Joints can go wrong in a lot of ways. You might fracture a bone, wear down cartilage, or tear a ligament. And sometimes, standard imaging, like an X-ray, doesn’t show enough detail to pinpoint the problem.
That’s when you might need an arthrogram, also called arthrography.
It’s another type of imaging where first you get a special dye, called contrast dye, injected into your joint. Then, your doctor uses X-rays, MRI, CT scan, or fluoroscopy -- which is like an X-ray video -- to take pictures. The dye helps highlight what’s gone wrong in your joint.
When Would I Need One?
You’d get an arthrogram to check on joint problems, such as:
- Pain you can’t explain
- Something feels off in your joint
- Trouble moving your joint
For example, your doctor could look for a small tear in a ligament or for damage you got from dislocating a joint several times. Your doctor can also use arthrography to check on a joint replacement.
You’d typically get one on your:
Are There Any Risks If I Take the Test?
Allergic reaction to dye: A contrast dye allergy may cause dizziness, hives, itching, sneezing, throwing up, or upset stomach. Usually, the dye goes into your joint and not your blood, so the risk of an allergic reaction is low.
Infection or bleeding: Because your doctor uses a needle to inject the dye, there’s a chance you could get an infection or have a bleeding problem.
Radiation: X-ray, fluoroscopy, and CT all give you some radiation. It’s very important to tell your doctor if you’re pregnant or think you might be because radiation can harm your baby. If you have concerns, talk to your doctor to see whether the test is safe for you.
How Do I Get Ready?
Typically, you don’t need to do anything special for the test. It helps to wear comfy, loose clothing and leave your valuables, such as jewelry, at home.
If your arthrogram is going to use an MRI or CT, and you have a fear of tight, closed spaces, you can get medicine to help keep you calm. That might mean you need to avoid eating or drinking for a few hours before the test. Your doctor will let you know.
Make sure to tell your doctor about:
- All medical devices you have such as cochlear implants, pacemakers, and manmade heart valves
- Allergies to contrast dyes, iodine, medicines, latex, and tape
- Bleeding disorders or other serious health problems you have, including recent surgeries
- Medicines, herbs, and supplements you take, including over-the-counter drugs and meds your doctor prescribes for you
- If you are or might be pregnant
What Happens During the Test?
First, you’ll remove your jewelry and take off any clothing around the joint. You’ll get a hospital gown if you need one. Then, you’ll lay on a table in the exam room.
It varies, but typically, your doctor:
- Takes X-rays before the dye goes in to compare them with the arthrogram results
- Covers your body around the joint and cleans your skin
- Numbs the skin around the joint using a small needle with medication
- Removes fluid from the joint, if you have any, with a longer needle
- Injects contrast dye or air with a long, thin needle -- your doctor will use fluoroscopy or ultrasound to guide the needle to the area around your joint. You may be asked to move the joint around so the dye spreads out.
- Takes images of your joint in different positions with either X-ray, fluoroscopy, MRI, or CT
Arthrography with fluoroscopy takes about 30 minutes. With CT or MRI, it could take up to 2 hours.
How Will I Feel Afterward?
You might have soreness, swelling, or a feeling of fullness around your joint. Use ice for the swelling and ask your doctor what you can take for soreness.
You’ll likely need to take it easy on your joint for a few hours after the exam. If you end up feeling sore, avoid heavy lifting or intense exercise for a few days.
Also, it’s normal to have some clicking or cracking in your joint for 1 to 2 days.
Call your doctor if you have:
- Redness, swelling, bleeding, draining, or increasing pain where the needle went in
- Soreness or swelling around your joint that lasts more than 1 to 2 days
What Do the Results Mean?
A radiologist -- a doctor who specializes in imaging -- will look at your results and talk to your regular doctor about what they mean.
Your doctor will then get in touch with you to cover what they found and what your next steps are. How long it takes to get your results depends on how much imaging you needed and where you had the test done.