Arthrography

Arthrography: Definition, Purpose, Preparation, and Procedure

What is an arthrography?

Arthrography, or an arthrogram, is a special kind of X-ray. It uses air or a  contrast dye or sometimes both along with a special x-ray to give your doctor a more detailed picture of the soft tissues of your joint. These tissues include muscles and cartilage, tendons and ligaments. These tissues can't be seen on plain X-rays.

There are two types of arthrography:

- Direct

- Indirect

Direct arthrography is when the contrast material is injected by the radiologist into the joints directly. This imaging technique is usually more preferred than indirect arthrography because it makes the joints bigger which enhances the imaging of small internal structures, giving it a clearer and precise image. Direct arthrography helps improve the diagnosis and evaluation of the possible conditions and diseases of the joint.
On the other hand, indirect arthrography is when the contrast material is not injected into the joint directly but rather in the bloodstream. The contrast material will then eventually be absorbed by the joint.

The Purpose of Arthrography

This procedure is commonly used to determine what causes joint pain and discomfort. Local anesthetic medications or steroids are sometimes injected together with the contrast material so that any inflammation or joint-related pain is decreased. These medications help doctors and physicians further information on what might be causing the joint pain.

The reason your doctor might recommend an arthrography is:

- To find out what is causing unexplained and chronic problems in your joints such as swelling, pain or unusual movement.

- To look for signs of tears, degeneration, or disease inside the joint or in the cartilage or ligaments.

- To look for disturbances in the way the bones meet and join each other

- To look for abnormal cysts or tumors

- To guide needle placement when fluid is taken from the joint for analysis

An arthrogram can be completed on several joints such as the jaw, wrist, elbow, shoulder, ankle, knee or hip. Sometimes an MRI or a CT scan is used with arthrography to give the doctor more information about what is going on in a joint.

If your doctor recommends arthrography, be sure to inform him as well as the technician performing the procedure if you:

- Have any drug allergies, including allergies to anesthetics

- Have an allergy to iodine. Iodine may be used in the contrast material.

- Have an allergy to shellfish or bee stings

- Might be or are pregnant

- Have rheumatoid arthritis

- Have asthma 

- Are taking blood thinners or have a bleeding problem

- Have an infection in your joint or near it. The contrast material could make the infection worse.

Preparation and Procedure

Preparing for the diagnosis can vary depending on the method your doctor will use.

Before the arthrogram begins, you will be asked to remove any metal objects or jewelry from around the joint being studied. You will then lie or sit down with your joint positioned under a special X-ray machine called a fluoroscope, which is connected to a monitor. The area will be thoroughly cleaned and covered, and you will be injected with a local anesthetic to help make you comfortable during the procedure.

A needle will be inserted into the joint and some fluid may be extracted to make more room for the contrast material to be injected. Some of the fluid that is removed may be sent to the lab to be analyzed. The contrast material is then injected, and as it enters the joint you may experience pressure, pain, tingling or fullness in the joint.  You may be asked to walk around or to move in different positions to help the contrast material become evenly distributed. Other than when you are asked to move, you should stay as still as possible. It's important for the x-rays to be taken quickly before the contrast spreads to the other tissues outside the joint. Typically it takes 30 minutes to one hour to complete the test.

After the Procedure

Following arthrography, you will need to rest the joint for at least 12 hours. Avoid exertion for one or two days. Using ice packs can help keep any swelling that may occur to a minimum. Over-the-counter pain medications like acetaminophen or aspirin are usually effective for pain management after arthrography.

Results of the Procedure

The results of the arthrography are interpreted by radiologists who are trained specifically to understand and interpret any radiology examinations. After the images are available, the radiologist will send a report to your referring physician which will be the one to discuss and relay the results of the examination with you.

 

In some cases, it may be necessary to undergo follow-up examinations. Your referring physician will explain why this is requested. Follow-up examinations are done if there is a potential abnormality which needs to be further evaluated. Most of the time, follow-up examinations are needed to monitor any known abnormality in order to best see if your treatment is working or not.
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Questions & Answers
Q:
What is the best way to treat permanent back and neck pain and stiffness?
A:

Here are some tips:

Neck Pain Tips: Sleep with a cervical pillow

Orthopedic or cervical pillows are made with special contours to support the space beneath the neck and head. They are also more concave for the head and provide more support to the neck.

Neck Pain Tips: Sleep on your back

The best position to lie to sleep is on your back. If you sleep on your stomach or on your side, make sure your pillow is not too thick. It should raise your head no more than 4 to 6 inches. This will keep your neck and head from turning to either side.

