Sometimes we experience severe pain and stiffness in our joints, such as our shoulders, knees, and hips. When we go to a doctor, they may take an X-ray. However, sometimes it is difficult to find out exactly what the problem is from that alone. In such cases, doctors refer us to this special test called an arthrogram. So, today we will talk about this simply, in a way that you can understand.
What is an arthrogram? Simply put...
An arthrogram is a medical imaging test. In this test, a special liquid (a contrast material or dye) is injected into your joint. Then, pictures of the joint are taken. This liquid allows the doctor to see very small details inside the joint, even subtle problems that cannot be seen on a regular X-ray. In other words, it takes a "sharp picture" of what is inside the joint.
Another name for this is arthrography.
Why am I being asked to have an arthrogram?
There are several reasons why your doctor may order an arthrogram.
- Unexplained joint pain or stiffness: If a routine examination or tests like X-rays cannot pinpoint the exact cause of your joint pain, this test can provide a clear answer.
- Injecting medication directly into the joint: Sometimes, for example, it is necessary to inject medications (steroids) directly into the joint. In this case, the medicine can be injected using arthrogram technology to see exactly where it is needed. This is called therapeutic arthrography.
- Check after joint replacement surgery: If you have had joint replacement surgery, this test will also help to see how the tissues in that joint are doing.
Imagine that you have pain in your shoulder, but nothing is visible on the X-ray. Then the doctor may suspect that there is something like a small tear in one of the cartilage or ligaments inside the shoulder. In such cases, an arthrogram can clearly see it.
What are the types of arthrograms?
There are several types of this test, depending on the joint being tested. The most common types are:
- Shoulder arthrogram
- Hip arthrogram
- Knee arthrogram
- Wrist arthrogram
- Ankle arthrogram
- Elbow arthrogram
How is an arthrogram performed?
This is a two-part process.
1. First step: A trained doctor or technician injects a special dye into your vein or directly into the painful joint. This dye goes into the joint and makes it easier to see even the smallest details and problems that are not normally visible.
2. Step 2: Next, the doctor will take pictures of your joint. This can be used to:
- CT scan (CT - computed tomography scans)
- Fluoroscopy (this is a technique similar to X-rays, but can take moving pictures)
- MRI (magnetic resonance imaging) scans
- Ultrasound
Sometimes, it is possible to take pictures of the joint before and after the injection. This makes it easier to compare.
How do I prepare for an arthrogram?
There are a few simple things you can do before this test:
- Wear loose clothing: This will allow the doctor to easily access your joint. You may also need to wear a hospital gown, depending on the joint being examined.
- Inform your doctor about your pregnancy: If you are pregnant, or think you may be pregnant, you should definitely tell your doctor , as some tests that use radiation can be harmful to a developing fetus.
- Stop taking medications as directed: Your doctor may tell you to stop taking certain medications a few days before the test. Follow those instructions carefully. Do not change any medications without your doctor's advice.
What happens during an arthrogram?
You may be asked to remove your clothes, depending on the joint being examined.
This test is performed by a radiologist. A specially trained technician may also help with the imaging. As mentioned earlier, pictures (like X-rays) may be taken before and after the injection.
During an arthrogram, the doctor will:
- You will be made to lie down (often face up) on a table with a mattress.
- The skin around the joint is cleaned with an antiseptic solution.
- The surrounding area is covered with a cloth, leaving only the joint exposed.
- Your skin and the area around the joint will be numbed by a local anesthetic. This will help you not feel much pain.
- That special liquid (contrast material) is injected directly into the joint or near the joint.
- The fluid will spread well throughout the joint, and your joint will slowly move back and forth.
- The needle is removed and the puncture site is cleaned.
- X-rays, MRIs, CT scans, or ultrasounds are used to take pictures of your joints.
- They look at the tissues of the joint from different angles, and take pictures while moving your joint into different positions.
Fluoroscopy and X-rays are often done in the same room where the joint is injected. But if you need a CT scan or MRI, you will be taken to another room right after the injection and the images will be taken.
The most important thing is to take pictures as soon as the fluid is injected into the joint. Otherwise, the fluid will spread throughout the body. If that happens, the images will not be able to capture specific details about the joint tissue.
In therapeutic arthrography, the doctor injects a medicine, such as cortisone, directly into the joint. The goal is to reduce swelling in the joint and relieve pain.
What to expect after an arthrogram?
You should be able to resume normal activities shortly after the test. Some people may experience some pain or swelling around the joint after the test. If this happens, it is best to rest for a few days.
This discomfort should go away within a couple of days. If it doesn't, call your doctor for advice.
What are the risks of an arthrogram?
Overall, the risk is very low. However, there are a few possible side effects:
- Allergic reaction to the specific contrast material/dye: There is a small risk of an allergic reaction to this. If you have any allergies, tell your doctor before the test. If you have an allergic reaction to this dye, you may experience hives, dizziness, or stomach upset.
- Bleeding or infection: Very rarely, complications can occur at the site of the needle insertion.
- Radiation exposure: Some imaging techniques, such as X-rays, use small amounts of radiation. This radiation can build up in the body over time and cause health problems. It can also be harmful to a fetus. To reduce this risk, it is important to tell your doctor about your medical history and whether you may be pregnant.
When will I know the results of my arthrogram?
The radiologist who performed your arthrogram will review the images of your joint. He or she will send your results to your referring doctor, usually within 24 hours. If you have your test done on a Friday, it may take a little longer for the results to come back.
Your doctor will discuss the test results with you. He or she may order more tests or suggest appropriate treatment (such as joint replacement surgery) to repair the joint and reduce your symptoms.
How painful is an arthrogram?
You may feel a little discomfort when the doctor injects the special fluid into the joint. Many people say that the joint feels "full" or "tight." But it's not too painful, because a numbing medicine is given.
What is injected during an arthrogram?
It depends on the type of imaging test your doctor is using. The two most commonly used contrast materials are iodine-containing contrast agents and gadolinium-containing contrast agents.
Can I drive home after an arthrogram?
Usually, you can drive yourself home after the test. However, if you are taking sedative medications to help you relax, you will need to bring a trusted friend or family member to drive you home that day and back. Ask your doctor if you need such medications for your arthrogram.
Finally, things to remember (Take-Home Message)
Joint pain is a major obstacle to our daily lives. However, finding the cause of joint pain can sometimes be very complicated. This test, called arthrography, can provide a clear picture of the very delicate things and delicate structures inside your joints. It is a relatively painless, low-risk diagnostic method. If you are worried about pain in your hip, shoulder, or other joint, talk to your doctor about it and find out about tests or treatments that can help you find relief. Don't worry, an accurate diagnosis is the first step to successful treatment!
` Arthrogram, joint pain, diagnosis, scans, contrast dye, health, medical tests
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