Arthrograms

The injection of an iodine-based contrast medium arthrogram. Photograph: Zezounet

An arthrogram is a series of images (mainly x-rays) of a joint after it has been injected with a contrast medium. These injections are usually administered under local anaesthetic. It is performed by a radiologist who uses fluroscopy and ultrasound to guide the placement of the needle into the joint, to then inject the contrast fluid.

Shoulder arthrograms are used to study tears of the rotator cuff (mainly tears of four tendons rather than the muscles in the shoulder). They can also define whether there are abnormalities of the glenoid labrum and bicipital tendon. 

Arthrograms (like radiography) can either be diagnostic or therapeutic. Therapeutic arthrograms are often joint distension and cortisone injection procedures. This procedure is most common for the shoulder. Diagnostic arthrograms can be direct or indirect, by a venous injection of contrast material and then followed by a CT or MRI scan.

Arthrograms are not not recommended to patients who are allergic or sensitive to:

• medications
• contrast dyes
• local anaesthesia
• iodine
• latex

Infection in the puncture site where the radiopaque substance is injected is a small risk, as is bleeding.

There have been reports that gadolinium contrast agents cause Neophrogenic Systemic Fibrosis (NSF). This has only occurred in cases where the patients have moderate-to-end-stage kidney disease; there have been no reports stating any case of NSF in those with healthy kidneys. Other than the risk of NSF for those enduring kidney disease, arthrograms carry the same risks as any ordinary X-ray scans.