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Arthrograpy is a procedure involving multiple x rays of a joint using a fluoroscope, or a special piece of x-ray equipment which shows an immediate x-ray image. A contrast medium (in this case, a contrast iodine solution) injected into the joint area helps highlight structures of the joint.


Frequently, arthrography is ordered to determine the cause of unexplained joint pain. This fluoroscopic procedure can show the internal workings of specific joints and outline soft tissue structures. The procedure may also be conducted to identify problems with the ligaments, cartilage, tendons, or the joint capsule of the hip, shoulder, knee, ankle or wrist. An arthrography procedure may locate cysts in the joint area, evaluate problems with the joint's arrangement and function, or indicate the need for joint replacement (prostheses). The most commonly studied joints are the knee and shoulder.


Patients who are pregnant or may be pregnant should not have this procedure unless the benefits of the findings outweigh the risk of radiation exposure. Patients who are known to be allergic to iodine need to discuss this complication with their physician. Patients who have a known allergy to shellfish are more likely to be allergic to iodine contrast.


Arthrograpy may be referred to as "joint radiography" or "x rays of the joint." The term arthrogram may be used interchangeably with arthrography. The joint area will be cleaned and a local anesthetic will be injected into the tissues around the joint to reduce pain. Next, if fluids are present in the joint, the physician may suction them out (aspirate) with a needle. These fluids may be sent to a laboratory for further study. Contrast agents are then injected into the joint through the same location by attaching the aspirating needle to a syringe containing the contrast medium. The purpose of contrast agents in x-ray procedures is to help highlight details of areas under study by making them opaque. Agents for arthrography are generally air and water-soluble dyes, the most common containing iodine. Air and iodine may be used together or independently. After the contrast agent is administered, the site of injection will be sealed and the patient may be asked to move the joint around to distribute the contrast.

Key terms

Aspirate — Remove fluids by suction, often through a needle.
Contrast (agent, medium) — A substance injected into the body that illuminates certain structures that would otherwise be hard to see on the radiograph (film).
Fluoroscope — A device used in some radiology procedures that provides immediate images and motion on a screen much like those seen at airport baggage security stations.
Radiologist — A medical doctor specially trained in radiology (x ray) interpretation and its use in the diagnosis of diseases and injuries.
X ray — A form of electromagnetic radiation with shorter wavelengths than normal light. X rays can penetrate most structures.
Before the contrast medium can be absorbed by the joint itself, several films will be quickly taken under the guidance of the fluoroscope. The patient will be asked to move the joint into a series of positions, keeping still between positioning. Sometimes, the patient will experience some tingling or discomfort during the procedure, which is normal and due to the contrast. Following fluoroscopic tracking of the contrast, standard x rays of the area may also be taken. The entire procedure will last about one hour.


It is important to discuss any known sensitivity to local anesthetics or iodine prior to this procedure. A physician should explain the procedure and the risks associated with contrast agents and ask the patient to sign an informed consent. If iodine contrast will be administered, the patient may be instructed not to eat before the exam. The timeframe of fasting may extend from only 90 minutes prior to the exam up to the night before. There is no other preparation necessary.


The affected joint should be rested for approximately 12 hours following the procedure. The joint may be wrapped in an elastic bandage and the patient should receive instructions on the care and changing of the bandage. Noises in the joint such as cracking or clicking are normal for a few days following arthrography. These noises are the result of liquid in the joints. Swelling may also occur and can be treated with application of ice or cold packs. A mild pain reliever can be used to lessen pain in the first few days. However, if any of these symptoms persist for more than a few days, patients are advised to contact their physician.


In some patients iodine can cause allergic reactions, ranging from mild nausea to severe cardiovascular or nervous system complications. Since the contrast dye is put into a joint, rather than into a vein, allergic reactions are rare. Facilities licensed to perform contrast exams should meet requirements for equipment, supplies and staff training to handle a possible severe reaction. Infection or joint damage are possible, although not frequent, complications of arthrography.

Normal results

A normal arthrography exam will show proper placement of the dye or contrast medium throughout the joint structures, joint space, cartilage and ligaments.

Abnormal results

The abnormal placement of dye may indicate rheumatoid arthritis, cysts, joint dislocation, rupture of the rotator cuff, tears in the ligament and other conditions. The entire lining of the joint becomes opaque from the technique, which allows the radiologist to see abnormalities in the intricate workings of the joint. In the case of recurrent shoulder dislocations, arthrography results can be used to evaluate damage. Patients with hip prostheses may receive arthrography to evaluate proper placement or function of their prostheses.



