If you are dealing with unexplained joint pain or disorder, you will require arthrography imaging for examination and accurate diagnosis. The type of imaging has proved to be efficient in diagnosing conditions around ligaments and cartilages. When you go for a medical exam involving arthrography imaging, the doctor can inject contrast into the bloodstream. The method is known as indirect arthrography.
Alternatively, the doctor could use a direct arthrography technique where contrast material is directly injected into the joint. Injecting the contrast enables the doctor to perform a CT scan or MRI to obtain a clear image of the joints that aid diagnosis. Therefore, if you are experiencing joint pains whose cause is unknown in Los Angeles, Los Angeles Diagnostics can perform direct arthrography imaging to diagnose and treat your joint condition accurately.
Understanding Arthrography
As mentioned above, arthrography is an imaging technique primarily utilized to diagnose joint illnesses. The imaging can be direct or indirect, although both methods provide clear images of the joint spaces after imaging.
Contrast is injected into the bloodstream and gradually absorbed in the joints in indirect arthrography. On the other hand, direct arthrography involves contrast injection directly into the joints. Of these two imaging techniques, radiologists recommend direct arthrography because of the more precise visualization of the internal joint structure by enlarging joint spaces. With this kind of imaging, you should expect correct evaluation and diagnosis of your joint condition, thus enhancing the chances of recovery.
Techniques for Performing Direct Arthrography
Traditional direct arthrography uses an x-ray known as fluoroscopy to direct and analyze iodine contrast in the joints. Also, your radiologist could utilize ultrasound to control the imaging. A radiologist is a specialist who oversees and interprets radiology results.
Another technique the radiologist might use is Magnetic Resonance Imaging (MRI) or Computed Tomography (CT) scanning after iodine has been injected into the joints.
X-rays are the oldest and most widely used medical imaging tool for evaluating, diagnosing, and treating various medical conditions. The medical imaging technique works by exposing your body to a trivial portion of ionizing radioactivity, enabling radiologists to obtain clear images of the internal body parts and organs.
However, when it comes to imaging joints, bones, and inner organs live, radiologists recommend the extraordinary form of x-ray known as fluoroscopy. When using this technique for diagnosis, the radiologists inject contrast in the affected joint, enlarging it. With the joint space enlarged, the doctor can obtain clear images during fluoroscopy, thus allowing for proper assessment of its internal structure and function.
Even though fluoroscopy performs imaging in real-time, the radiologist can capture radiographs for records and future review and store them electronically.
Another technique is the MRI technique which involves injecting contrast into the joints. The method is different because it doesn’t include the injection of iodine. Instead, the radiologist administers a material called gadolinium, which interferes with the magnetic fields around the joints, outlining the internal composition of the joint, including cartilages, tendons, bones, and labrum. When the MR Imaginings are produced, it becomes easy for the doctor to evaluate the inside of the joint and make an accurate diagnosis of your joint illness or pain.
When you walk into one of our Los Angeles MRI clinics for a direct MRI arthrography, it’s critical to understand your expectations. An MRI uses magnetic fields, radiofrequency pulsations, and a computer to generate detailed internal joint structure images. Besides, the technique could be used for interior imaging organs and soft tissues.
After the images are generated, they are displayed on a monitor and stored electronically. If you need some hard copies of the radiographs, you can request the radiologist print a few.
This information shows that the main difference between the MRI technique and x-ray is the contrast used. Again, MRI doesn’t rely on ionizing radiation to produce images of the interior of your body.
Typical Applications of Direct Arthrography
When you walk into our MRI clinic in Los Angeles with joint pain or illness, our physicians will recommend a direct arthrography to examine the changes in the build and role of the joints. We will then use the images produced in the imaging to determine the condition causing joint problems and recommend the proper treatment. The physician could suggest arthroscopy, joint replacement, or open surgery based on your joint disease.
Some of the joints that might necessitate you to undergo the procedure are:
- Hip
- Knee
- Shoulder
- Ankle
- Elbow
- Wrist
Therefore, if you have been experiencing chronic and mysterious joint distress or pain in the areas mentioned above, you should consider direct arthrography. And because of the pain experienced in the joints, the radiologist performing the procedure should administer a local anesthetic when injecting the gadolinium contrast to temporarily alleviate the joint pain and provide additional information on the pain source.
