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Everything You Need to Know About CT/MRI Arthrogram

By DuPage Medical Group Radiology



A CT or MRI arthrogram is a two-step process that includes an injection, followed by a scan in order to obtain detailed images of a joint. This is performed to evaluate joint issues that may not be visible on a routine CT or MRI. This imaging helps your physician see any problems with tissues such as cartilage, tendons and ligaments that help cushion the bones in a joint.

What Should I Expect?

Upon arrival, an X-ray technologist will ask you to change into a procedural gown which allows access to the joint being evaluated. Depending on your condition, the X-ray technologist may take a few X-ray images prior to your procedure. This is done to provide the radiologist with additional information about the anatomy of your joint.

A radiologist or radiologist assistant (mid-level provider), who performs the arthrogram, will explain it in detail and answer any questions you may have. Once all of your questions have been answered, you will be asked to lie on the X-ray table for your arthrogram.

How is the CT or MRI arthrogram performed?

  • The skin around your joint will be cleaned with an antiseptic solution.
  • The skin and muscle around your joint will be numbed through an injection. This usually is a very quick shot done with a thin needle. The effects of the numbing medication may last for up to an hour.
  • Once the skin and muscle around your joint are numb, a small needle will be guided inside the joint with the help of fluoroscopy (real-time X-ray) to ensure precision.
  • Once the needle is in place, a fluid called contrast will be injected into the joint. Your joint may feel a little stiff due to the injection. The type of contrast used will be determined by the imaging which will occur after the injection.  CT and MRI scanners need different types of contrast material in order to visualize the anatomy.
  • The arthrogram procedure normally takes about 5 - 10 minutes. Once this portion is complete, you will be transferred to either CT or MRI to complete the second half of the procedure.

What Should I Expect During the CT or MRI Portion of the Exam?

CT exam

  • A CT scanner uses a small amount of ionizing radiation that produces an image of the joint which is enhanced by the contrast material previously injected into the joint.
  • You will be asked to lie on the CT table on your back.
  • Once positioned, the CT technologist will step out of the room to begin the exam; you will be able to speak with the technologist at any time during the exam through the intercom system.
  • The CT exam should take approximately 5 to 10 minutes.

MRI exam

  • An MRI scanner uses a very strong magnet that produces an image of the joint.
  • You will be asked to lie on the MRI table in a position which allows the best access to the body part being scanned.
  • A device called a surface coil will be placed around the joint that is being imaged.
  • Once positioned, the MRI technologist will step out of the room to begin the exam; you will be able to speak with the technologist at any time during the exam through the intercom system. In addition, you will be provided a hand held device which allows you to send a signal to the technologist should you need assistance.
  • The MRI scanner is very sensitive to movement and the MRI technologist will explain the importance of remaining still throughout the exam.
  • The MRI scan may take up to 45 minutes with the technologist repositioning you throughout that time to obtain the necessary imaging.

Post-Arthrogram Care

  • Once the numbing effects wear off, you may experience some minor discomfort where the needle was placed for 1-2 days following the procedure.
  • Over-the-counter Tylenol® or Motrin® can be taken to help alleviate any minor discomfort, however, we recommend calling your physician prior to taking any medication.
  • Minor bruising and/or swelling may occur where the needle was placed.
  • Applying ice packs for the first 24 hours (3 - 4 times, for no more than 15 minutes), followed by hot packs after the first day (20 minutes, 4 times a day) may be helpful for pain and swelling.
  • You may resume light daily activities directly after your procedure.
  • Overexertion of the joint after the procedure may irritate the joint and prolong recovery time.
  • You may shower the day of the procedure, however, bathing, use of a hot tub, sauna, or swimming (even in your personal pool) is NOT recommended for up to seven days following the procedure.

Possible Complications

Infection

Infection of the joint and/or the surrounding tissues is a very rare complication; however, if you have symptoms of severe pain, swelling, red skin, or develop a fever within 3 days of your arthrogram, call your physician immediately.

Allergic Reaction

An allergic reaction to the local anesthetic, CT or MRI contrast is extremely rare. Most allergic reactions occur within 30 minutes of medication being administered. However, allergic reactions can occur up to three days after the procedure (latent allergic reaction).  Most allergic reactions result in mild symptoms, which may include redness at the injection site, hives or itchiness. If you develop any of these symptoms, call your physician immediately. A severe allergic reaction may include shortness of breath, facial swelling, tongue/throat swelling, rapid heartbeat or low blood pressure. If you experience any of these symptoms, call 911 immediately!

Bleeding

A small amount of bleeding may occur under the skin, causing bruising or a small lump (hematoma). Patients taking blood thinner medication (Coumadin®, Motrin® 800 mg, etc.) are more susceptible to bleeding than patients not on blood thinners. If you notice a lump under the skin, draw a circle around the lump with a marker or pen. The circle will allow you to monitor the size of the lump. If the lump becomes larger and spreads outside the circle, immediately notify your physician.

How Do I Obtain My Results?

The radiologist who reads your exam will send a report to your referring physician. The referring physician will review your results with you during a follow-up appointment to help you decide on the next steps of your treatment.

 

If you have any questions regarding a CT/MRI arthrogram, or need to schedule an appointment, please call 630-545-7880.


Topics and Subtopics: Diagnostic Testing, Joints & Tissue & Radiology

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