Arthrography

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The arthrography is the representation of the joint interior with contrast medium as radiological examination method of joints . Before imaging the ultrasound , the magnetic resonance imaging and computed tomography were available, arthrography was the only way to soft tissue structures of the joints by means of an X-ray examination show. To do this, a contrast agent is injected into the joint. X-rays are then taken from different angles. The non-bony components of the joint can now also be assessed on the X-ray image thanks to the contrast agent.

With the increasing spread of cross-sectional imaging methods such as magnetic resonance tomography and computed tomography, the soft tissues around and in the joints can also be visualized without invasive arthrography. Sonography offers another option for visualizing the superficial soft tissues . Arthrography has therefore lost its justification in the x-ray examination of joints.

At the same time, with the development of magnetic resonance tomography and computed tomography, new areas of application for arthrography have emerged. The injection of contrast medium into the joint serves to unfold the joint capsule and thus to better assess the soft tissue structures that are otherwise close together. Furthermore, some injuries to the cartilage, the joint discs ( menisci ), the joint capsule and the joint ligaments can only be reliably assessed with the help of a contrast agent injection . Arthrography with subsequent magnetic resonance imaging or computed tomography has once again become a standard procedure, particularly in diagnosing the shoulder joint and the wrist.

Methods by type of contrast agent

  • X-ray: arthrography with air or another gas (negative contrast)
  • Magnetic resonance tomography, computed tomography: arthrography with a water-soluble contrast medium (positive contrast)
  • Computed tomography: arthrography with air and a water-soluble contrast medium (double contrast)

Risks

Arthrography is usually an examination that is well tolerated by the patient. Taking into account possible contraindications and careful sterile working methods, the probability of the risks listed below can be assessed as very low.

During the contrast examination, the joint is punctured. This can be painful, depending on the qualifications of the examiner. The joint puncture itself is a risk of infection, bacteria can be introduced into the joint, and the resulting pyarthrosis is to be assessed as very severe damage to the joint. The contrast agent is usually iodine-based in X-ray examinations and computed tomography , and gadolinium-based in magnetic resonance imaging . Both types of contrast media can cause allergic reactions.