What You Should Know About Your Arthrogram

What is an arthrogram?

An arthrogram is an image that your health care providers use to evaluate the condition of your joints. It is frequently used to identify problems in the hip, shoulder, elbow, wrist, knee, or ankle. Arthrography can be performed using a variety of imaging techniques, including fluoroscopy, MRI, and CT.  Injected contrast material outlines the distinct structures within the joint, such as cartilage, bone, and ligaments, better enabling the radiologist to accurately assess their condition.[1]

What should I expect during the procedure?

The radiologist will clean the joint to be examined to prevent infection and then insert a needle to inject the contrast.  The type of contrast will depend upon what type of imaging is used.  For X-ray images (fluoroscopy and CT), iodine contrast is used; in MRI arthrography, the contrast is gadolinium-based.[2] The radiologist remains in the room and views the live images. You may be asked to change positions during the procedure to create the most useful images possible for your diagnosis. 

If your doctor orders an MRI arthogram, following the injection of contrast, you will be escorted to the MRI suite for an MRI exam of the injected joint.   You may experience increased discomfort in the affected joint immediately following the procedure.  Be sure to avoid heavy lifting and other strenuous activity for at least the next 24 hours.

How should I prepare? 

An arthrogram requires very little preparation on the patient’s part.  You should, however, consider a few things:

• If you will be undergoing a CT or MRI arthrogram and tend to experience claustrophobia or anxiety, let your radiologist know. You may be a good candidate to receive sedative medication prior to the procedure to put you at ease.
• If you will be getting an MRI arthrogram, remember that the MR machine contains a powerful magnet. Leave all unnecessary metallic objects at home (or at least outside the MRI room), including all jewelry, hairpins, credit cards, hearing aids, eyeglasses, removable dental work, and pocket knives.  This is not a complete list.  If you have any kind of implanted or imbedded metallic or electronic objects in your body, be sure to tell the radiologist so we are able to ensure your safety. For more information about MRI safety, see our post, "MRI Safety – Practical Points for Patients and Providers"
• Let the radiologist know if you have impaired kidney function.  This may affect the decision to use an imaging technique that requires a contrast medium.[3]

What risks are associated with arthrography?

Arthrography is a safe procedure with a low incidence of complications. The most serious associated complication is infection of the joint.  For this reason, the area is cleansed thoroughly prior to injection, and injections will not be made through broken or infected skin.  Approximately 1 in 40,000 patients who undergo arthrography develop joint infection following the procedure.  A small percentage of patients have an allergic reaction to the contrast material.  About 1 in 2,000 experience a mild reaction such as hives.  Severe reactions are rare.[4]

When can I expect to know my results?

Our radiologists will review your MRI, CT, or fluoroscopy images and send a report to your physician within one business day.  Your doctor will review your report and then contact you with the results.

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Sources 

[1] http://www.radiologyinfo.org/en/info.cfm?pg=arthrog

[2] Ibid.

[3] http://www.insideradiology.com.au/pages/view.php?T_id=54 - .VLh4pEvxXos

[4] Ibid.