Arthrogram

An arthrogram is used to diagnose a problem or relieve pain in a joint, most commonly the shoulder, hip, knee, elbow or wrist.

The Procedure

With live X-ray (fluoroscopy) for guidance, a doctor will numb the skin around the joint, then place a small needle into the joint and inject a small amount of X-ray dye to confirm that the needle is in the proper place. During the procedure, your child will be protected by an x-ray shield.

If the arthrogram is for diagnosis, the doctor will inject another dye, for MRI. The needle will be removed and a bandage applied. We will take your child to an MRI machine to scan the joint. Using the MRI images, a doctor will evaluate the joint and the tissue, ligaments and cartilage around it and attempt to determine the cause of pain, swelling or abnormal movement.

If the arthrogram is for pain relief, the doctor will inject pain-relief medicine.

Once the procedure is complete, the needle will be removed and a bandage will be applied to the area of injection.

The procedure should take less than an hour to complete.

Will my child be awake during the procedure?

Some children remain awake, and we use a local numbing medicine at the site of the injection. In other cases, we use IV sedation or general anesthesia and the child will be asleep.

Pain

Your child will feel a needle prick when we inject the local numbing medicine. After the procedure, some patients experience mild discomfort, or a fullness or tightness, in the joint for several days. If your child has pain, apply a cool compress to the area or use over-the-counter pain medication.

Risks

An arthrogram is considered low-risk. However, potential complications include:

• bleeding
• infection
• injury to surrounding structures (such as veins)
• increased risk of joint dislocation after the procedure (because of the extra fluid in the joint)
• nerve damage

Bathing

Leave the bandage in place for one day. After the bandage is removed, your child may shower or take a bath.

Activity Restrictions

Your child should rest the joint for 24 hours and may not participate in strenuous activity for one week. There is an increased risk of joint dislocation for one week, so avoid activities that directly stress the joint. For instance, a child who had an arthrogram of the shoulder shouldn’t do pull-ups or play on the monkey bars, while a child who had an arthrogram of the hip should avoid hard running and jumping.