Arthrography is a special kind of x-ray that is also known as fluoroscopy. It uses a contrasting dye to make the insides of the joints of the shoulders, wrists, ankles, and other parts clearly visible to the medical examiner. The dye used is iodine. Iodine is transferred into the body and it moves into the joint space, to form an inner lining in the joint. This allows the radiologist to clearly see if there are any structural differences to the joint or bones. The parts of the joint lined with Iodine appear bright white in color.
Some of the common uses of arthograms are that they help the doctor assess any differences or alterations in the structure of the bones, causing alterations in the functioning of the particular joint. It can help the physician determine if a particular treatment is required or if a corrective surgery is required for the patient.
A person generally goes in for an arthography when he/she experiences discomfort in any particular joint or continuous pain in the area. An arthogram is generally done in the shoulder, knee, ankle or wrist joints.
A simplified injection technique is used for shoulder arthograms. A 3.5 inch, 22 gauge needle is inserted vertically into the the lower half of the glen humeral joint. This needle is guided with the iodine present. This technique however has its risks as the inserting of the needle can affect the normal structure of the shoulder joint. It is also a difficult technique for the resident doctor to master. Therefore in recent times the rotator cuff interval is being used, which is proven to be safer and better.
The patient is asked to lie flat on the table and stretch his/her arm out with the palm facing up. In case this position is too painful, the patient will be asked to keep his/her arm facing the thighs. The x-ray machine is held perpendicular to the table and the area to be injected is marked in the upper half of the humeral head, close to the shoulder joint. Assessments are made regarding the length of the needle used, duration of fluoroscopy, and position of the joint at the beginning of the procedure. The doctor specifically looks for any opafication of the tendon sheath in the biceps. Patients are also asked to rate their level of pain by the end of the procedure on a scale of 1-10.
Before a patient goes in for this test, he/she should inform the doctor of any allergies that he/she may have to any Barium products or any illnesses of late. A detailed list of the medication taken should also be mentioned. Pregnant women should also let the doctor know about their condition. The whole procedure should not take more than 30 minutes.