Diagnostic Testing

Autonomic Nervous System Test

Autonomic Nervous System (ANS) is a painless, non-invasive diagnostic tool that may be ordered by your doctor to assess your body’s physiological response to stimuli or nerve damage in the body. The test assesses communication from your brain to various organs in your body such as the heart and vascular system, lungs, kidneys, stomach, liver, intestines and digestive systems. This is testing for dysfunction outside of your conscious control. It does not measure for any specific disease but it helps understand the degree of dysfunction to parts of the nervous system controlling certain areas of the body. The autonomic nervous system regulates processes such as blood pressure, heart rate, temperature, digestion, metabolism and electrolyte balance, urination, sweating, sexual functions and more.

It is well established that healthy autonomic activity reduces complications of chronic disease thereby reducing morbidity and mortality.

Autonomic Nervous System (ANS) testing is a simple test that lasts anywhere from 7 – 15 minutes depending on the model of the system. ANS testing is based on Heart Rate Variability (HRV) which (in its simplest form) monitors the R-R intervals, beat by beat blood pressure and pulse wave form throughout all segments of the test. The general concept is for the patient to perform a series of maneuvers while the ANS system monitors the body’s response. The system looks at changes in heart rate & blood pressure to calculate response as well as autonomic balance in both branches of the autonomic nervous system – the parasympathetic & sympathetic nervous systems.


There are no known risks to having ANS testing.

How to prepare

No special preparation is required for this test.

What to Expect

The test will last up to 15 minutes total and consists of four parts. You will be guided through the sections by a technician. You may be asked to undress from the waist up so the tech can place electrodes to monitor your heart rhythm for a portion of your test.

After the test is complete, you may resume normal activities as tolerated.

Autonomic Nervous System Testing. Autonomic Dysfunction Website. https://autonomicdysfunction.com/autonomic-nervous-system-ans-testing Accessed January 30, 2019

Autonomic Nervous System Testing. Blue Cross Blue Shield. https://www.bcbst.com/mpmanual/Autonomic_Nervous_System_Testing.htm. Accessed January 30, 2019.

Bone Density

A Bone Density scan, or a dual-energy X-ray absorption (DEXA) is a noninvasive test your doctor orders to screen you for osteoporosis or to decide if treatment needs to be started for you. It may also be used to screen for maintenance of bone health while a patient is on therapy to ensure there is no further bone loss and that the medication is working. The test is not painful, is more precises than an X-ray and your results are compared to peak bone mass of an average healthy adult of the same gender and age group. Talk to your provider about getting screened if you think you may be as risk.

You may be a risk for bone loss if:

  • You have experienced early menopause, surgical or natural
  • You have a history of heavy smoking and/or drinking
  • You have female, blood related relatives with osteoporosis or bone fractures
  • Long term medication use for other illnesses that lead to bone decay (steroids, some anti-seizure medications, etc.)
  • You are Asian or Caucasian descent
  • You already have bone fractures
  • You are female Over 65 years old
  • You are make Over 70 years old
  • You are a thin male with loss of height

How to Prepare

  • You can typically eat before this test but avoid Ca supplement 24 hours prior to the test.
  • Notify us if you are possibly pregnant or have been injected with nuclear medicine or have had a recent barium exam.
  • Remove any metal piercings or objects from your person and clothing as these interfere with the images.
  • You may be asked to wear a gown as the portion being examined may need to be undressed.

How it Works

  • The tech will prep and position you and will be nearby to instruct you on how to turn for the desired images.
  • Images will be taken of your lower spine and hips. If you have had a hip replacement, alternate studies may be required or images of just your spine will be taken if both hips were replaced.
  • When the image is taken, the scanner will hover and move across you without making any direct contact.
  • When the exam is finished, you may dress and proceed with regular activities.
  • A radiologist will interpret the images and report back to your provider.

