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Arthrogram
Medical diagnostics
ICD-9-CM
88.32
OPS-301 code
3-13k
An arthrogram is a series of images of a joint after injection of a contrast medium, usually done by fluoroscopy or MRI. The injection is normally done under a local anesthetic.The radiologist or radiographer performs the study using fluoroscopy or ultrasound to guide the placement of the needle into the joint and then injects an appropriate amount of contrast.
Contents
1Related technologies
2Use
3Risks
4See also
5References
6External links
Related technologies
The physician or radiographer then obtains a series of X-rays, or alternatively Computed Tomography (CT) scans or Magnetic Resonance Imaging (MRI) scans. The joint can be imaged from many angles in fluoroscopy, or on a slice by slice basis in CT and MRI scans.
Use
Shoulder arthrography can be used to study tears of the rotator cuff, glenoid labrum and biceps.[1] The type of contrast injected into the joint depends on the subsequent imaging that is planned. For pneumoarthrography, gas is used, for CT or radiographs, a water-soluble radiopaque contrast, and for MRI, gadolinium. Double-contrast arthrography can be used for more anatomically complex cases, though its use is relatively infrequent. The needle is radiographically guided into the glenohumeral joint space, after which the patient is evaluated by fluoroscopy, CT or MRI. The gadolinium in the contrast fluid yields a bright signal on T1 weighted images allowing for better evaluation of the 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.[1] 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.[1]
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, nephrogenic systemic fibrosis (NSF) can occur in patients with impaired renal function who receive gadolinium, a debilitating and potentially fatal disease affecting skin, muscle, and internal organs.[2]
See also
Medical Imaging
Radiographer
Radiologist
References
^ abcR. Crim, Julia, Specialty Imaging: Arthrography: Principles and Practice in Radiology, Lippincott Williams & Wilkins, ISBN 978-1-931884-15-0
^Bloom, Mark (22 December 2006), Medical News: FDA Issues Alert on Gadolinium-Based Contrast Agent for Kidney Patients, Nephrology, General Nephrology, MedPage Today, retrieved 2009-05-05
External links
FDA website on gadolinium-containing contrast agents
Video tutorial for performing an arthrogram
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Orthopedic surgery, operations/surgeries and other procedures on bones and joints (ICD-9-CM V3 76–81, ICD-10-PCS 0P–S)
5. 回旋筋腱板断裂の症状と診断 presentation and diagnosis of rotator cuff tears
English Journal
Pincer-type MRI morphology seen in over a third of asymptomatic healthy volunteers without femoroacetabular impingement.
Bensler S, Dietrich TJ, Zubler V, Pfirrmann CWA, Sutter R.
Journal of magnetic resonance imaging : JMRI. 2019 May;49(5)1296-1303.
In daily routine, pincer femoroacetabular impingement (FAI) findings are often seen without a clinical diagnosis of pincer FAI. To assess the presence of pincer FAI MRI findings in asymptomatic volunteers with negative impingement test versus patients with clinically confirmed FAI. Case-control stud
Cartilage imaging of small joints is increasingly of interest, as early detection of cartilage damage may be relevant regarding individualized surgical therapies and long-term outcomes. The aim of this review is to explain modern cartilage imaging of small joints with emphasis on MRI and to discuss
The comparison of direct magnetic resonance arthrography with volumetric interpolated breath-hold examination sequence and multidetector computed tomography arthrography techniques in detection of talar osteochondral lesions.
Pirimoglu B, Ogul H, Polat G, Kantarci M, Levent A.
Acta orthopaedica et traumatologica turcica. 2019 Apr;().
The aim of this study was to compare additive diagnostic values of magnetic resonance (MR) arthrography with volumetric interpolated breath-hold examination (VIBE) sequence and multidetector computed tomography (MDCT) arthrography for diagnosis and grading of talar osteochondral lesions. MDCT arthro
… Based on the results of two-directional arthrography of the hip, closed reduction was performed in 2 hips, and open reduction was performed without osteotomy in 12 hips. … Arthrography was useful for identifying asymmetry, demonstrating the usefulness of a treatment strategy based on arthrography of the hip. …
Current and accurate information for patients about Arthrography. Learn what you might experience, how to prepare for the exam, benefits, risks and much more.
