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What is arthrography? it is the study of synovial joints and related soft tissue structures such as tendons, ligaments, muscles, bursae, cartilage & joint capsules
What are the reasons an arthrogram may be done? to find the cause of persistent pain, swelling, or abnormal joint movement. It may also be done to detect a loose prosthesis or congenital abnormality.
What may be demonstrated on an arthrogram? things such as tendon, ligament and cartilage tears, degenerative disease of the joints & cartilage, & cysts.
Arthrography may be done by itself or in conjunction with a CT or MRI scan.
This modality has largely replaced arthrography for evaluation of the soft tissue structures of joints. MRI
This is one reason that arthrography will always be needed despite MRI Some patients cannot have an MRI due to internal metal from surgical procedures or for those who have had an inconclusive or negative MRI and still exhibit symptoms
These are typical joints studied with arthrography Hip, Knee, Ankle, Shoulder, Elbow, Wrist, & TMJ's
The Two most common arthrography procedures are Knee and Shoulder
Arthrograms are done in radiographic rooms with Fluoroscopy & Overhead Tubes
Arthrography requires the use of a sterile arthrogram tray
Some items included in the arthrogram tray include Razor Sterile gloves (3) skin prep sponges Antiseptic solution (betadine) Gauze Sponges Fenestrated drape (2) 10 ml syringes (for xylocaine + iodinated contrast) (1) 50 ml syringe (used to inject room air) Plastic connecting tubing
Two other items on the sterile tray are 5ml ampule of xylocaine adhesive bandage (Band-Aid)
The contrast media used for arthrography is Iodinated water-soluble media Room Air
The purpose of a knee arthrogram is to demonstrate the joint capsule, bursae, menisci, collateral, cruciate & other minor ligaments of the knee
When is a knee arthrogram generally done? when tears of the joint capsule, menisci, or ligaments are suspected
What is needed for preparation of a knee arthrogram? patients signed consent form, patient must be questioned about any allergy to iodine
If the patient is on anticoagulant therapy, their medications may need to be withheld for a period of time prior to the procedure
What if any, clothing must be removed before the procedure is started? Pants must be removed so they will not be in the way of the knees
Two images will be taken before the procedure is started A Scout AP, and a Lateral knee image will be done and shown to the radiologist
The patient position should be supine on the x-ray table
What will be done after the patient is positioned knees will be shaved with a razor if necessary. Gloves will be put on & injection site will be prepped with betadine soaked sponges. Gauze should be used to dry the area & knee will be covered with a fenestrated drape.
Injection site should be anesthetized with a numbing agent called xylocaine
The patients knee is gently flexed for this reason to evenly mix and spread the contrast/air that's been injected
For imaging the patient will be placed in this projection on the x-ray table prone
This anatomy is demonstrated in the spot images Medial and Lateral menisci in profile
This anatomy is demonstrated on the AP & Lateral images The entire articular joint capsule
Shoulder arthrography is done for this purpose to demonstrate the joint capsule, rotator cuff, long tendon of the biceps & the articular cartilage
Created by: ABIGAILDRAKE1984