How Is an Arthrogram Performed?

An arthrogram is a two-stage imaging procedure that involves injecting contrast material into a joint, followed by MRI imaging. This combination provides far greater detail of the joint's internal structures than a standard MRI alone. Here is a step-by-step overview of what to expect.

Before the Procedure

You will be asked to complete a brief medical history questionnaire. Inform our staff of any allergies, medications you are taking, and any prior reactions to contrast agents or joint injections. Remove all jewelry and metal objects from the area being imaged.

The Injection Phase

The arthrogram begins with the contrast injection, performed by a physician using real-time imaging guidance (typically fluoroscopy or ultrasound) to ensure accurate needle placement within the joint space.

1. Skin preparation: The skin over the joint is cleaned with an antiseptic solution.
2. Local anesthetic: A local anesthetic is injected into the skin and soft tissue surrounding the joint to minimize discomfort.
3. Contrast injection: A thin needle is advanced into the joint under imaging guidance, and contrast material is injected directly into the joint capsule. You may feel a sensation of pressure or fullness as the contrast fills the joint space.
4. Needle removal: Once the contrast is injected, the needle is removed and the injection site is covered with a small bandage.

The MRI Phase

Immediately following the injection, you will proceed to MRI imaging. The contrast within the joint highlights and outlines the internal joint structures, allowing detailed visualization of:

• Labrum (in the shoulder and hip)
• Articular cartilage surfaces
• Ligaments and tendons
• Joint capsule integrity
• Loose bodies within the joint

The MRI portion typically takes 30 to 45 minutes, during which you will need to remain still.

After the Arthrogram

Some mild discomfort, swelling, or a feeling of fullness in the joint is normal for 24 to 48 hours after the procedure. Avoid strenuous activity involving the injected joint for 24 hours. Over-the-counter pain relievers can help manage any post-procedure discomfort. Contact our office if you experience increasing pain, redness, warmth, or fever.