Advanced Imaging for Joint Injury and Pain
Joint pain is caused by many types conditions or injuries and can be very bothersome. Rochester General Health System's advanced orthopaedic imaging can help, particularly when standard x-rays are inadequate. Arthrography is one example of medical imaging we use to evaluate conditions of joints , such as the knee, shoulder, elbow or wrist. This enables us to see what is happening in the structures of the joint, including ligaments, cartilage and bursa (the fluid-filled joint capsule). This kind of imaging is useful when a patient suffers an injury to a joint, or if the joint feels painful or stiff.
Orthopaedic imaging procedures performed by our experienced staff:
- Conventional Arthrography
- CT Arthrography
- MR Arthrography
- Diagnostic and Therapeutic Joint Injections
- Joint Aspiration
What is arthrography?
Joint arthrography involves imaging the internal joint structures after injecting a contrast agent into the joint. After the injection, imaging can be obtained with conventional radiographs (conventional arthrography), CT (computed tomography arthrography), or MRI (magnetic resonance imaging arthrography).
Diagnostic and therapeutic joint injections usually involve injecting an anesthetic and a steroid. The anesthetic is used to confirm that your symptoms are actually coming from the joint injected. The steroid is used to decrease any inflammation which may be associated with the joint. The injections do not reverse the arthritis but provide diagnostic and therapeutic effects.
Joint aspirations are performed in a similar manner, but rather than injecting into the joint, fluid is removed from the joint. Your referring physician will usually specify what tests should be performed on any aspirated fluid, such as those to evaluate for possible infection, crystal arthropathy, or other reasons.
All of these procedures are performed by an attending radiologist with special fellowship training in musculoskeletal imaging and musculoskeletal procedures.
How should I prepare for the exam?
Do not eat or drink for 2 hours prior to the exam. Please bring your requisition if your doctor has provided one.
Please inform the technologist if you are pregnant or think you might be pregnant, or if you are allergic to the contrast.
Take all of your prescribed medications as scheduled unless otherwise instructed.
What can I expect during the exam?
After changing into an examining gown, the technologist will position you on the examining table, and briefly explain the procedure. The radiologist will also tell you about the procedure. Scout images of the involved joint may be obtained. The joint will be cleansed and marked under fluoroscopy and local anesthesia will be given prior to entering the joint with a small needle. Additional images will be obtained as necessary.
The actual procedure usually takes about 10 minutes, but sterile set-up and preparation may take 20 to 30 minutes.
What can I expect after the exam?
After the radiologist evaluates the results of your exam, the information will be sent to your referring physician in order for him or her to make a diagnosis and review next steps with you. If you are having further imaging with CT or MRI, a separate report will be issued for that portion of the diagnostic procedure.
You may experience a mild fullness sensation from the injected medications, minimal discomfort from the injection itself, or you may feel symptomatic relief after the procedure. If your symptoms are actually referred from elsewhere, such as the spine, muscles, or bursitis, you may notice no change in your symptoms. You should avoid heavy lifting for 24 hours until the fluid is resorbed naturally.
Although rare, if you experience any signs of infection such as redness, swelling, or fever, please contact your referring physician, primary physician, or call our office directly.
If you have had a therapeutic injection and experienced symptomatic relief, you should be aware that the duration of relief is variable. Your referring physician may suggest repeating the injection in the future depending on your specific situation.