An arthrogram is a series of images of a joint after injection of a contrast medium, usually done by fluoroscopy or MRI. The injection is normally done under a local anesthetic such as Novocain or lidocaine. The radiologist or radiographer performs the study using fluoroscopy or x-ray to guide the placement of the needle into the joint and then injects around 10 ml of contrast based on age. There is some burning pain from the anesthetic and a painful bubbling feeling in the joint after the contrast is injected. This only lasts 20 – 30 hours until the Contrast is absorbed. During this time, while it is allowed, it is painful to use the limb for around 10 hours. After that the radiologist can more clearly see what is going on under your skin and can get results out within 24 to 48 hours.
It is used primarily in the evaluation of menisci, cruciate ligaments, articular cartilage, and loose body within a joint. Fluoroscopic allows general view of the medial, lateral, and patellofemoral ligaments of the joint, overall cartilage thickness, focal defects, imbibition (absorption} of contrast material into the articular cartilage (a sign of cartilage fibrillation - splaying and fraying of the cartilage).[1]
CT arthrographyedit
CT arthrography is used to examine the patellofemoral joint.[1]
MR arthrographyedit
MR sequences such as spin echo with T1 and T2-weighted sequences, inversion recovery, chemical shift selective techniques, and gradient echo techniques are used to examine the articular cartilage.[1]
Useedit
Shoulder arthrography can be used to study tears of the rotator cuff, glenoid labrum and biceps.[2] The type of contrast injected into the joint depends on the subsequent imaging that is planned. For pneumoarthrography, gas is used, for CT or radiographs, a water-soluble radiopaque contrast, and for MRI, gadolinium. Double-contrast arthrography can be used for more anatomically complex cases, though its use is relatively infrequent. The needle is radiographically guided into the glenohumeral joint space, after which the patient is evaluated by fluoroscopy, CT or MRI. The gadolinium in the contrast fluid yields a bright signal on T1 weighted images allowing for better evaluation of the joint capsule, the articular surface of the bones and, in particular, the labral cartilage. MR arthrography is most often used in evaluation of the hip and acetabular labrum, of the shoulder rotator cuff and glenoid labrum, and less often in the wrist.[2] Arthrograms can be diagnostic and therapeutic. Therapeutic arthrograms often distend the joint with cortisone and lidocaine, with a common site being the shoulder. Diagnostic arthrograms can be direct, as described above with penetration of the joint, or indirect, by a venous injection of contrast material and delayed imaging with CT or MRI.[2]
Risksedit
Patients who are allergic to or sensitive to medications, contrast dyes, local anesthesia, iodine, or latex should not have this procedure. Potential risks are infections at the puncture site where the radiopaque substance and/or air are injected. Bleeding is also a small risk. Rarely, gadolinium, found in MRI contrast agents, can cause nephrogenic systemic fibrosis (NSF), a debilitating and potentially fatal disease affecting skin, muscle, and internal organs, in patients with impaired renal function.[3]
^ abcHayes, C W; Conway, W F (May 1992). "Evaluation of articular cartilage: radiographic and cross-sectional imaging techniques". RadioGraphics. 12 (3): 409–428. doi:10.1148/radiographics.12.3.1609135. ISSN 0271-5333.
