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Arthrography
Arthrography
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Arthrography
Category: Skeletal system.
Subcategory: Radiography and nuclear medicine.
Material studied: Interior of knee (or other skeletal joint), including aspirated fluid.
Estimated cost of test: Knee $130.00 to $180.00; shoulder $100.00 to $150.00; other $100.00 to $180.00.
Patient time for test: 1-2 hours.
Reliability of test results: Good.
Available as home self-test? No.
Note: Test permits examination of a joint. It requires injection of air and/or dye into a joint space.
BEFORE THE TEST
Purpose of test:
Evaluates suspected tears in the knee cartilage.
Detects shoulder abnormalities, such as a torn rotator cuff.
Detects adhesions* of a joint capsule.
Where is test performed?
Commercial laboratory, hospital, doctor's office.
Who performs test?
Lab technician or doctor.
Risks and precautions:
This X-ray procedure may be hazardous to an unborn child during pregnancy. The value of the information derived from the test must outweigh the risk. If X-rays must be taken, insist on protecting your abdomen with a lead apron.
Test is unsuitable if you have active arthritis or joint infection.
Tell your doctor if you have any allergic reactions to local anesthetics, iodine, seafood or other dyes used in diagnostic tests.
Patient preparation:
Activity--No changes necessary.
Diet--No changes necessary.
Medicines--No changes necessary.
Disrobing--As directed.
THE TEST
Sensory factors:
Touching--Inserting a needle into the joint is painful, but local anesthesia helps a great deal. You may be uncomfortable for short periods when you assume the positions the technician requests. X-ray rooms are frequently uncomfortably cool when you disrobe for the examination.
Seeing--You will see strange-appearing heavy equipment in a small space.
Hearing--You will hear sounds of X-ray machine during exposure to X-ray films.
Feeling--You may feel intimidated by the large equipment. Some degree of apprehension or fear is normal and should be expected. This discomfort disappears when the test is completed. You may also feel uncomfortable for a short while if small, enclosed space causes you discomfort.
Other senses (smell, taste)--Not affected.
Equipment used:
X-ray machine.
Fluoroscope.
Povidone-iodine solution.
Local anesthetic.
Sterile needles.
Syringes.
Water-soluble X-ray dye (to be used alone or with air).
Sterile sponges.
Shave preparation kit (optional).
Elastic knee bandage.
Sterile towels.
Sterile specimen container.
Culture tube.
Sterile adhesive bandage.
Description of test:
Remain as still as possible during the procedure, except when following instructions to change position.
Cooperate in assuming various positions because films must be taken as quickly as possible.
The anesthetic is administered. The procedure does not begin until you are numb.
Needle is placed into joint space.
Fluoroscopic exam confirms correct location of the needle.
Fluid from the joint space is collected for study.
Dye is injected into the joint space.
You may experience a tingling sensation or pressure in the joint when dye is injected.
Move the joint when directed to disburse dye throughout the joint.
X-rays are taken.
Fluid is sent to the laboratory for analysis.
You may be asked to wait a short while until films are developed.
AFTER THE TEST
Immediate post-test care:
Recovering from a local anesthetic, your vital signs are checked and pain medication provided, if needed.
Rest your joint for at least 12 hours.
If knee arthography was done, wrap the knee in an elastic bandage. Keep the bandage in place for several days. You will be shown how to rewrap the bandage.
Activity after test:
You may experience some swelling or discomfort or may hear crackling noises in the joint after the test. These symptoms usually disappear after 1 or 2 days. Inform your doctor if symptoms persist.
Apply ice to the joint if swelling occurs, and take a mild pain killer, such as acetaminophen.
Time before test results available:
Time before results are reported to the doctor or patient varies from a few minutes to a few days.
TEST RESULTS
Test values:
Test results are determined by study of X-rays.
Normal values:
No abnormalities.
What ABNORMAL may indicate:
Cartilaginous abnormalities.
Chondromalacia patellae*.
Disruption of the joint capsule and collateral ligaments.
Damage from recurrent dislocations.
Medial meniscal tears and lacerations.
Osteochondral* fractures.
Osteochondritis dissecans*.
Adhesive capsulitis*.
Bicipital tenosynovitis*.
Rotator-cuff tears.
Synovial abnormalities.
Tears of the cruciate ligaments.
Taking these drugs may affect test results:
None expected.
Other factors that may affect test results:
Incomplete withdrawal of joint fluid dilutes dye, diminishing quality of X-rays.
Improper injection technique may cause misplacement of dye.
*See Glossary.
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From Complete Guide to Medical Tests by H. Winter Griffith, M.D. Copyright by Fisher Books. Electronic rights by Medical Data Exchange.
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