Arthrogram

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An arthrogram is an X-ray of a joint after injection of a contrast medium. The injection is normally done under a local anesthetic. An arthrogram can be performed similarly to an MRI scan; as such, the patient can be scanned from many angles at once and the consultant/radiologist can assess the images produced by the scan in real time.

The contrast medium used during an MRa scan may vary among hospitals, but iodine is generally used.

Purpose/Description/Indications: Radiography to visualize the soft tissue structures of a joint or joints (menisci, ligaments, articular cartilage, bursae). The contrast study can be done on any encapsuled joint; however, the knee is the most frequent site of investigation. Arthrogram examinations are usually done with a local anesthetic. The injection is made under careful aseptic conditions in combination with fluoroscopic-radiographic examining room, which should be carefully prepared in advanced.

Contraindications/Risks: Contraindications are patients who are allergic to or sensitive to medications, contrast dyes, local anesthesia, iodine, shellfish, or latex. Potential risks are infections at the puncture site where the radiopaque substance and/or air are injected.

Contrast: For pneumoarthrography, a gaseous medium is used, for opaque arthrography a water-soluble iodinated medium is used and a combination of both is used in double-contrast arthrography.

Patient Prep/Patient Position: The patient is asked to remove any clothing, jewelry, or other objects that may interfere with the area of interest. The area around the joint is scrubbed with an anti-bacterial soap and covered with sterile drapes, usually leaving a small space for the injections.

Equipment/Types of Images: The exam is done under the fluoroscope to guide the needle into the correct place in the joint.

Findings: Shoulder arthrography can be used to study tears of the rotator cuff. The procedure can also define subtle abnormalities of the bicipital tendon and sheath, and can demonstrate the nature of periarticular soft tissue masses. Alternative Exams: MRI allows a noninvasive imaging technique to evaluate joints.