Electrocardiogram (ECG/EKG)

An electrocardiogram is a painless, non-invasive test used to quickly detect for heart problems or monitor the status of a heart condition after or during a procedure, if medications are working, etc.

In a standard EKG, abnormalities will only be recorded if the patient is experiencing those symptoms at the time of the test. If the patients symptoms come and go, a different type of EKG may be done, called a holter monitor (add link to click on word)

If you have the following symptoms, you may require an EKG:

  • Chest Pain
  • Shortness of Breath
  • Irregular heart beat
  • Dizziness, lightheadednedd
  • Weakness, fatigue
  • Palpitations


There are no known risks to having an EKG done.

How to Prepare

  • No specific instructions for preparation.

What to Expect

  • You may be asked to undress from the waist up and hair from the chest may be removed. A technician will place electrodes on your chest and sometimes your limbs. The electrical activity from the impulses in your heart are measures as waves on a graph that corresponds to each phase of the heartbeat.
  • The test takes about 10 minutes to perform and you may resume all activities after the test is complete.
  • Notify your doctor and technicians about the medications you take and if they are safe to take prior to the test.

Electrocardiogram. Mayo Clinic. https://www.mayoclinic.org/tests-procedures/ekg/about/pac-20384983 Accessed January 28, 2019.

Holter Monitor

A holter monitor is a wearable wire device that monitors your heart beat. Your doctor may order this if your symptoms are coming and going. This test can monitor your heart for one or two days. It may be ordered by your doctor if there was not enough information found on the EKG. If it still does not reveal enough information, your doctor may order a wireless monitor for several weeks. It can be done to explain irregular heartbeat, unexplained fainting, etc.


There are no known risks regularly associated with holter monitor application and use.

What to Expect

  • Bathe prior to your appointment as you may not be able to until its removed.
  • You may be asked to undress from the waist up, and hair may be removed from parts of the chest if needed. Electrodes are placed on the chest and you will be instructed on how to keep the wires and electrodes.
  • You will be asked to record daily activities and symptoms while wearing the monitor.
  • It is non-invasive and painless and you may resume most activities as normal unless otherwise directed by your doctor.
  • Your doctor will review the results and your symptoms and may recommend further testing or treatment.

Holter Monitor. Mayo Clinic. https://www.mayoclinic.org/tests-procedures/holter-monitor/about/pac-20385039 Accessed January 28, 2019.

Holter Monitor. American Heart Association. https://www.heart.org/en/health-topics/heart-attack/diagnosing-a-heart-attack/holter-monitor Accessed January 28, 2019.


X-ray is a quick and painless diagnostic picture taken of a portion of your body, highlighting mostly the bone structure. These mediums are barium or iodine. X-ray beams shoot through your body and are absorbed according to the density of the material they pass through. Bones and metallic objects appear white, lungs filled with air appear black and the muscles and fat appear mostly gray. Examples of what X-rays detect: bone decay or fracture, infection, one cancer, foreign objects, lung infection, enlarged heart, vascular disease, digestive issues, etc.


Radiation exposure is concerning for some due to beliefs that if you receive too much radiation it may cause cancer. The risk is quite low and generally the risk is outweighed by the benefit in most situations.

Suspected or confirmed pregnant women should notify their doctor of such prior to having any testing done.

Children are at a greater risk for sensitivity to radiation than adults.

How to Prepare

Typically you will need to undress the part of the body being examined. You may be asked to wear a gown and remove all jewelry and metallic objects.

What to Expect

  • A tech will position you accordingly to obtain the views needed. You may be asked to stand still or hold your breath to avoid moving.
  • After the test you may resume all activities as normal.  The images will be sent to a radiologist for interpretation and the results sent back to your doctor to review with you.

X-ray. Mayo Clinic. https://www.mayoclinic.org/tests-procedures/x-ray/about/pac-20395303 Accessed January 28, 2019.

X-ray Medline Plus. https://medlineplus.gov/xrays.html Accessed January 28, 2019.