Preparations for the Procedure
There is little prepping involved in direct MRI arthrography. Generally, you can observe a regular diet before the procedure unless advised otherwise by your physician. However, you could be discouraged from taking particular foods or fluids if a sedative is administered. The prepping required depends on the procedure of the examination technique.
If you have allergies or kidney problems, share this information with your physician because gadolinium or iodine might trigger allergens, further complicating the procedure. Also, you should tell your doctor of any recent illness you have suffered from and the medication you have been using for treatment. If there is a pregnancy possibility, don’t forget to mention it.
A direct arthrography using the MRI method requires injecting gadolinium in the affected joints. It’s critical for the radiologist undertaking the procedure to inquire if you have asthma or an allergic reaction to a particular medication before injecting the contrast. Luckily, gadolinium contains little or no iodine, highly associated with allergic reactions. Therefore, if the doctor is performing a direct MR arthrography, you should be less concerned about the side effects and allergies.
Moreover, when you suffer from a significant health condition like kidney disease or undergo a major operation, you should notify your physician or radiologist to prevent them from administering contrast material.
Direct arthrography should be painless. However, if you are suffering from anxiety or claustrophobia, you should inform your doctor. This is because MRIs are often conducted in enclosed rooms, triggering fear or anxiety. If this is your case, the doctor will administer a sedative before commencing the exam.
Recall, MRI uses magnetic fields to obtain detailed images of the internal structure of your joints. Your precious metals and electronic gadgets might interfere with these magnetic fields, cause burns and other kinds of injuries if they are not removed when entering the MRI room. Therefore, you are encouraged to leave the following personal effects at home when going for treatment:
- Body piercings
- Jackknives, pens, and spectacles
- Removable dental work
- Credit cards, jewelry, or hearing aids
- Pins, hairpins, and all other metallic items might interfere with the magnetic fields of the MRI unit.
What do you do if you have metallic implants? Just because metallic items aren’t allowed in the scanning room doesn’t rule you out of the procedure if you have a metallic or medical device in the body. However, you must undergo an evaluation to determine the safety of the MRI before the procedure. You will need the safety evaluation if you have the following implants in the body:
- Ear implants
- Certain kinds of metal loops placed in blood vessels
- Vagal nerve stimulators
- Particular sorts of older pacemakers
These devices increase the risk of complications in the procedure or impede exam efficiency. Luckily, many of these metal or medical devices in the body contain pamphlets that outline its MRI risks. If you have a booklet for your implant, let the radiologist know. The leaflet can also address any questions the radiologists might have before the imaging. MRI is not possible without corroboration and records of a medical implant and its compatibility with MRI for medical reasons.
If you are unsure of the metal implants in your body, the radiologist can use an x-ray to spot them. Typically, orthopedic surgery metal implants are compatible with MRI. However, you should explore other alternatives if you recently had a joint implant because MRI won’t be consistent.
Any foreign objects, especially the eyes, pose a significant risk when they heat during imaging because they may explode, causing blindness. People with tattoos must be careful, too, because some of the dyes utilized in the procedures contain iron which could cause heating during the MR arthrogram.
Furthermore, you should notify the radiologist about your dental fillings, braces, and other makeup. Even if they don’t interfere with the magnetic fields, they might distort the brain or facial images produced during the procedure. Therefore, you want your radiologists to know these before the imaging procedure commences.
Also, wear loose and comfortable clothing like a robe for the exam. If you are pregnant, the doctor will perform the necessary tests, and when the pregnancy is confirmed, they will take the required measures to protect the baby from radiation exposure.
Equipment Used for the Procedure
A direct arthrography uses the following equipment:
- Radiographic table
- Video monitor
- A single or two x-ray cylinders
These x-rays utilized in the convention direct arthrography to view joints in motion. Also, it produces pictures and movies which doctors and physicians rely on to guide their diagnosis and subsequent treatment. Here, the video is produced by the x-ray and detector hanging over the assessment table.
The conventional MRI machine is a cylindrical duct enclosed by a circular magnet. During an MRI, you lie on the assessment table that slides into the cylindrical tube to the epicenter of the magnet.
Today, new MRI machines called shore-bore systems are designed to prevent the circular magnet from surrounding you. Also, some units have a loftier diameter bore as it is suitable for patients with bigger body sizes or those suffering from fear of enclosed spaces, also called claustrophobia. Another recent unit is the open MRI. It produces quality pictures for diagnosis, but it doesn’t perform particular MRIs.