Neck Pain Tips: Position your computer screen at eye level

While you are working at a computer, sit comfortably in your chair with your computer in front of you. Close your eyes and then open them. When you open your eyes, you should see the middle of the computer screen. If your gaze is not in the middle of the screen, adjust the height of the screen using items like books.

To keep your head from gradually drifting forward, take frequent breaks to stretch. Getting up to walk around at least once every half-hour is one of the best neck pain tips.

Neck Pain Tips: Use a telephone headset

Never hold a phone between your shoulder and your ear. Use a headset or other hands-free system to talk on the phone and avoid abusing your neck and spine.

Neck Pain Tips: Exercise your neck muscles

One of the best neck pain tips is using the chin tuck. You can do this often throughout the day. In addition to helping strengthen the muscles that hold the head in alignment over the shoulders, it also helps strengthen the scalene and sub-occipital muscles.

Read more tips here: Neck Pain Tips: Sleeping, Posture, Exercising, Hydration & Prevention

Read more
Temed Holdings
4 answers
Q:
What is the best treatment for neck pain and shoulder Pain?
A:

One of the best treatment for neck pain and shoulder pain is exercises:

Neck Pain Exercises: Neck Extension

  1. To begin this neck pain exercise, sit up straight in a chair with your feet flat on the floor.
  2. Looking straight ahead, tuck your chin slightly (starting position)
  3. Place the palm of your hand on the back of your neck, at the base of your head
  4. Apply slight forward pressure with your hand, while resisting the forward motion of your neck and head
  5. Hold for a count of 5 and return to the starting position and relax
  6. Repeat the neck pain exercises 5-10 times

Neck pain exercises: Side bend

  1. Sit up straight in a chair with your feet flat on the floor.
  2. Looking straight ahead, tuck your chin slightly (starting position)
  3. Place your left hand, palm down, on the left side of your head (around your ear)
  4. Slightly push your head to the right side with your hand, while resisting the sideways motion of your neck and head
  5. Hold for a count of 5 and return to the starting position and relax.
  6. Repeat 5-10 times
  7. Repeat the neck pain exercises with the other side.

Neck pain exercises: Neck flexion

  1. Sit up straight in a chair with your feet flat on the floor.
  2. Looking straight ahead, tuck your chin slightly (starting position)
  3. Place the tips of your fingers on your forehead
  4. Slightly push your head backward with your fingers, while resisting the backward motion of your neck and head
  5. Hold for a count of 5 and return to the starting position and relax.
  6. Repeat the neck pain exercises 5-10 times

More exercises here: Neck Pain Exercises

Read more
Temed Holdings
4 answers
Q:
How do I reduce the shoulder and neck pain?
A:

Here are some tips:

Neck Pain Tips: Sleep with a cervical pillow

Orthopedic or cervical pillows are made with special contours to support the space beneath the neck and head. They are also more concave for the head and provide more support to the neck.

Neck Pain Tips: Sleep on your back

The best position to lie to sleep is on your back. If you sleep on your stomach or on your side, make sure your pillow is not too thick. It should raise your head no more than 4 to 6 inches. This will keep your neck and head from turning to either side.

Neck Pain Tips: Position your computer screen at eye level

While you are working at a computer, sit comfortably in your chair with your computer in front of you. Close your eyes and then open them. When you open your eyes, you should see the middle of the computer screen. If your gaze is not in the middle of the screen, adjust the height of the screen using items like books.

To keep your head from gradually drifting forward, take frequent breaks to stretch. Getting up to walk around at least once every half-hour is one of the best neck pain tips.

Neck Pain Tips: Carry weight evenly

Many people make the mistake of carrying a heavy briefcase or their purse on their shoulder or on one side of their body. Doing this causes strain in the muscles and leads to pain.

Remove non-essentials from your briefcase or purse. Consider using a backpack to evenly distribute the weight across your shoulders. If you choose to carry a purse or backpack, keep your shoulders level while carrying it.

Neck Pain Tips: Maintain a proper posture

The most common posture contributing to neck pain is the “head-and-shoulders-forward” posture. In this position, the neck slopes forward, putting the head in front of the shoulders.

In this position, the head pulls the upper back forward also in a slumped position. This places a strain on the entire spinal column.

More tips here: Neck Pain Tips: Sleeping, Posture, Exercising, Hydration & Prevention

Read more
Temed Holdings
4 answers