Arthrogram

What is an arthrogram?

An arthrogram is a medical imaging test. It uses contrast material (dye) to give healthcare providers a detailed view of what’s happening inside your joints.

Another name for arthrogram is arthrography.

Why would I need an arthrogram?

Your provider may recommend an arthrogram if a physical exam or medical tests (like X-rays) don’t provide enough information for a diagnosis.

Providers also use arthrograms to:

• Pinpoint the cause of unexplained joint pain or stiffness.
• Precisely deliver medication, like steroids, inside a joint. Healthcare providers call this procedure therapeutic arthrography.
• Evaluate joint tissues after joint replacement surgery.

Types of arthrograms

There are several kinds of arthrograms based on the location of the affected area. Common types include:

• Shoulder arthrogram.
• Hip arthrogram.
• Knee arthrogram.
• Wrist arthrogram.
• Ankle arthrogram.
• Elbow arthrogram.

How does an arthrogram work?

Arthrogram is a two-part procedure. First, a trained healthcare provider injects a special dye (called contrast) into a vein or directly into your affected joint. The dye absorbs into your joint, making tiny structures (and hard-to-detect issues) easier to see.

Next, a provider takes pictures of your joint. To do this, your provider may use:

• CT (computed tomography) scans.
• Fluoroscopy.
• MRI (magnetic resonance imaging) scans.
• Ultrasound.

In some cases, your provider may take pictures of your joint before and after the dye injection.

How do I prepare for an arthrogram?

There are a few things you can do to prepare for your arthrogram:

• Wear loose-fitting clothes. This will allow your provider to easily access your joint. Depending on the joint location, you may need to wear a hospital gown.
• Alert your provider to possible pregnancy. Be sure to tell your provider if you are or think you may be pregnant. Imaging tests that use radiation can harm a developing fetus.
• Stop taking medications as your provider directs. Your provider may tell you to stop taking certain medications before your procedure. Follow their instructions closely and don’t make any changes unless they tell you to.

What to expect during an arthrogram

Your provider may ask you to remove clothing, depending on which joint they need to access.

A radiologist will perform your arthrogram. A specially trained technologist may assist in taking medical images. Your providers may take images (like X-rays) before and after the joint injection.

During an arthrogram, your provider will:

1. Position you on a padded table (most likely lying on your back).
2. Clean your skin around the joint with an antiseptic solution.
3. Drape a cloth over the affected joint to cover surrounding areas while leaving the joint accessible.
4. Numb your skin and the area around the joint with local anesthetic (pain-relieving medication).
5. Inject the contrast material directly into or near the joint space.
6. Gently move your joint to distribute the dye evenly.
7. Remove the needle and clean the injection site.
8. Take pictures of your joint using X-rays, MRI, computed tomography or ultrasound.
9. Move your joint in different positions to get a complete view of joint tissues from various angles.

Providers often perform fluoroscopy and X-ray in the same room where you get the joint injection. If you need a CT or MRI, your provider may walk you to another room to take those images right after your joint injection.

It’s important to have pictures taken soon after the joint injection. Otherwise, the dye travels throughout your body. Once that happens, images no longer provide extra detail around your joint tissues.

During therapeutic arthrography, your provider injects medication (like cortisone) right inside your joint. The injection aims to reduce inflammation or relieve pain.

What to expect after an arthrogram procedure

You should be able to resume normal activities shortly after the test is over. Some people have a bit of soreness or swelling around their joints after an arthrogram. If that’s the case, take it easy for the rest of the day.

Any discomfort should go away within two days. If it doesn’t, call your healthcare provider for guidance.

What are the risks of an arthrogram?

The overall risks are low. Possible arthrogram side effects include:

• Allergic reaction to the contrast material (dye): The risk of having an allergic reaction is low. Tell your provider about any allergies you have before your test. An allergy to the dye used in an arthrogram may cause hives, dizziness or an upset stomach.
• Bleeding or infection: Rarely, people experience complications at the injection site (where the needle went into your skin).
• Radiation exposure: Certain medical imaging technologies (like X-rays) use small amounts of radiation. Radiation can build up in your body over time and cause health issues. It can also hurt a fetus. To minimize your risks, be sure to tell your provider about your medical history and if there’s a chance you may be pregnant.

When should I know my arthrogram results?

The radiologist who performed your arthrogram will review the pictures of your joint. They’ll send your results to your provider who ordered the study, usually within 24 hours after the test. Results may take longer if you have your test on a Friday.

Your provider will discuss your test results with you. They may recommend more tests or possible treatments (like joint replacement surgery) to fix the joint and relieve your symptoms.

How painful is an arthrogram?

You may feel slight discomfort when your provider releases the contrast material into the joint. Many people report feeling a “full” or “tight” sensation around the joint.

What is injected in an arthrogram?

It depends on the type of imaging test your provider uses. Two of the most common contrast materials include iodine- and gadolinium-based dyes.

Can I drive home after an arthrogram?

Generally, you can drive yourself home after your procedure. But if you plan to take sedative medications to help you relax, you’ll need to arrange for a trusted friend or family member to take you to and from your appointment. Ask your provider whether you’ll need sedation for your arthrogram.

A note from Cleveland Clinic

Joint pain can keep you from living an active life. But diagnosing joint pain can be tricky. Arthrography reveals fine details of the tiny structures inside your joints. It’s a relatively painless diagnostic procedure with few risks. If pain in your hip, shoulder or another joint is holding you back, reach out to your provider about tests or treatments that may help you find relief.