The word arthrogram sounds complicated and so it is only natural to be apprehensive before this procedure. To simply put it, an arthrogram is a test that uses X-rays to obtain pictures of a particular joint in the body. These pictures are taken after a contrast material, such as, dye, air, water or a combination of all these, is injected into the joint. This contrast material allows your doctor to examine tissue structure, tendons, ligaments, cartilage, muscles as well as joint capsule. The reason a contrast material is essential is because these elements are not visible in a regular X-ray. Also, in an arthrogram, the X-ray is used to take pictures of the joint and this is called fluoroscopy.
Why to conduct it
This procedure is done to check a particular joint in your body to determine the cause of any symptoms or problems you're facing with your joint. An arthrogram can be done on your ankle, shoulder, elbows, wrist, knee, your hip as well as your jaw. Frequently, an MRI (magnetic resonance imaging) and CT (computed tomography) are also ordered along with an arthrogram to provide comprehensive information about the joint.
So, your doctor will order a hip arthrogram only when there are symptoms of pain and discomfort in your hip joints. These could be caused as a result of tear or degeneration or some infection in the ligaments, cartilage, joint capsule or bones in the joint.
You will be asked to sit or lie down such that your hip joint is under the fluoroscope. This X-ray viewer is attached to a video screen that will display the X-ray images. The skin around your joint area will be cleaned with antiseptic soap and then draped with a sterile towel. You will then be administered a local anesthesia on your hip to numb the skin and tissues over the hip joint.
The doctor or radiologist will then insert a needle into the joint area. Some joint fluid is removed in order to make more room for the contrast material, to be inserted into the joint. The joint fluid collected is sent to the lab for examination. The fluoroscope will indicate if the needle is in the correct position in the joint. If it is, the dye or air is inserted into your hip joint through the needle.
Once the needle is withdrawn, you may be asked to move your hips in order to help the contrast material spread through the joint area. The images in the fluoroscope will indicate if the dye has spread in the entire joint. You will then have to sit as still as possible so that X-rays can be taken.
The X-rays need to be taken quickly to ensure the dye doesn't spread to other tissues around the joint. If you are having an MRI or CT scan after the arthrogram, then you will be administered a medicine called epinephrine along with the dye to prevent the dye from spreading to other tissues.
There is no specific preparation for an arthrogram. But you need to tell you doctor about any medications you are consuming and if you have any reactions or allergies to any medication.
An arthrogram generally takes half an hour to an hour, sometimes longer. If you have discomfort in your hip, it would be wise to strain it as less as possible on the day of the procedure.
If you are having an MRI scan too, it is best to keep a pair of socks handy as the machine will be freezing cold. Also, the MRI machine can be really loud, so earplugs will be handy too.
Since the arthrogram is performed when you're under local anesthesia, you will experience no sensation during the procedure. Another thing you can do is ensure you bring someone along, or at least have someone come over after the procedure to drive you home.
There is soreness, pain and sometimes swelling for about 12 hours after the procedure and you need to rest your hip as much as you can in that time. The doctor will usually prescribe something for the pain and you can use ice on the swelling, if any.
Even though arthrogram sounds complicated, it is no cause for concern. It is a simple procedure, which can accurately diagnose any problems you have so that effective treatment can be meted out at the earliest.
Submitted by M T on March 10, 2010 at 11:34