Arthrogram

Arthrogram
Arthrogram
ICD-9-CM	88.32
OPS-301 code	3-13k

An arthrogram is a series of images of a

radiologist or radiographer performs the study using fluoroscopy or x-ray

to guide the placement of the needle into the joint and then injects around 10 ml of contrast based on age. There is some burning pain from the anesthetic and a painful bubbling feeling in the joint after the contrast is injected. This only lasts 20 – 30 hours until the Contrast is absorbed. During this time, while it is allowed, it is painful to use the limb for around 10 hours. After that the radiologist can more clearly see what is going on under your skin and can get results out within 24 to 48 hours.

Types

Conventional arthrography

It is used primarily in the evaluation of menisci, cruciate ligaments, articular cartilage, and loose body within a joint. Fluoroscopic allows general view of the medial, lateral, and patellofemoral ligaments of the joint, overall cartilage thickness, focal defects, imbibition (absorption} of contrast material into the articular cartilage (a sign of cartilage fibrillation - splaying and fraying of the cartilage).^[1]

CT arthrography

CT arthrography is used to examine the patellofemoral joint.^[1]

MR arthrography

MR sequences such as

gradient echo techniques are used to examine the articular cartilage.^[1]

Use

Shoulder arthrography can be used to study

joint capsule, the articular surface of the bones and, in particular, the labral cartilage. MR arthrography is most often used in evaluation of the hip and acetabular labrum, of the shoulder rotator cuff and glenoid labrum, and less often in the wrist.^[2] Arthrograms can be diagnostic and therapeutic. Therapeutic arthrograms often distend the joint with cortisone and lidocaine, with a common site being the shoulder. Diagnostic arthrograms can be direct, as described above with penetration of the joint, or indirect, by a venous injection of contrast material and delayed imaging with CT or MRI.^[2]

Risks

Patients who are allergic to or sensitive to medications, contrast dyes, local anesthesia, iodine, or latex should not have this procedure. Potential risks are infections at the puncture site where the radiopaque substance and/or air are injected. Bleeding is also a small risk. Rarely, gadolinium, found in MRI contrast agents, can cause nephrogenic systemic fibrosis (NSF), a debilitating and potentially fatal disease affecting skin, muscle, and internal organs, in patients with impaired renal function.^[3]

References

^
ISSN 0271-5333
.

^
ISBN 978-1-931884-15-0

^ Bloom, Mark (22 December 2006), Medical News: FDA Issues Alert on Gadolinium-Based Contrast Agent for Kidney Patients, vol. Nephrology, General Nephrology, MedPage Today, retrieved 2009-05-05

External links

[Hayes_1992-1] 
ISSN 0271-5333
.

[principles-2] 
ISBN 978-1-931884-15-0

[3] Bloom, Mark (22 December 2006), Medical News: FDA Issues Alert on Gadolinium-Based Contrast Agent for Kidney Patients, vol. Nephrology, General Nephrology, MedPage Today, retrieved 2009-05-05

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