American College of Radiology. 1891 Preston White Drive, Reston, VA 22091. (800) 227-5463.
Arthritis Foundation. 1300 W. Peachtree St., Atlanta, GA 30309. (800) 283-7800.
Gale Encyclopedia of Medicine. Copyright 2008 The Gale Group, Inc. All rights reserved.


radiography of a joint.
air arthrography pneumoarthrography.
Miller-Keane Encyclopedia and Dictionary of Medicine, Nursing, and Allied Health, Seventh Edition. © 2003 by Saunders, an imprint of Elsevier, Inc. All rights reserved.


Act of making an arthrogram.
[arthro- + G. graphō, to describe]
Farlex Partner Medical Dictionary © Farlex 2012


Examination of the interior of a joint using x-rays following the injection of a radiopaque substance.

ar′thro·gram′ (är′thrə-grăm′) n.
The American Heritage® Medical Dictionary Copyright © 2007, 2004 by Houghton Mifflin Company. Published by Houghton Mifflin Company. All rights reserved.


A clinical test in which air or a radiocontrast is injected into a joint (e.g., shoulder, wrist, knee, ankle) to visualise an articular space.
Abnormal in osteochondral disruption and fractures, osteochondritis dissecans, rheumatic diseases, synovial defects, and tears of rotator cuff, joint capsule, ligaments, etc. Classic arthrography with standard imaging has been largely replaced by CT and MRI, the latter of which can be enhanced with a splash of gadolinium, which causes capsular defects to light up on T1-weighted images.
Segen's Medical Dictionary. © 2012 Farlex, Inc. All rights reserved.


Orthopedics A test in which air or radiocontrast medium is injected into various joints–eg shoulder, wrist, knee, ankle to allow visualization of the articular space Abnormal in Osteochondral disruption and fractures, osteochondritis dissecans, rheumatic diseases, synovial defects, tears of rotator cuff, joint capsule, ligaments, etc
McGraw-Hill Concise Dictionary of Modern Medicine. © 2002 by The McGraw-Hill Companies, Inc.


Radiography of a joint after injecting one or more contrast media into the joint.
[arthro- + G. graphō, to describe]
Medical Dictionary for the Health Professions and Nursing © Farlex 2012


X-ray examination of a joint after injection of a radio-opaque fluid or a gas.
Collins Dictionary of Medicine © Robert M. Youngson 2004, 2005
References in periodicals archive ?
The measurements were performed and recorded by a physician who was blinded to the clinical and MR arthrographic findings of the patient.
A thickened CHL and joint capsule, decreased axillary recess volume and obliteration of the subcoracoid fat triangle was used for presumptive MR arthrographic diagnosis of adhesive capsulitis (3,8).
Caption: Figure 17: Anteroposterior radiograph (A) and MR arthrographic image (B) of the right hip in a patient with cam-type femoral-acetabular impingement.
This results in an elongated appearance of the hip joint and can be useful for evaluation of acetabular labral tears (note anterior labral detachment, arrow, on the MR arthrographic axial oblique image).
Humeral head cysts and rotator cuff tears: An MR arthrographic study.
Chung and coworkers (8) found only 42% agreement between arthrographic and final arthroscopic diagnoses in the setting of chronic wrist pain.
Sensitivity and specificity of arthrography compared to arthroscopy were 60% and 100%, respectively, for SLIL and articular disc lesions, and 93% and 97% respectively for LTIL lesions.7 A negative arthrographic examination, therefore, does not eliminate the possibility of a ligament tear(s).
Triad of MR arthrographic findings in patients with cam-type femoroacetabular impingement.
Bigliani and colleagues (12) reported that findings on CT scans taken after injection of arthrographic contrast medium correlated with operative findings in less than two-thirds of 20 shoulders studied.
Tarsal sinus: Arthrographic, MR imaging, MR arthrographic, and pathologic findings in cadavers and retrospective study data in patients with sinus tarsi syndrome.
Arthrographic MR examination lends the greatest accuracy in making this diagnosis.
Iliotibial band friction syndrome: MR imaging findings in 16 patients and MR arthrographic study of six cadaveric knees.

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