications with water.
- Unless you take long lasting insulin, then continue as normal:
- Check your blood sugar levels at least hourly. If your sugar level is less than 4 or you feel ‘hypo’, have a sugary, non-fizzy drink, GlucoGel or glucose tablets to correct this.
- Bring a drink and some biscuits or a sandwich with you for after your scan.
- If you have a continuous subcutaneous insulin pump you must contact your nurse contact specialist or care provider for specific advice. The information is intended to give standard advice to insulin and non-insulin dependent diabetic patients who have been asked to fast in preparation for an ultrasound scan with GP Care. However, every patient’s needs are different so if you have any doubts you are strongly advised to further seek the advice from your GP Practice or Diabetes Specialist Nurse
For a female pelvic scan, in most cases, you will be offered a transvaginal (TV or internal) scan as this can often provide greater detail to aid diagnosis in the pelvic region. The Sonographer will place a narrow probe inside your vagina. This probe will have a latex-free cover over it. The probe is then gently moved to allow visualisation of the pelvic organs. The sonographer will discuss this examination with you, should it be required. You will be asked to empty your bladder before this procedure.
The examination can still be undertaken during your period, and will also be offered if you have not been sexually active in line with national guidelines.
If you have had a positive pregnancy test prior to your scan, please contact us on 0203 818 7777
Important
If you are unable to tolerate an internal scan you will be offered a transabdominal scan (TA) instead. Please follow Preparation instruction as outlined above.
Non-Diabetic Patients
- Please do not eat or drink anything (except water) for a minimum of 6 hours before your appointment time.
- Please only drink clear fluids (i.e. water) before your appointment;
- You may take required medications with water.
- Please wear loose clothing to enable the sonographer to easily access the part of your body that is being examined.
Diabetic Patients
- Please do not eat or drink anything (except water and clear fluids) for 4 hours before your appointment time.
- Please wear loose clothing to enable the sonographer to easily access the part of your body that is being examined
- Have a starchy bedtime snack on the night before your appointment if you are concerned that you may become ‘hypo’
- Do not take your morning diabetic tablets or insulin:
- Unless you take long lasting insulin, then continue as normal:
- Abasaglar® [insulin glargine]
- Humulin® I [isophane insulin]
- Insulatard® [isophane insulin],
- Insuman® Basal [isophane insulin]
- Lantus® [insulin glargine], Levemir® [insulin detemir]
- Semglee® [insulin glargine]
- Suliqua® [insulin glargine with lixisenatide]
- Tresiba® [insulin degludec]
- Toujeo® [insulin glargine],
- Xultophy® [insulin degludec with liraglutide]
- Or unless you take injectable GLP-1 receptor agonists, then continue as normal:
- Exenatide (Byetta, Bydureon)
- Dulaglutide (Trulicity)
- Liraglutide (Saxenda, Victoza)
- Lixisenatide (Lyxuma)
- Semaglutide (Ozempic, Wegovy)
- But you may take other required medications with water.
- Unless you take long lasting insulin, then continue as normal:
- Check your blood sugar levels at least hourly. If your sugar level is less than 4 or you feel ‘hypo’, have a sugary, non-fizzy drink, GlucoGel or glucose tablets to correct this
- Bring a drink and some biscuits or a sandwich with you for after your scan.
- If you have a continuous subcutaneous insulin pump you must contact your nurse contact specialist or care provider for specific advice. The information is intended to give standard advice to insulin and non-insulin dependent diabetic patients who have been asked to fast in preparation for an ultrasound scan with GP Care. However, every patient’s needs are different so if you have any doubts you are strongly advised to further seek the advice from your GP Practice or Diabetes Specialist Nurse.
Please arrive with a full bladder for this examination. Use the following instructions to achieve this:
- One and a half hours before your appointment time, go to the toilet and empty your bladder.
- Then drink 1½ pints (800ml) of water, or more to ensure your bladder is full.
- Finish drinking 800 ml of water 30 – 45 minutes before your exam time.
- Please DO NOT empty your bladder until after your examination.
- Please wear loose clothing to enable the sonographer to easily access the part of your body that is being examined.
For a female pelvic scan, in most cases, you will be offered a transvaginal (TV or internal) scan as this can often provide greater detail to aid diagnosis in the pelvic region. The Sonographer will place a narrow probe inside your vagina. This probe will have a latex-free cover over it. The probe is then gently moved to allow visualisation of the pelvic organs. The sonographer will discuss this examination with you, should it be required. You will be asked to empty your bladder before this procedure.
