Orthopedic Arthrogram

An arthrogram is a type of X-ray in which a contrast material such as a dye, air or both is injected into a joint. Arthrography is used so that your doctor or surgeon can see the soft tissues of the joint (tendons, ligaments, muscles and cartilage) better. These things cannot be seen on a standard X-ray.

An arthrogram is done to:

  • Find the cause of chronic, unexplained joint pain, swelling or abnormal movement
  • Identify degeneration, tears or disease in the joint capsule, ligaments and cartilage
  • Identify abnormalities in how the bones come together
  • Identify abnormal growths or cysts
  • Guide the placement of a needle when joint fluid is taken for analysis

It can be done on many joints including the hip, knee, ankle, shoulder, elbow, wrist or jaw. Other types of imaging such as magnetic resonance imaging or computerized tomography are sometimes used with arthrography to get a clearer understanding of what is happening in a joint.

Before having arthrography, be sure to tell your doctor and the technician if you:

  • Are allergic to any drugs, including anesthetics
  • Are allergic to iodine (which may be in the contrast material) or have had a serious allergic reaction to bee stings or eating shellfish
  • Are or might be pregnant
  • Have active rheumatoid arthritis
  • Have asthma
  • Have bleeding problems or are taking blood-thinners
  • Have an infection in or near your joint. The contrast material might make this worse.

Before the test, remove any jewelry or metal objects from the area being examined. You will sit or lie down with your joint under an X-ray viewer (fluoroscope) connected to a video monitor. After the area has been cleaned with antiseptic and covered with sterile cloths, a local anesthetic is injected where the contrast material will be injected.

A needle is then inserted into the joint. Joint fluid may be taken so that more contrast material can be injected into the joint. Some of this removed fluid may be sent to a lab for analysis. The contrast material is then injected into your joint. At this point, you may feel tingling, pressure, pain or fullness in your joint as the contrast material is injected.

You may be asked to move the joint or walk around a little to help evenly distribute the contrast material. During the taking of the arthrogram, you should remain as still as possible except when instructed otherwise. The X-rays need to be taken quickly before the contrast material spreads into the other tissues around your joint. It usually takes 30 to 60 minutes to take the X-rays.

After having arthrography, you should rest your joint for about 12 hours and avoid strenuous activity for one to two days. Applying ice can help keep down any swelling that may occur. Pain relievers such as aspirin or acetaminophen can help with any pain or discomfort.

More information on preparing for your arthrogram.