Arthrography is a type of x-ray examination of a joint after injection of a contrast medium containing iodine after desensitizing the local area with some local anesthetic. An arthrogram demonstrates the structures of the joint, including cartilage, ligaments and bursa. Using Fluoroscopy or Ultrasound a needle is put inside the joint and appropriate quantity of contrast medium is injected after which a series of X-rays, CT Scans and MRI Scans can be obtained. The joint can be imaged from many angles in fluoroscopy, or on a slice by slice basis in CT and MRI scans. Fluoroscopy makes it possible to see internal organs in motion. When iodine is injected into the joint space, it coats the inner lining of the joint structures and appears bright white on an arthrogram, allowing the radiologist to assess the anatomy and function of the joint. The most common type of arthrogram is a knee examination, and a knee arthrogram can demonstrate conditions such as a torn meniscus which is a small, crescent-shaped piece of cartilage.
Test can be prescribed when a patient is having some joint disease due to which joint feels stiff, painful and locked. Arthrographic images help physicians evaluate alterations in structure and function of a joint and help to determine the possible need for treatment, including surgery or joint replacement. Most commonly the following joints are examined using this technique.
Shoulder Arthrography can be used to study tears of the rotator cuff. The procedure can also define subtle abnormalities of the bicipital tendon and sheath.
For Pneumoarthrography, a gaseous medium has been used, for opaque Arthrography a water-soluble iodinated medium is used, and a combination of both has been used in double-contrast Arthrography. Current practice is single contrast Arthrography coupled with CT or MR imaging.
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.