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General Radiology

Arthrogram 

Arthrography, or an Arthrogram, is medical imaging to evaluate conditions of joints. Conventional arthrography is the x-ray examination of a joint that uses a special form of x-ray called fluoroscopy and an injection of a contrast material containing iodine directly into the joint. Beverly Hospital's Radiology departments use advanced digital technology to produce high quality images with minimal doses of radiation to capture images of the body. 
Alternate methods of arthrography examinations use magnetic resonance imaging (MRI) or computed tomography (CT).

An x-ray (radiograph) is a noninvasive medical test that helps physicians diagnose and treat medical conditions.  Imaging with x-rays involves exposing a part of the body to a small dose of ionizing radiation to produce pictures of the inside of the body.  X-rays are the oldest and most frequently used form of medical imaging.

Fluoroscopy makes it possible to see bones, joints and internal organs in motion.  When an iodine contrast is injected into the joint, it fills the entire joint and becomes clearly visible during x-ray evaluation, allowing the radiologist to assess the anatomy and function of the joint.  Although the injection is typically monitored by fluoroscopy, the examination may involve taking radiographs for documentation.

Why is it performed?
Arthrographic images help physicians evaluate alterations in structure and function of a joint to help to determine the possible need for treatment, including arthroscopy, open surgery or joint replacement.  The procedure is most often used to identify abnormalities within the:

-shoulder
-wrist
-hip
-knee
-ankle
-elbow

How should I prepare?
No special preparation is necessary before arthrography.  Food and fluid do not need to be restricted unless a sedative will be given. You should inform your physician of any medications you are taking and if you have any kidney problems or allergies, especially to iodinated contrast.  Women should always inform their physician and x-ray technologist if there is any possibility that they may be pregnant.  Many imaging tests are not performed during pregnancy so as not to expose the fetus to radiation.  If an x-ray is necessary, precautions will be taken to minimize radiation exposure to the baby.

How is it performed?
This examination is usually done on an outpatient basis.  The patient is positioned on the examination table and x-rays are taken of the joint to be compared later with the arthrogram images.  The skin around the joint is cleaned with antiseptic and is covered with a sterile drape.  Using a small needle, our radiologist injects local anesthetic into the area.  After the local anesthetic has taken effect, a longer needle is then inserted into the joint.  The contrast material is injected into the joint space while our radiologist observes with fluoroscopy.  After the needle is removed, the patient will be asked to move the affected joint to distribute the contrast material throughout the space.  In some cases, our radiologist will move the joint while evaluating the joint motion under fluoroscopy.
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What will I experience during and after the procedure?
You will experience a slight pinprick and may feel a momentary burning if a local anesthesia is used to numb the joint area.  You may feel a fullness as the joint is filled and hear gurgling when the joint is moved.  After the examination, you may experience swelling and discomfort.  You may apply ice to the joint to reduce swelling if it is bothersome.  A mild, over- the- counter analgesic can be taken for pain.  These symptoms usually disappear after 48 hours.  Contact your doctor if they persist after 48 hours. Vigorous exercise is not recommended for 12 hours after the exam.

The conventional arthrography exam is usually completed within 30 minutes.  If you go on to have a CT or MRI following your arthrogram, exam time may be 1-2 hours.

One of our board certified radiologists will interpret the images and send a report to your referring physician within 24 hours.