Radiologic examination, abscess, fistula or sinus tract study, radiological supervision and interpretation
CPT4 code
Name of the Procedure:
Radiologic examination, abscess, fistula or sinus tract study, radiological supervision and interpretation.
Common name(s): Sinogram, Fistulogram
Summary
A radiologic exam to visualize and assess abscesses, fistulas, or sinus tracts within the body. The procedure involves the use of contrast dye and X-ray imaging to create detailed images for evaluation.
Purpose
This procedure is used to diagnose and evaluate the extent and characteristics of abscesses, fistulas, or sinus tracts. The goal is to identify the presence, location, and connection of these abnormal passages to guide appropriate treatment.
Indications
- Persistent or unexplained infections
- Suspected abscess formation
- Chronic draining sinuses
- Unexplained fluid collections
- Recurrent skin or tissue infections
Preparation
- No eating or drinking for a specified period before the procedure, usually a few hours.
- Inform the healthcare provider of any allergies, particularly to contrast dye or iodine.
- Blood tests or other imaging studies may be conducted prior for more information.
Procedure Description
- The patient lies on an X-ray table.
- The treatment area is cleaned and sterilized.
- A small needle or catheter is inserted into the abscess, fistula, or sinus tract.
- Contrast dye is injected through the needle or catheter.
- X-ray images are taken to track the flow of the dye and visualize the structure.
- The healthcare provider interprets the images to assess the condition.
- Upon completion, the needle or catheter is removed, and the site is covered with a sterile bandage.
No anesthesia or only local anesthesia is typically used for comfort.
Duration
The procedure usually takes about 30-60 minutes.
Setting
Performed in a hospital radiology department or an outpatient imaging center.
Personnel
- Radiologist
- Radiologic technologist
- Nursing staff
Risks and Complications
Common:
- Mild discomfort or pain at the injection site
- Allergic reaction to contrast dye
Rare:
- Infection at the puncture site
- Bleeding
- Rare severe allergic reaction
These risks are usually manageable with appropriate intervention.
Benefits
The procedure provides detailed images that help diagnose and treat abscesses, fistulas, or sinus tracts, leading to more targeted and effective treatment. Results are typically available within a few days.
Recovery
- Keep the injection site clean and dry.
- Monitor for signs of infection (e.g., redness, swelling, increased pain).
- Follow-up appointments may be needed to discuss results and next steps.
- Most patients can resume normal activities immediately but should follow specific instructions given by their healthcare provider.
Alternatives
- Ultrasound imaging
- MRI or CT scan
- Clinical examination without imaging Each alternative has its pros and cons, such as different sensitivity levels, costs, and availability.
Patient Experience
Patients may feel some pressure or slight discomfort during the needle insertion and injection of the contrast dye. Pain is usually minimal, and comfort measures such as local anesthetics are used. Most patients can return to normal activities shortly after the procedure. Pain management and post-procedure care are discussed to ensure patient comfort.