Wentworth-Douglass Hospital
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Evaluates the joint cartilage and other internal joint structures.  Indications include, but are not limited to:

  • Joint Pain
  • Swelling
  • Limited range of motion

Shoulder:  For suspected tear of rotator cuff or labrum
Elbow:  Evaluation for pathalogic plica
Wrist:  Ligament tears and Triangular Fibrocartilage Complex (TFCC)
Hip:  For susptected tear of labrum
Knee:  ONLY for patients with contraindications for MRI, and then
             should be done with CT to follow

MRI Arthrogram is recommended (2-part study:  Fluoroscopic guided injection & arthrogram
with an MRI to follow)  CT Arthrogram -- for patients who have a contraindication for MRI.

An Arthrogram looks at the structures in a joint such as a shoulder, elbow, wrist, knee or hip.  The structures include cartilage, ligaments and bursa (fluid-filled joint capsules).  Sometimes these procedures are done along with an MRI to gain even more information regarding possible injury.  Procedure Duration:  45 minutes for x-ray portion followed by MRI.

Patient Preparation:
Please make sure the tell your doctor or the technologist if you have any allergies to medications, especially to radiology contrast (dye).  If you have had any contrast (dye) reactions in the past you may need to pre-medicate.  Please make your physician aware of this prior to your visit, as well as your technologists at the time of  your procedure.

Upon arrival to the radiology department, you will change into a gown and robe provided by the hospital.  You are required to remove all clothing and jewelry that will interfere with the procedure.  Your privacy and comfort will be maintained at all times.

If you are having an Arthrogram with an MRI to follow, you may need pre-screening orbit x-rays.  This is required for anyone who has done machinist, welding, or metal work or who has had metal removed from their eyes at any point in their life.  You will also need to inform the Radiology Dept if you have a heart pacemaker or defibrillator, any metal implants, or infusion pumps. 

**NOTE:  If you are a woman of childbearing age, the technologist will ask if there is any possibility of pregnancy.

During the procedure:
A doctor of radiology (radiologist) and registered technologist(s) will perform the procedure.  Your technologist will assist the doctor and you during the procedure.  Please feel free to ask questions at any time.

A technologist will go over some medical history and your medication list with you prior to the procedure.  She/he will explain the procedure and what your procedure requires.  You will be positioned on a table.  It is attached to a fluoroscope, an x-ray unit that works with a television/computer screen.  The doctor will use this to view your joint area.  This will ensure he/she is in the joint space adequately so the colorless contrast agent (dye) will be administered in the best location of the joint to provide the most information regarding your symptoms. 

The doctor will work in a sterile fashion to reduce the risk of introducing infection.  A numbing medicine similar to Novocain will be injected just under the skin and into your joint.  This feels much like a bee sting and only lasts a short time.  Once numbed, the radiologist will insert a second needle into the joint.  The x-ray and/or MRI contrast will be injected through the inserted needle and may make your joint feel full.  Fluoroscopic images will be taken with your joint in various positions.  Moving the joint will distribute the contrast in the joint and produce good quality images. 

Once the fluoroscopic portion of the procedure is complete, the technologist may take additional still x-rays.  The technologist will provide discharge instructions in both verbal and in written form.  You will then be taken to the MRI suite if an MRI is to follow.  MRI will scan your joint with the MRI contrast to gain further information regarding your symptoms.

Post-procedure Information:
The radiologist (doctor) will read all images from the procedure(s) and dictate a report.  Your physician will receive a report of the findings within 3 business days and should advise you of the results.  Be sure to follow the discharge instructions given to you after your procedure.

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Wentworth-Douglass Hospital
789 Central Avenue, Dover, NH 03820
Phone: (603) 742-5252
Toll free: 1 (877) 201-7100