Additionally, the technologist will use syringes, needles, and contrast materials to complete the procedure. The material enhances visualization of the inside of the joint for detailed pictures that help guide evaluation and treatment.
How Direct Arthrography Works
A direct MR arthrography is different from using an x-ray or CT scan because it doesn’t use radiation. Instead, it’s the radio waves that realign the hydrogen atoms in the body. They produce various kinds of radio waves based on the tissue location as they align to their usual alignment. A scanner then captures the radio waves and displays them as images.
An MRI machine produces magnetic fields when an electric current passes through wire spirals. Also, the coils can be inside the unit or attached to the body part that requires imaging. The loops allow for the transmission of radio waves which produce signals sensed by the machine, capturing images.
Direct Arthrography Procedure
Your doctor only needs one appointment to perform the examination.
Before the direct MRI arthrography, the radiologists position you on the exam table and perform an x-ray of the affected joint. The radiographs obtained from the x-ray guide the injection of gadolinium contrast material and provide a primary evaluation to be matched with the images produced by the direct arthrography procedure. The x-ray is not mandatory if a recent one is available because the physician can rely on this for reference.
The second step involves cleaning the skin around the joint using an antiseptic. The doctor will then cover the cleansed area with a sterilized surgical wrap and inject a local anesthetic in the joint space using a tiny needle. If you are afraid of needles, the injection shouldn’t scare you because you will only experience a sting that only lasts for at most twenty seconds.
Once the anesthetic kicks in, the radiologist will inject an elongated needle into the joint area. An ultrasound or fluoroscopy must guide the insertion to inject the suitable joint space. If your doctor needs the joint fluid to be tested for infections, the radiologist uses a syringe for aspiration and sends the sample to the laboratory for testing.
The joint space is then injected with gadolinium to enhance visibility on the ultrasound or fluoroscopy. That way, the radiologist can see detailed images of the interior structure of the joint and interpret the radiology examination. Other times, the radiology expert injects air in the joint or contrast material along with other medications like an anti-inflammatory.
Next, the radiologist pulls out the needle and asks you to move the joint in question for the contrast to spread into the space. During these motions, the radiologist will be observing joint movement through fluoroscopy. An arthrogram exam using an MRI machine takes more than an hour.
What to Expect Throughout and After the Exam
During the administration of the local anesthesia, you might experience a sting of momentary burning. As the needle is inserted further into the joint, you might feel some pressure or slight pain. However, if the pain persists, inform the expert to inject more local anesthesia.
And because your arthrography involves an MRI, the imaged joint area might feel somewhat warm. This is normal but if it’s a problem for you, notify the radiologist to make adjustments for the procedure to be more comfortable. Once you are satisfied, the radiologist can begin taking images. If you feel or hear loud thumping sounds, you should know the imaginings are being taken, which is the time to remain seamlessly still.
To minimize the sound produced by the unit and ensure you remain relaxed throughout the imaging, you will be given earplugs or headsets to put on. Kids are given smaller earplugs, and some music is played in the background to pass the time and prevent anxiety.
Note that although you will be in the MRI room alone, the radiologist can observe, hear, and voice from outside. Also, you will be holding a squeeze-ball so that if you need any help, you can ask without having to move.
If no sedative was administered in the procedure, you could resume your routines right away. However, if one was used, you might have some side effects, so you are discouraged from driving yourself home after the procedure. Also, the material itself might have some side effects like headaches, discomfort, and nausea. Some patients with an allergic reaction to the injection might experience itchy eyes and hives. If you experience these or any other allergen symptoms, notify the radiologist immediately to obtain the appropriate medical attention.
After the procedure, you might observe swelling or inflammation around the joint area. This can be controlled by placing or rubbing ice on the joint. Also, you should minimize movement around the affected joint for at least a day until all the fluid around it is removed.
Find the Right MRI Clinic Near Me
Direct arthrography has proven effective in detecting illnesses on the joint area like the tendons, ligaments, and cartilages. Therefore, if you have been experiencing unexplained pain or illness on the joints, we at Los Angeles Diagnostics invite you to visit our Los Angeles MRI clinic to evaluate and correctly diagnose your joint problem. Call us today at 323-486-7502 to schedule an appointment.
