Arthrography is the radiographic or MRI examination of a joint after the injection of a dye-like contrast material to outline the soft tissue and joint structures on the image. Arthrography is done most commonly to identify abnormalities associated with the shoulder, elbow, wrist, hip, and ankle. Patients who undergo this procedure usually have complained of persistent, unexplained joint pain or discomfort. Arthrography may identify problems with a joints function or indicate the need for a joint replacement.
There is no special preparation required before arthrography. You may be required to change into a gown for your examination, and to remove jewellery, and any metal objects that could obscure the x-ray images. Women should always inform their doctor or the x-ray technologist if there is any possibility that they are pregnant.
You will be positioned on an examination table. Above you will be a box-like structure containing the x-ray tube and fluoroscopic equipment that will send the images to a screen monitor for viewing by the Radiologist.
Other equipment necessary for performing arthrography includes a variety of needles, syringes, water soluable and colourless contrast material and sterile sponges and bandages.
Contrast material is injected into the affected joint. A series of x-rays called arthrograms are obtained before the joint tissue absorbs the contrast material.
Once positioned on the examination table, x-ray images of the affected joint are obtained to compare with the arthrograms.
Next, the skin around the joint is cleaned with antiseptic, and a local anaesthetic is injected into the area around the joint. A needle attached to a syringe containing contrast material is inserted into the joint space. If the fluoroscopic examination shows correct needle placement, the contrast material is injected into the joint space. The needle is removed and you will be asked to move the affected joint to more evenly distribute the contrast material. Images are then obtained with the joint in various positions. Sometimes MRI images are obtained after the contrast material has been injected.
The examination is usually complete within 20 minutes.
As the joint is numbed with local anaesthetic you do not feel anything related to the arthrographic procedure. Initially, you may experience a slight pinprick and momentary burning as the anaesthetic is injected into the joint area. Soon, you will note the numbing sensation around the joint. You may feel a fullness as the joint is filled.
Arthrography is especially effective for detecting tears or lesions of the structures and ligaments of the shoulder, elbow, wrist, hip and ankle as well as rotator cuff tears or damage from a shoulder dislocation.
Arthrography is not recommended for patients suffering from arthritis or joint infection. Patients who have known allergies to iodine may have an adverse reaction to the contrast material, although, because the contrast material is injected into a joint and not a vein, allergic reactions are rare.
After the examination the affected joint should be rested for 12 hours. You may experience mild swelling and discomfort. Occasionally there may be severe pain in the few days after the procedure. Bruising may be seen at the needle site.
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