X-Rays : Arthrogram

The arthrogram is a special type of x-ray used to visualize the anatomy of a joint. The joints most commonly evaluated by arthrogram are those of the wrist, knee, hip, and shoulder. After a radiopaque contrast fluid is injected into the joint, x-rays are taken which demonstrate the contour and articular surface of the joint (cartilage).

The arthrogram is useful in evaluating the joint with unexplained pain, or decreased range of motion. It is commonly performed on the wrist joint and hip joint, especially when a joint prostheses (artificial joint) is suspected to be loose or infected. This test can help identify problems that are surgically correctable.

Another procedure often performed in place of the arthrogram is MRI scanning or arthroscopy. Deciding which test is most appropriate will be left to your physician and, most frequently, is based on the specific joint involved. In many cases, arthrograms are being replaced by the use of MRI, particularly cases of shoulder and knee problems. In the majority of the remaining cases, a normal arthrogram replaces the need for arthroscopy.

The arthrogram is also helpful in treating the claustrophobic patient who will not tolerate the close confines of the MRI scanner.

* This test is performed under local anesthetic. The dye is injected and x-rays are taken with the joint in several different positions.

***** RISKS *****

1. The risks of this procedure are minimal, although there is a slight chance of infection at the injection site.

2. There is always the possibility of an allergic reaction to the contrast material (iodine). In the vast majority of cases, this reaction is easily treatable. Death due to an allergic reaction from contrast dye is approximately 1 in 40,000 cases.

3. In this examination, radiation exposure is relatively low compared to other diagnostic x-ray studies. Women should be screened beforehand, for possible pregnancy. With the use of pelvic lead shielding, some arthrograms can be performed safely in pregnant women.

4. Radiation in high doses is thought to contribute to the development of some forms of cancer. It can also cause birth defects in early pregnancy. The radiation dosage used in the arthrogram is far below this dangerous level.


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