Arthrography of the hip, knee or shoulder: X-ray examination
Arthrography is an examination that uses a contrast fluid and X-rays. It is not the same as an MRI scan, but is sometimes performed in combination with an MRI scan. This examination makes it easier to examine joints. The hip, knee and shoulder in particular are examined most often. This may be necessary if there is a suspicion of wear or damage to the joint or in case of unexplained pain complaints. After the examination, the joint will often feel stiff, swollen and painful for some time.
What is arthrography?
Arthrography is also sometimes written as arthrography (without h). It is an X-ray examination of the joints using contrast fluid.
Contrast fluid
Arthrography uses contrast fluid. This fluid makes the joint cavity clearly visible. The fluid is injected using a thin needle. Contrast fluid may contain iodine because iodine transmits X-rays. Depending on the examination, a small amount of contrast fluid and air, or only one of the two, is used. The skin is first disinfected and anesthetized beforehand. The contrast fluid disappears from the body automatically after one to two days.
X-ray examination
The joint is punctured using ultrasound or x-rays. Once the contrast fluid has been injected, photos can be taken. An X-ray machine takes X-rays or recordings using X-rays. X-rays are electromagnetic radiation that can pass through tissue but are blocked by heavier substances such as bones. Nowadays digital radiography is widely used. Only 10 percent of the original radiation is required.
Frequent exposure to X-rays increases the risk of cancer. An X-ray at the dentist yields 5 microsieverts, an X-ray of the colon 7,000 microsieverts and a CT scan 1,400 microsieverts.
Why an arthrography?
This examination is often used when there is a suspicion that a joint is damaged. A moderately worn joint is sometimes calmed by injecting an anesthetic. This can only be done by arthrography. In addition, this method can sometimes be useful to identify pain complaints. It is often difficult for doctors to find the precise cause. Arthrography can be used to determine exactly what is going on.
The knee
This type of examination is often performed on the knee when there is suspicion of a damaged meniscus. The meniscus is a cartilage structure located in the knee joint. Once it is known exactly what the complaint is, appropriate treatment can take place. The knee joint will feel stiff for some time after the examination.
Hip
Arthrography of the hip is often performed when the hip is given temporary rest through analgesic injections. This allows the doctor to see exactly where the injection needs to be done. In addition, this examination is also carried out for hip complaints for which the cause cannot be immediately determined and when there is suspicion of wear or damage to the hip. In case of severe wear and tear of the hip, this can be clearly visualized through this examination. The treatment is then aimed at replacing (part of) the hip.
Shoulder
The shoulder is a joint that often comes under great stress. Various conditions and complaints of the shoulder can lead to arthrography. After the examination, the shoulder may feel stiff for some time and the arm may sometimes be difficult to use. This feeling usually disappears within hours to days.
Does the examination hurt?
You won’t notice anything from X-rays themselves: they don’t hurt. The injection itself can be painful. The joint may also feel swollen, stiff and painful for some time afterwards. A wet, cold washcloth numbs the pain. In severe cases, a painkiller can be taken. If the joint is overloaded, additional pain complaints may arise. If the pain persists for a long time, it is advisable to contact the doctor.
Sometimes a second examination is necessary. In other cases, arthrography is performed together with an MRI scan. An MRI scan works differently than an X-ray machine. MRI stands for magnetic resonance imaging. This works with a large strong magnet and radio waves. Sometimes contrast fluid is also used for an MRI scan. In these cases, arthrography is also sometimes referred to. An MRI scan creates images of the body that resemble cut slices. This makes it easier to look inside an organ or joint.
Pregnancy
Both an X-ray examination and an MRI scan cannot be performed without dangers, especially in pregnant women. A pregnant woman must always report in advance that she is pregnant. The first three months of pregnancy are especially a critical period. The fetus is completely formed during this period and external influences can cause mutation.