Arthrography Flashcards
What pathology is this showing?
A torn vs. healthy meniscus
What is this showing here?
Infected arthroplasty
What is this showing here?
Antibiotic leads
What process is this showing here?
Joint injection
What is this showing?
MR Shoulder with Contrast
What is arthrography?
Radiography of a joint, joint capsule, soft tissues or cartilage
T/F
Arthrography requires contrast to see structures
True
What modality is used for arthrography?
Requires fluoroscopy and potentially an overhead tube
T/F
Arthrography requires a sterile tray and set-up
True
What are the 3 contrast agents that were used in the past for arthrography?
1.Negative-air
2.Positive-iodinated compound
3.Double contrast-Both positive and negative
What are the cons to using Negative - Air contrast for an arthrogram?
-Large amounts needed (150 ml)
-Very painful (distention)
-Least accurate diagnosis
What are the benefits to using positive contrast for arthrography?
-Readily absorbed, greater accuracy
-Smaller amounts, less painful
What is the best of methods at producing an accurate diagnosis in arthrography?
A combination of positive and negative contrast
T/F
When using positive and negative contrast together, you need to increase the amount of contrast of each
False; Smaller amounts of both contrast agents used
What are the joints that arthrography evaluates?
Hip, Knee, Ankle, Shoulder. Elbow, Wrist
T/F
In Double Contrast Studies, joints are exercised and manipulated
True
What views are done in double contrast studies in arthrography?
-Cross-table images
-Stress views
What are the Pathologic indications for arthrography?
–Tears in joint capsule
–Tears or degeneration of menisci
–Ligament injury
–Loose bodies
What is the radiographic criteria for arthrography?
-Entire articular capsule outlined
-Proper AP and lateral positions
-Markers
Where is double Contrast injected for a meniscal injury?
Into the lateral aspect of the suprapatellar recess
What views are done for meniscal imaging of the knee with arthrography?
-Images taken from prone to lateral to supine, rotating the knee 30 degrees each exposure
-Cross-table imaging required
How many views can be done on a single image receptor in arthrography?
Six views per image receptor
What modalities are used now in replacement for arthrography? Why??
-MRI and US
-Are non-invasive
-Less risk and better diagnosis
T/F
MRI demonstrates MOST pathologies involving ligaments and tendons and joint capsule without needing an injection
True
T/F
Current arthrograms use negative contrast only
False; Positive
T/F
Arthrograms can use conventional X-ray
True
What equipment is needed on an Arthrogram Tray?
–Prep sponge
–Fenestrated drape
–Syringes
–Flexible connector
–Needles
What position is the patient placed in for an arthrogram; supine or prone?
Supine
Read over the procedure for an arthrogram:
1.EXPLAIN procedure to patient
2.Consent form signed
3.Patient supine
4.Preliminary image (for localization)
5.Aseptic procedure
6.Local anesthetic
7.May aspirate some fluid
8.Injection of contrast(s) into joint capsule under fluoroscopy
What are the current applications of arthrography?
1.Joint aspiration – sample sent to the lab to rule out infection
2.Joint injection – therapeutic to try and reduce pain in joint.
-Like an oil change
3.Arthrogram Pre-MRI
What is an example of a pathology that requires MRI contrast?
A Labral tear in the shoulder
What contrast must be given for pathologies that cannot be seen on MRI without it?
Iodinated contrast and gadolinium mixed
T/F
Fluoro can be used to ensure that gadolinium has been injected into the joint
True
