Fluoroscopy - Arthrogram

What is an arthrogram?

An anthrogram is the fluoroscopic evaluation of a joint after the injection of a dye-like contrast material and sometimes air to outline the soft tissue and joint structures on the images.

What are some common uses of the procedure?

Arthrography is most commonly used to identify abnormalities associated with the shoulder, hip, knee, wrist or ankle.  Patients who undergo this procedure usually complain of persistent, unexplained joint pain or discomfort.  Arthrographic images may allow identification of problems with a joint's function or indicate a need for joint replacement.

How should I prepare for the procedure?

No special preparation is necessary before an arthrogram.  Food and fluid intake do not need to be restricted.

Before the procedure begins, you will be asked to remove all jewelry and to change into a gown, so that no metal items will show up on the images.

Women should always inform their physician or technologist if there is any possibility that they may be pregnant.

What does the equipment look like?

You will be positioned on an exam 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 in the exam room.  Underneath the table will be a special drawer that holds film in a cassette tray for the development of still images.

How does the procedure work?

Contrast material, and sometimes air, is injected into the joint.  Images are taken before the joint tissue absorbs the contrast material.  Occasionally, the radiologist will take additional images as they push and/or pull on the joint.

How is the procedure performed?

In the exam room, you are positioned on a table to examine the affected joint.  Simple x-ray images are obtained before the contrast material is injected for comparison to the arthrogram images containing contrast.  Next, the skin around your joint is cleansed with antiseptic, and a local anesthetic is injected in the area around the joint.  A needle is then inserted into the joint space.  If the fluoroscopic images show correct needle placement, the contrast material, and sometimes air, are injected into the joint.  After the injection, the needle is removed.  You may be asked to move the joint somewhat to evenly distribute the contrast material.  Still images are then obtained with the joint in various positions.

Often times, arthrograms are followed by an MRI or Computed Tomography (CT) scan, for additional evaluation and information while the contrast material is still present in the joint.

The exam is usually completed within 45 - 60 minutes.

What will I experience during the procedure?

To many patients, the thought of having needles plunged into their joints seems particularly gruesome.  Just as major dental work is done only after the administration of an anesthetic to numb the area, your joint area will be numbed so you do not feel anything related to the arthrogram.  Initially, you will feel a slight pinprick and experience a burning sensation as the local anesthetic takes effect.  You may also experience fullness as contrast is added to the joint, or hear gurgling as the joint is moved.  Some patients also experience discomfort as a result of lying on the exam table, a hard surface that is typically quite cold.

Who interprets the results and how do I get them?

A radiologist will interpret the images, and a signed report will be sent to your physician who will discuss the results with you.