Patient Information
If you are unable to find the information you are looking for or have any further questions please do not hesitate to contact our practice and we will be happy to assist you.
Breast Biopsy
What is it?
A biopsy is a sample of tissue obtained to look at its microscopic structure and cells. It can also be used for other tests such as hormone receptor status.
It is different from a fine needle aspiration (FNA)which only looks at cells and not structure.
Why do I need it?
You may have felt a lump in your breast, and the xrays and ultrasound may have revealed a lesion. Alternatively, you may have had a FNA which was suspicious or inconclusive.
The cell type and structure in a lesion helps your doctor or surgeon make a definitive diagnosis and formulate a management plan.
How is it performed?
At Uniradiology, the breast biopsies are performed under ultrasound only. Xray guided or stereotactic biopsies are not performed.
The Radiologist will explain the procedure and answer any questions you may have. You will be asked to sign a standardised consent form.
The procedure is done with you lying on your back. The skin is prepped using an antiseptic solution. An ultrasound probe is used to localise the lesion. An injection of local anaesthetic will be given prior to the biopsy needle being inserted. One or several samples may be taken, depending on the lesion.
When the biopsy is taken you will hear a loud click, which is the needle taking the sample. It is important to stay still at this time. A dressing is used on the wound and you will be given an ice pack to place on the wound site.
An uncomplicated procedure involving one lesion should take around 10-15 minutes.
The sample is sent to pathology. Usually results take around one week.
Are there any risks with the procedure?
Bleeding is usually self limiting and pressure on the wound immediate after the procedure can minimise bleeding and bruising.
Infection is rare. If there is any redness, swelling, pain or if you develop fevers after the procedure, contact your local doctor as you may require antibiotics.
In patients with breast implants, there is a very small chance of the needle perforating the implant. If this happens you will need to see a surgeon for further management. Please inform us when you make the booking if you have breast implants.
Is it painful?
The local anaesthetic will sting for several seconds, after which you should not feel any pain. You will however still feel pushing as the procedure is being performed.
After the procedure the local anaesthetic will wear off, and the breast may be uncomfortable. If required, a simple analgesic such as Panadol can help. However if there is excessive pain, or any associated redness, swelling or bleeding you should contact the Radiologist or your local doctor.
What can I expect after the procedure?
You should expect some bruising which will disappear over the next several days. The dressing can be removed in 24-36 hours. You should avoid strenuous activity for 24 hours after the procedure.
You may find it uncomfortable to drive after the procedure, and having someone drive you home may be helpful. However, usually driving after the procedure is not a problem.
How should I prepare for the procedure?
If you are on blood thinning medication, such as Aspirin or Warfarin, it may be appropriate to cease these prior to the biopsy. Please discuss this with your doctor and inform us when making the appointment.
Please bring in any breast imaging and reports with you on the day.
Are there any upfront costs?
There are no upfront costs if you have a Medicare card.
What if I have more questions?
Please feel free to contact us if you require further information.
Shoulder Hydrodilatation
What is it?
This is a procedure whereby fluid is used to dilate the shoulder capsule in order to relieve immobility and improve pain in cases of frozen shoulder, also known as adhesive capsulitis.
How is the procedure performed?
At Uniradiology, the doctor will first discuss the procedure with you in order to answer any questions you may have. You will be asked to sign a standardised consent form.
You will change into a gown with the affected shoulder exposed.
The procedure is performed using Ultrasound or CT guidance to ensure accuracy.
The skin is prepped with chlorhexidine, an antiseptic agent. A small amount of local anaesthetic is used to numb the skin. A needle is then placed into the shoulder capsule. Once in the correct position, a combination of Cortisone, local anaesthetic, and normal saline will be injected in order to dilate the shoulder capsule. Up to 40mL can be injected.
A small dressing will be placed on the skin at the injection site.
What will I feel during the procedure?
The local anaesthetic is usually associated with a very short sting.
During the dilatation, the shoulder will feel tight and heavy. Some patients describe a feeling of pressure. Some patients may experience discomfort or pain, and you should let the doctor know, the procedure may be stopped at this point.
How long does the procedure take?
The procedure itself does not take very long, approximately 10 minutes. However, this does not include time for paperwork, preparation of materials, changing gowns, etc. All up, the procedure should take around 30 minutes.
What happens after the procedure?
You will be asked to remain in the department for a short period of time (30 minutes) to make sure you are well enough to go home.
Ideally you should have someone drive you home, or take public transport. You may find that your arm is clumsy after the procedure. It may also feel heavy or tight for a couple of days.
Gentle movements of the shoulder are encouraged to prevent adhesions from reforming. However heavy lifting and intense activity should be avoided for 2-3 days.
