Background
An arthrogram is a particular type of radiograph whereby a
contrast medium is used to visualize a joint abnormality. Despite the
introduction of more advanced diagnostic imaging modalities, such as CT and
MRI, arthrography remains a popular diagnostic tool, as it is not a technically
difficult procedure to perform, and the findings are easier to interpret than
are those obtained using ultrasound, CT or MRI.1
Historical Overview
During the last century, arthrography has evolved from crude
approaches to more advanced CT and MR arthrographic techniques.2 Arthrography was most widely
used during the 1960s and 1970s, but indications for its use in many joints decreased
after the introduction of cross-sectional imaging modalities. Nevertheless, arthrography
continues to provide valuable anatomic information about the joints and
provides accurate depiction of internal derangement.2
Description
For arthrography, the area to be visualized is cleaned, and
a local anesthetic is injected into the area around the joint. If fluid is
present in the joint, it may be aspirated and sent to the lab for further
analysis. A contrast agent (eg, iodine solution, air), or combination of
agents, is injected into the joint. After the contrast agent is injected, the
site is sealed, and the patient may be asked to move the joint to distribute
the contrast. The purpose of contrast agents is to highlight details of the
structures under study by making them opaque.
A normal arthrogram shows proper placement of the contrast
medium throughout the joint, cartilage and ligaments. In an abnormal
arthrogram, the entire lining of the joint becomes opaque. Abnormal arthrograms
may indicate degenerative
changes, a cyst or other mass, joint dislocation, ruptures or
tears in the ligaments and other conditions.
