Having an Arthrogram Study

Having an Arthrogram Study

Patient Information

Radiology

What is an arthrogram?

An arthrogram is an examination used to diagnose a problem inside a joint, usually a shoulder, hip, wrist, elbow or another joint. To do this, a needle is inserted into the joint.  An injection of dye, called contrast medium, is used to outline the joint. The arthrogram is performed by a specially trained doctor called a Radiologist.  They will explain the procedure to you and answer any questions you may have. The procedure is in two parts, both performed in one visit.  The first part is performed in the main X-Ray Department, involving an injection into the joint under X-Ray guidance. The second part will be performed using Computed Tomography (CT) or Magnetic Resonance (MR) imaging and looks at the joint structures and how they have been injected.

Are there any risks?

There are some small risks associated with the injection, which will be explained to you before the procedure. These are infection, bleeding, bruising, increased pain, and possible reaction to the local anaesthetic, contrast media or steroid injections, if given.

MR scanning has its own risks – you will not be able to enter the scan room with any loose change, metal pieces on clothing or any electronic devices. 

If you have had any of the following, we may have to defer your scan until we gather more information about your medical history: 

• Heart pacemaker, loop recorder, implantable cardioverter defibrillator (ICD)

• Artificial heart valve

• Intra-cranial vessel clips / coils

• A possibility of pregnancy

• Metal splinters / fragments in eyes or body

• Gastric band

• Internal electronic devices

Please contact MR Appointments on receipt of your appointment on 01942 778675, if any of the above apply to you.

The X-ray equipment used to see the injection site and CT both use ionising radiation to produce the images. The clinician who referred you for the test, and the performing Radiologist, consider the risk of the radiation you would receive during the test, and compare it with the benefit you may get from receiving an accurate diagnosis. If you are, or could be, pregnant, please let a member of staff know.

Will it hurt?

Local anaesthetic is given into the area which is injected. You may feel an initial sharp scratch, and some pushing / pulling of the needle. After the injection, you may feel a fullness or heaviness in the joint. This will wear off within a few hours.

What happens during the procedure?

Before any imaging is performed, you will be booked in to the Department and if you are having an MR, you will be asked questions to screen your safety to have the MR scan. You will then be taken to the X-ray room. If needed, you will be asked to undress and put on a patient gown. 

There will be three or more people in the X-ray room - the Radiologist, a Radiographer and one or more nurses or imaging assistants. Wrightington, Wigan and Leigh NHS Trust is a teaching hospital, so there may also be trainee Radiographers or Radiologists. Everyone will be introduced to you properly before we start. 

For the first part of the procedure, you will be made comfortable on the X-ray table. The position you will be in depends on the area being injected, but you would usually be lying on your back. If you need any additional support to be comfortable, please let staff know, as you will need to stay quite still for the procedure.

The staff will go through some questions with you and confirm the procedure you are expecting before starting. Your skin will be cleaned with an antiseptic solution, and local anaesthetic will be injected to numb the area. A fine needle will be inserted into the joint and X-rays are taken to help show the needle is in the correct place; once this is confirmed, the contrast medium can be injected. Some patients may also have a therapeutic steroid injected too. A sticking plaster is then applied. 

The second part of the procedure involves taking in depth images of the soft tissue, cartilage, joint and bones, which is usually by MR imaging. However, some patients may have CT imaging. You should know from your appointment letter which method will be used. Please read all information leaflets.

How long will it take?

As the test is performed in two parts, you should plan to be in the Department around 1½ to2 hours. The X-ray injection part will take approximately 20-40 minutes. The MR scan could take approximately 30-60 minutes. Please be aware that the MR Department may need to scan urgent patients from the Emergency Department, so you may not have your scan straight away. 

For patients who have a CT, this will take around 10 minutes.

After the procedure

Once the procedure is complete, you are advised not to drive for 24 hours, as the joint can feel quite full and heavy, and it may affect the movement and reaction times within this period. Otherwise, you are encouraged to move the joint around and to try to continue with other daily tasks to disperse the fluid out of the joint.

How do I get the results?

You will not get your results straight away. The images will be reported by the performing Radiologist and sent to the person who referred you for the test.

Pregnancy

If you are or think you might be pregnant, please let a member of staff know. The Department operates an inclusivity policy towards pregnancy status; all patients aged 12 to55 years will be asked whether they may or may not be pregnant, if radiation is to be given within the abdomen or pelvis area.

Relatives and Escorts 

You can bring a relative or friend with you to the Radiology Department, however they will not normally be allowed in the examination room. 

Children/Vulnerable Adults 

Please be aware that the Department does not have the facilities to supervise children / vulnerable adults. If you need to bring a child or vulnerable adult with you, you must bring an appropriate adult to supervise them whilst you are having the examination.

Interpreters 

If you require an interpreter, please contact the Department before your appointment so that this can be arranged. (Please Note: Hospital policy states that relatives cannot act as interpreters).

What if I am unable to attend? 

The average missed outpatient appointment costs the NHS £160. If you cannot attend your appointment, please contact the MR Imaging Suite on 01942 778675 so that we can offer your appointment to somebody else. We will be glad to offer you an alternative appointment and will try our best to accommodate you at a date and time suitable to you. Please allow plenty of time to park your car. If you are running late, please let us know.