Arthrogram MRI

Fluoroscopy of shoulder – needle injecting contrast

Well this was fun. Prior to having shoulder surgery which you can read about here I had to have a shoulder arthrogram MRI. This is basically a special type of MRI where they inject contrast fluid directly into the joint. This lets them see things that they can’t really see otherwise, for instance tendon and ligament tissue around the joint.

In short it goes like this:

  1. Go to the x-ray room and get prepped – expose the area, mark the joint, etc.
  2. Get under the fluoroscope (The doctor uses this specialized live x-ray to place the injection in exactly the right spot in your joint.)
  3. Get an injection of lidocaine or possibly some other painkiller down through until they get to the joint
  4. Get the contrast injected into the joint
  5. Move to the MRI room where you sit for 15 to 20 minutes while the MRI is being done

Now, if you need this done then you really need it. The arthrogram will give you and  your doctor the right and accurate information for you both to make decisions. That said, this is definitely not a pleasant experience.

Steps one and two are your standard simple part – getting set up. Three and four however start to get sticky. When the doctor marks the spot they use an admittedly thin needle to push down through your tissue into the joint. What the lidocaine step felt like to me was that he would go in a little bit and put some painkiller and push further put some more painkiller push further put some more painkiller. Each time the needle went deeper it obviously hurt again, then subside.

Step four was actually odd, because you know he is putting a needle back down through the hole he just created. At the same time, while uncomfortable it doesn’t hurt because they just put painkiller all through that area. When they inject the contrast however it’s both uncomfortable and painful. The joint also must be kept as still as possible from here on so that the contrast stays where it was placed until the MRI can be performed, which also kind of sucks.

For me, once this was done, my arm hurt for a few days afterwards but otherwise no issues. In short, this is an uncomfortable slightly painful process that you sometimes need to go through to get enough information.

The result:

The result – an MRI with contrast in the joint.

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