The examination can still be undertaken during your period, and will also be offered if you have not been sexually active in line with national guidelines.
If you have had a positive pregnancy test prior to your scan, please contact us on 0203 818 7777
Important
If you are unable to tolerate an internal scan you will be offered a transabdominal scan (TA) instead. Please follow Preparation instruction as outlined above.
Please arrive with a full bladder for this examination. Use the following instructions to achieve this:
- One and a half hours before your appointment time, go to the toilet and empty your bladder.
- Then drink 1.5 pints (800ml) of water, or more to ensure your bladder is full.
- Finish drinking 800 ml of water 30 – 45 minutes before your exam time.
- Please DO NOT empty your bladder until after your examination.
- You can continue to take any medication.
- Please wear loose clothing to enable the sonographer to easily access the part of your body that is being examined.
If you are known to the Renal Team, please contact us on 0203 818 7777 for further advice on how to prepare for your exam.
This is for all Ultrasound visits not listed in a Special Preparation section above.
- Please eat and drink normally prior to and after your scan.
- You can continue to take your usual medication.
- Please wear loose clothing to enable the sonographer to easily access the part of your body that is being examined.
What is an Ultrasound scan?
An ultrasound scan is a test that uses high frequency sound waves to create images of the organs and soft tissues in your body. It can provide accurate information about the size, shape and structure of these different parts. Ultrasound is a very commonly used method of imaging and has no known harmful effects on humans.
What to expect during a scan?
You will be called into the scan room and your identity will be checked. You will be asked to move or remove some clothing and then to lie down on an examination couch. The lights will be dimmed to allow the sonographer a clear view of the screen.
Gel will be spread on the area of your body being examined and the sonographer will place a hand-held probe onto your skin. By moving the probe, the sonographer will be able to see the necessary views of your anatomy to allow them to obtain the information needed. You may be asked to hold your breath at times to help them see more clearly. Selected images are saved as a record of the examination.
An ultrasound examination should not be painful, but some patients may occasionally find a little discomfort from the pressure of the probe over certain areas.
After your scan
After the examination you will be able to eat and drink as normal.
The sonographer will review the images and write a report of their findings and these results will be forwarded to your doctor. You should contact your doctor approximately one week after your appointment to get the results of the scan.
A corticosteroid (or ‘cortisone’) is an anti-inflammatory medicine, which can be injected directly into the soft tissues or joints that are causing your symptoms. It is a safer alternative to taking anti- inflammatory medication by mouth. It acts directly in the area injected and is not the same as the steroids taken by bodybuilders or athletes.
The injection can help to relieve swelling, pain and stiffness caused by inflammation. This may in turn help you to start your rehabilitation and return to normal activities sooner by ‘breaking the cycle’ of pain and inflammation. It can also be helpful to aid in the diagnosis of your condition if it is not clear which structures are responsible for your pain. You may also have a local anaesthetic injected at the same time, which allows for temporary pain relief.
Side effects of the injection are rare and however this includes:
- Flushing of the face for a few hours.
- Small area of fat loss or change in skin colour around the injection site.
- Post-injection pain: You may experience an increase in pain a few hours
- after your injection that can last a few days. You could continue you’re
- your pain killers or discuss this with your doctor or pharmacist.
- Diabetic patients may notice a temporary increase in blood sugar levels.
- Temporary bruising or bleeding if you are taking blood thinning tablets
- (such as aspirin or warfarin).
- Slight vaginal bleeding / menstrual irregularities.
- Allergic reaction (Anaphylactic shock):This is extremely rare but is a medical emergency and is associated with difficulty breathing (and other symptoms). It is most likely to happen in the first 15 minutes after an injection (usually involving analgesic) but can happen up to 6 hours after the procedure. For this reason, you will need to remain in the clinic / reception for 15 minutes after the injection. If you have any difficulty breathing or any unusual symptoms you must tell us immediately. If it happens after you have left you must seek medical help immediately. Treatment involves another injection and this must be administered quickly. However, please be assured this is extremely rare.
- Infection: if the area becomes hot, swollen and painful for more than 24 hours, or if you feel generally unwell, you should contact your physiotherapist or doctor immediately. If they are unavailable, you should seek advice from your GP or Accident & Emergency (A&E) department.
- Coronavirus: A side effect of corticosteroid injections is the increased risk of infection due to immunosuppression. This may increase the risk of contracting COVID 19 and the ability to fight a COVID 19 infection.
