Musculoskeletal Imaging & Sports Medicine
Arthrograms are a diagnostic tool performed in conjunction with MRI, CT or X-ray to evaluate joints. This procedure involves a contrast injection into the joint that enhances the visualization of structures and aids the evaluation of joint abnormalities, such as cartilage tears and other injuries.
Fluoroscopy makes it possible to see internal organs in motion. When contrast is injected into the joint space, it coats the inner lining of the joint structures and appears bright white on an arthrogram, allowing the radiologist to assess the anatomy and function of the joint.
How does the procedure work?
X-rays are a form of radiation like light or radio waves. X-rays pass through most objects, including the body. Once it is carefully aimed at the part of the body being examined, an x-ray machine produces a small burst of radiation that passes through the body, recording an image on photographic film or a special digital image recording plate.
Fluoroscopy uses a continuous x-ray beam to create a sequence of images that allow the radiologist to view the anatomy in real time on a screen similar to a television monitor. When used with a contrast material, which clearly defines the area being examined by making it appear bright white, this special x-ray technique makes it possible for the physician to view internal organs in motion. Still images are also captured and stored either on film or electronically on a computer.
Today, most images are digital files that are stored electronically. These stored images are easily accessible and are sometimes compared to current x-ray images for diagnosis and disease management.
What to Expect:
After local anesthesia, a needle is maneuvered into the area of interest under fluoroscopic guidance. Correct needle placement is confirmed by using a combination of imaging and injection of a small amount of iodinated contrast. A combination of a short-acting anesthetic, such as bupivacaine or ropivicaine, and an intermediate to long acting corticosteroid, such as triamcinolone, are then injected. The anesthetic can provide immediate pain relief lasting 4-6 hours while the corticosteroid takes effect approximately 1-2 days after the injection, reaching maximum effectiveness within 5-7 days. The duration of the pain relief varies depending on the severity and reversibility of the patient’s condition. If therapeutic effect is achieved, several injections per year can be performed with few long term consequences.
The procedure is most often used to identify abnormalities within the:
The procedure is also used to help diagnose persistent, unexplained joint pain or discomfort.