What is a arthrogram?
An arthrogram is a test used to take detailed pictures of your joint. There is a special dye called gadolinium that makes MRI pictures easier to read. You will get an injection (shot) of this dye into your joint. You may have anesthesia and a special dye used for x-rays injected as well. Either low-dose x-rays or ultrasound pictures are used to find the exact location for the injection.
X-rays or ultrasound pictures will be taken to help your doctor locate where the needle should enter the skin. This spot will be cleaned and marked. The doctor will inject local anesthesia to numb your skin. Then, a small amount of x-ray dye or anesthesia will be injected. This makes the x-ray or ultrasound pictures clearer helping make sure that the doctor in the correct spot. Next, the gadolinium will be injected into your joint. Any of these injections may cause some mild pain.
Now you are ready to have your MRI.
Why do I need an arthrogram?
Arthrograms help your doctor find what is causing the pain or problem with your joint. The MRI dye helps to see all parts of your joint (tendons, ligaments, muscles, cartilage), not just the bones.
What do I need to do before my arthrogram?
Continue taking all of your medications unless your health care team gives you different instructions. On the day of the injection, take any medications with small sips of water. It is okay to keep taking blood thinners (Coumadin®, Heparin®, Lovenox®, Ticlid®, Plavix®).
Tell your health care team if you are allergic to x-ray dye or iodine. It is also important to tell your health care team if you have kidney problems, diabetes and/or if you are pregnant.
Make sure to tell your health care team if you are claustrophobic (get anxious in small spaces). During an MRI you will be enclosed in a narrow tube for up to 1 hour. It is important that you remain still. Your health care team may be able to give you medication to help you relax.
What happens after the arthrogram?
After you get the injection, you will be taken to the MRI room. The MRI may take up to 1 hour. After the MRI, we will give you written instructions about how to take care of yourself when you get home and also about follow-up appointments. At this point you should be able to go home.
What should I do when I get home?
It is important to drink a lot of fluids. The dyes used for both the x-ray and the MRI do not stay in your body. You will get rid of the dye when you urinate (pee). The more you drink, the faster this will happen.
Keep the injection site clean and dry for at least 24 hours. There will be a bandage over the area where you had the injections. You can remove the bandage after 2-3 days if it does not fall off on its own.
Remember, you had anesthesia injected in your joint. This means you may not be feeling joint pain. The anesthesia should wear off in 1- 6 hours. Pain you felt before your arthrogram may return and could be slightly worse for a short time.
Try to restthe joint that had the injection as much as possible for 24 hours. Your health care team will give you more detailed instructions.
What are some side-effects of an arthrogram?
Joint Pain or Swelling
You may have pain or swelling in your joint for 1-2 days after the arthrogram. You can place an ice-pack on the joint 3-4 times during the first day for 15 minutes each time. After the first day, put a hot-pack on the joint 4 times a day for 20 minutes each time.
You may also take Tylenol® or any NSAID (non-steroidal anti-inflammatory agent) such as Motrin®, Naprosyn®, Alleve®, Celebrex®, Vioxx® or Bextra®. Ask your health care team how much you can take and how often.
It is possible that the injection site will continue to bleed. This does not happen often. The bleeding should stop if you put pressure on the injection site by holding a clean towel or bandage on the site. Call your health care team right away about either heavy bleeding or light bleeding that does not stop after 1 hour.
It is possible for the injected joint to become infected. This is rare but serious. The infection would need to be treated with antibiotics. Tell your health care team right away if you have any pain, swelling, red skin or fever that lasts for 3 or more days after the injection.