^ abcR. Crim, Julia (2009), Specialty Imaging: Arthrography: Principles and Practice in Radiology, Lippincott Williams & Wilkins, ISBN978-1-931884-15-0
^Bloom, Mark (22 December 2006), Medical News: FDA Issues Alert on Gadolinium-Based Contrast Agent for Kidney Patients, vol. Nephrology, General Nephrology, MedPage Today, retrieved 2009-05-05
External linksedit
FDA website on gadolinium-containing contrast agents
Video tutorial for performing an arthrogram
December 15, 2023
arthrogram, this, april, 2009, needs, additional, citations, verification, please, help, improve, this, article, adding, citations, reliable, sources, this, april, 2009, unsourced, material, challenged, removed, find, sources, news, newspapers, books, scholar,. This April 2009 needs additional citations for verification Please help improve this article by adding citations to reliable sources in this April 2009 Unsourced material may be challenged and removed Find sources Arthrogram news newspapers books scholar JSTOR May 2009 Learn how and when to remove this template message An arthrogram is a series of images of a joint after injection of a contrast medium usually done by fluoroscopy or MRI The injection is normally done under a local anesthetic such as Novocain or lidocaine The radiologist or radiographer performs the study using fluoroscopy or x ray to guide the placement of the needle into the joint and then injects around 10 ml of contrast based on age There is some burning pain from the anesthetic and a painful bubbling feeling in the joint after the contrast is injected This only lasts 20 30 hours until the Contrast is absorbed During this time while it is allowed it is painful to use the limb for around 10 hours After that the radiologist can more clearly see what is going on under your skin and can get results out within 24 to 48 hours ArthrogramICD 9 CM88 32OPS 301 code3 13k Contents 1 Types 1 1 Conventional arthrography 1 2 CT arthrography 1 3 MR arthrography 2 Use 3 Risks 4 See also 5 References 6 External linksTypes editConventional arthrography edit It is used primarily in the evaluation of menisci cruciate ligaments articular cartilage and loose body within a joint Fluoroscopic allows general view of the medial lateral and patellofemoral ligaments of the joint overall cartilage thickness focal defects imbibition absorption of contrast material into the articular cartilage a sign of cartilage fibrillation splaying and fraying of the cartilage 1 CT arthrography edit CT arthrography is used to examine the patellofemoral joint 1 MR arthrography edit MR sequences such as spin echo with T1 and T2 weighted sequences inversion recovery chemical shift selective techniques and gradient echo techniques are used to examine the articular cartilage 1 Use editShoulder arthrography can be used to study tears of the rotator cuff glenoid labrum and biceps 2 The type of contrast injected into the joint depends on the subsequent imaging that is planned For pneumoarthrography gas is used for CT or radiographs a water soluble radiopaque contrast and for MRI gadolinium Double contrast arthrography can be used for more anatomically complex cases though its use is relatively infrequent The needle is radiographically guided into the glenohumeral joint space after which the patient is evaluated by fluoroscopy CT or MRI The gadolinium in the contrast fluid yields a bright signal on T1 weighted images allowing for better evaluation of the joint capsule the articular surface of the bones and in particular the labral cartilage MR arthrography is most often used in evaluation of the hip and acetabular labrum of the shoulder rotator cuff and glenoid labrum and less often in the wrist 2 Arthrograms can be diagnostic and therapeutic Therapeutic arthrograms often distend the joint with cortisone and lidocaine with a common site being the shoulder Diagnostic arthrograms can be direct as described above with penetration of the joint or indirect by a venous injection of contrast material and delayed imaging with CT or MRI 2 Risks editPatients who are allergic to or sensitive to medications contrast dyes local anesthesia iodine or latex should not have this procedure Potential risks are infections at the puncture site where the radiopaque substance and or air are injected Bleeding is also a small risk Rarely gadolinium found in MRI contrast agents can cause nephrogenic systemic fibrosis NSF a debilitating and potentially fatal disease affecting skin muscle and internal organs in patients with impaired renal function 3 See also editMedical Imaging Radiographer RadiologistReferences edit a b c Hayes C W Conway W F May 1992 Evaluation of articular cartilage radiographic and cross sectional imaging techniques RadioGraphics 12 3 409 428 doi 10 1148 radiographics 12 3 1609135 ISSN 0271 5333 a b c R Crim Julia 2009 Specialty Imaging Arthrography Principles and Practice in Radiology Lippincott Williams amp Wilkins ISBN 978 1 931884 15 0 Bloom Mark 22 December 2006 Medical News FDA Issues Alert on Gadolinium Based Contrast Agent for Kidney Patients vol Nephrology General Nephrology MedPage Today retrieved 2009 05 05External links editFDA website on gadolinium containing contrast agents Video tutorial for performing an arthrogram Retrieved from https en wikipedia org w index php title Arthrogram amp oldid 1103641666, wikipedia, wiki, book, books, library,