You should consult your physiotherapist for advice on an exercise program or how much to use your arm.
Are there any potential complications?
This is a very common and safe procedure. However there are some risks.
Infection is rare but is a known complication arising from this procedure. You may feel the shoulder become hot and increasingly painful. You may develop fevers.
If this happens you should see your local doctor or go to the emergency department for further management and antibiotics. Early antibiotic treatment is very successful and important.
Allergic reactions to contrast material are even rarer, but can be potentially life threatening. If you have a known allergy to contrast you should let the staff and the treating doctor know. An allergic reaction may manifest as breathing difficulties, swelling of the face and airway. This requires immediate emergency medical help.
Bleeding. This is usually only a problem if you are on blood thinning medication such as Warfarin. You should come off these medications and wait until your blood levels have normalised prior to the procedure.
How should I prepare for the procedure?
Apart from those patients who require cessation of their blood thinning medication, no specific preparation is necessary. You should ideally avoid driving and therefore having someone to drive you home is preferable.
Please let the staff know if you have any allergies.
Will I need to pay any up front costs?
At Uniradiology Southport, there is no cost to patients as this service is bulk billed.
What if I have further questions?
Please feel free to contact our staff if you require further information.
CT Guided Nerve Root and Facet Joint Injection
What is it?
This procedure uses the CT images to guide the radiologist in placing a needle either adjacent to a nerve root as it leaves the spine, or into a joint in the back (facet joint). The needle allows for an injection of steroid and/or local anaesthetic for treatment of back pain and/or sciatica.
Why do I need it?
Patients with back pain that has not responded to conservative measures (e.g. medications, massage, physiotherapy) may benefit from this type of procedure. In particular, this is performed if there is evidence that the back pain is localised to a particular facet joint, or due to compression of one of the nerve roots.
The steroid component in the injection decreases the bodies’ inflammatory response which can relieve pressure on a nerve root, or relieve pain caused by degeneration.
How do I prepare for it?
Patients on blood thinning medication such as warfarin should cease and have their levels normalised prior to attending. Please discuss this with your local doctor.
You should have someone drive you home afterwards, or take public transport. If you must drive, please wait until the effects of the local anaesthetic have worn off before driving.
Please bring all your radiological examinations with you when you attend.
How is the procedure performed?
The radiologist will explain the procedure and answer any questions you may have. You will be asked to sign a standardised consent form if you are happy to proceed.
The procedure is performed with you lying face down on the CT table. An initial planning CT scan is performed to localise the affected joint or nerve root. The radiographer/radiologist will then mark the entry point on your skin with a pen. It is important to stay very still during this as any movement can disrupt the planned needle route.
The radiologist will clean the skin with an antiseptic solution and inject a small amount of local anaesthetic at the entry point in the back. The needle is then placed in the correct position using the CT images. Once there, the injection is performed, the needle is removed and a dressing placed at the entry point.
What will I feel, is it painful?
The local anaesthetic will sting for several seconds, after which you will feel no pain as the needle is placed. However, when the medication is injected, you may feel exacerbation of your back pain and you may have pins and needles down the leg. The local anaesthetic may also cause the leg or foot to feel numb. This is transient and will recover when the local anaesthetic wears off.
You may go in and out of the CT scanner several times. This is normal, and it is important to stay still during this.
The whole procedure usually takes around 10-15 minutes.
What are the risks?
Bleeding can occur but is usually self limiting. Very occasionally the bleeding may worsen the compression of a nerve root which will worsen the pain. This will resolve once the blood is absorb by the body.
Infection is rare, and may be centered on the skin or around the nerve root (arachnoiditis). Archnoiditis is minimised by CT guidance.
Unintentional injection of the nerve root itself, rather than around the nerve root can cause damage to the nerve. This can result in worsening of the pain, loss of sensation and weakness. CT guidance again minimises this risk.
How long will the effects last for?
As this is a treatment and not a cure, results are variable and usually transitory, although some patients only require a single injection for complete relief of symptoms.
Most patients get relief for months to years, while occasionally there is no benefit.
Can I get more than one level injected in a single sitting?
Yes, this is possible. However most patients prefer to have only the worst level injected initially, as this may be all that they need. The risks of having more than one level injected include a wider field of numbness post procedure and possible exacerbation of the pain over the coming 24-48 hours.
Your doctor and radiologist will discuss the pros and cons of your specific case.
Are there any upfront costs?
At Uniradiology Southport, there is no cost to patients as this service is bulk billed.
Apart from this, there are no additional costs for medicare card holders.
What if I have further questions?
Please feel free to call our staff if you have any further questions.