An introduction to Arthrography
Joints such as the shoulder, elbow, wrist, hip, knee, or ankle can be affected in many ways, causing pain and discomfort. You may fracture your bone, wear down cartilage, dislocate your shoulder or tear a ligament in your knee. Oftentimes, standard imaging, such as X-ray, do not show sufficient detail to locate the source of the problem. That’s when an MR Arthrogram, also called MR Arthrography, may be required as it can capture better and clearer pictures of the joint and the surrounding soft tissues.
Common uses of the procedure
Arthrography is usually recommended when there has been unexplained and consistent pain, discomfort, loss of motion, or variations in the way the joint works. Other common uses for which arthrography is used include:
- To identify problems like tears in the soft tissues of the joints, including ligaments, tendons, cartilage, and joint capsules
- To determine the damage from recurrent dislocations of the joint
- To examine prosthetic joints
- To check for synovium or cartilage problems
- To locate loose bodies in the joints
How is an MR Arthrography performed?
Arthrography may be indirect, where contrast material is injected into the bloodstream, or direct, where contrast material is injected into the joint. The contrast material contains gadolinium that affects the local magnetic field within the joint to produce high-quality, enhanced images of even the most minor structures in and around the joint. Once the contrast material is in the joint, pictures of the joint area will be captured using MRI.
What to expect during the exam
In the first part of the exam, the patient is positioned on an exam table in the procedure room. The skin around the joint is then cleaned with an antiseptic solution and numbed by using a small needle to inject a local anesthetic.
A small needle will be placed in the joint and contrast material will be injected into the joint space. Some patients may feel a slight pressure sensation or discomfort as the contrast is injected.
After the injection, the patient may be asked to move the joint so that the dye spreads out.
Once the contrast dye has moved throughout the joint, an MRI of the joint will be performed. The entire process (injection and MRI) usually lasts between 1 to 2 hours.
How to prepare (before/ during/ after)
Specific instructions will be given when scheduling your appointment. Depending on your age and medical history, you may be required to complete bloodwork and other tests and cease certain medications.
On the day of your exam, you may need to restrict eating or drinking for a few hours prior to your appointment.
During the test, you may be asked to move the joint and change position which could cause slight discomfort. During the MRI portion, you will need to remain still until the test is complete.
Following the procedure, you might be advised to rest the joint for some hours as there may be mild swelling and fullness around the joint.
Results and follow-up
Once the exam is complete, the images produced will be reviewed by a radiologist and a full report, along with the images, will be sent to your healthcare provider, usually within 24 to 48 hours. Your healthcare provider will then contact you to go over the results and discuss the recommendations and next steps in your treatment plan.