Arthrogram

An arthrogram is an x-ray of a joint. It is performed by injecting contrast dye directly into the joint. The contrast dye fills the joint and is visible during x-ray evaluation. This helps the radiologist find the cause of your joint pain and to see if surgery is needed.  At the time of injection, the radiologist may also inject gadolinium into the joint which is a contrast dye used with MRI. The gadolinium contrast dye outlines additional structures within the joint, such as cartilage, tendons, and ligaments and allows them to be evaluated by the radiologist after additional MRI images are taken.

Before the Procedure

  • No food or liquids for 2 hours prior to the procedure. However, you may take all regular medications as scheduled with small sips of water.
  • It is recommended that you arrange a relative or friend to drive you home after the procedure.
  • Report any medications you are taking to the radiology nurse, including “blood thinners”, such as aspirin, Plavix, Lovenox, Coumadin, Pradaxa, Xarelto, or Eliquis. Your physician may advise you to stop taking a “blood thinner” for a specific period of time before your procedure.
  • If you are taking Coumadin or heparin, or you have known or suspected liver disease, your blood will be tested to determine if your blood clots normally.
  • Report any allergies to the radiology nurse, especially those to iodine contrast (x-ray dye) or local anesthetic medications.
  • Women should always inform the x-ray technologist if there is any possibility that they are pregnant. Many imaging tests are not performed during pregnancy so as not to expose the fetus to radiation.

During the Procedure

  • You will be positioned lying on your back on the x-ray table and images will be taken to find the best location for the joint injection.
  • The skin is cleaned with an antiseptic solution and the area is covered with a large sterile sheet.
  • You will feel a slight pin prick when the local anesthetic (numbing medicine) is injected in the area around your joint.
  • The tip of a long, thin needle will be placed into your joint space. X-rays will be used to guide the needle to the correct location.
  • A small amount of contrast dye is injected into your joint. After the dye is given into your joint space, the needle is removed.
  • You will be asked to move your joint around to help the dye coat your whole joint and then x-rays will be taken.
  • Afterwards, you may need additional imaging with MRI or CT. Do not enter the MRI room with anything metal.

Potential Risks and Complications

  • Bleeding at the procedure site
  • Infection at the procedure site
  • Problems due to iodine contrast, including allergic reaction or kidney damage
  • Injury to an adjacent nerve, blood vessel, or muscle

After the Procedure

  • You may full fullness, swelling, discomfort, or hear a crackling noise in the joint after the test. This is not unusual. These symptoms usually disappear after 48 hours. You may take over-the-counter Tylenol for any pain you may experience.
  • Ice may be applied to the joint to reduce swelling. An ace wrap may be applied to the joint if desired.
  • Do not lift or exercise the joint after the test. Rest that joint for the remainder of the day.
  • You may return to normal activities the day after the test, provided you are not experiencing problems.
  • You will have a small bandage over the site. You may remove the bandage in 3 days and leave the site dry and exposed. You may shower, but do not have a tub bath for 3 days.
  • Call your doctor if you have any of the following:
    • Signs of infection at the procedure site, such as redness, swelling, or a fever.
    • Bleeding from the procedure site.
    • Worsening, severe pain near the procedure site.
  • If any further questions or complications arise and you do not know what to do, please call the radiology department at Summit Healthcare Regional Medical Center at (928) 537-4375, ext. 6332.
  • Your results will be sent to your doctor by the following day.