You SHOULD NOT have the injection carried out if you:
- Are in a high risk group of contracting coronavirus
- Have any infection in the area or anywhere else in your body.
- Are allergic to local anaesthetic or steroid.
- Feel unwell or due to have surgery in the treatment area soon.
- Are pregnant or breast feeding.
- Have poorly controlled diabetes.
- Do not want the injection or needle phobia
- Have Pancreatitis
- Lifestyle changes – rest activity modification
- Heat or cold packs, self-massage
- Pain relieving, anti-inflammatory gel application
- Use of anti-inflammatory medicines
- Physiotherapy
- Sometimes surgical opinion
Do I need any special preparation before an X-ray?
Usually there is no preparation required and you can continue to eat and drink as normal and take any medication.
What are X-rays?
X–rays are similar to light, except that they have a much higher frequency which makes them invisible to the naked eye. An X-ray is a widely used diagnostic test, used to examine the inside of the body by creating an image, like a photograph.
Why should I have an X-ray?
An X-ray will to help provide information that can assist your doctor to diagnose what may be wrong with you or can be used to monitor an existing condition.
What are the risks?
X-rays are a type of radiation known as ionising radiation. The dose that you get from a medical X-ray is very low and the associated risks are minimal. They are similar in strength to other sources of natural radiation that we are exposed to in everyday life. A dose from an X-ray is equivalent to just a few days natural back ground radiation. The Radiographer is responsible for keeping the dose as low as possible to ensure that the benefits outweigh any risks. For more information about the risks of having an X-ray please look at the following sites:
https://www.nhs.uk/conditions/x-ray/
What happens during an X-ray?
You will be taken to the X-ray room by the Radiographer; this person has had specialist training in taking X-ray images and the required qualifications to practice radiography. Your personal details will be checked and the examination will be explained to you. All patients between the ages of 12 and 55 will be asked if there is any possibility of them being pregnant before any examination can be performed.
You may be asked to stand, sit on a chair or lie on a bed, depending on the area being examined. The Radiographer will position the X-ray camera over the area to be examined and you will be asked to remain still during the procedure, as movement can affect the quality of the image and result in the process having to be repeated. For some examinations you may be asked to hold your breath whilst the X-ray is taken.
The radiographer will move behind a screen to take the image at a control panel, but will be able to see and hear you at all times. Often the radiographer will need to take two or more X-rays of the same area but from different angles to ensure maximum information is obtained for each examination. Once the X-ray is completed it will be viewed on a computer monitor and stored digitally.
Giving your consent to the X-ray
The Radiographer will ask you if you are happy for the X-ray to go ahead or if you have any questions. If you do not wish to have the X-ray, please inform a member of staff.
Remember, it is your decision. You can change your mind at any time and your wishes will be respected. This may however delay your diagnosis as the doctor may not have all the required information
How long will my X-ray take?
The examination will normally take 5-15 minutes depending on the area of the body being examined and the views required.
What happens after your X-ray?
You may be asked to wait while the X-rays are reviewed to ensure they meet with the requirements of your doctor/consultant. If no further images are required, you will be free to leave the clinic. A Consultant Radiologist, who specialises in interpreting X-rays will assess your images and write a report on the findings. The report will be forwarded to your clinician or GP to discuss with you during your follow up appointment.
All patients between the ages of 12-55 years will be asked if there is any chance of pregnancy when their pelvic area may be exposed to radiation.
Why am I being asked if I may be pregnant?
Your healthcare professional/Doctor has requested an X-ray that requires an exposure to radiation. We have a legal responsibility and professional duty to ensure that we protect individuals from unnecessary exposures to radiation.
It also ensures that specialist Doctors reviewing your images are aware of your registered sex at birth and any natural physical variations you might have in your pelvic anatomy, as this may be relevant to your diagnosis.
Please inform your radiographer if you are aware that you were born with an intersex variation, also known as variations in sex characteristics (VSC) or diverse sex development (DSD). We acknowledge that you may wish to use a different term when informing the radiographer of this.
What do we do with this information?
The Ionising Radiation (Medical Exposure) Regulations 2017 legally requires us to document that a pregnancy status check has been performed for examinations that may result in a radiation exposure to the pelvis and so we will store an electronic copy of this form in your confidential records.
If you do not wish us to save this form, please let us know. The form will only be available for the radiographer looking after you today, and the specialist Doctor reviewing your images.