Arthrography is a radiological examination (X-rays) which consists of introducing a contrast medium (dye) into a joint (shoulder, hip, etc.) followed by taking X-rays. The injection of an iodinated contrast medium allows confirmation of the correct position of the needle before injection of the medication (e.g. Cortisone).
Arthrography may detect anomalies in the ligaments or meniscus, which are not visible on plain radiographs without dye. It may also be used to introduce medications (cortisone or other) in the specific location requested by the referring physician. The most frequently examined joints under fluoroscopic guidance are: the shoulder, hip, knee and ankle.
The patient is in a prone position; the radiologist uses a local anesthetic and then guides the needle with the help of a screen or monitor until it reaches the proper position.
Therapeutic arthrography (infiltration)
This is a technique in which the radiologist first injects an anti-inflammatory product, such as cortisone, into the joint, and then proceeds to position the needle. When the needle is in the right place, the medication is injected.
Indications: these techniques are designed to relieve articular (joint) or periarticular pain due to arthritis or inflammation.
It is important to provide before your examination, the images and reports of relevant previous examinations done elsewhere (X-Rays, MRI, CT-SCAN, Ultrasound). This is necessary for purposes of comparison.
After the infiltration or arthrography:
In the hours following the examination, discomfort may be felt at the site of injection.
Some people may feel pain (relieved by Tylenol or Advil, as well as compresses) for a day or two.
Distensive arthrography of the shoulder
A product visible to X-rays (iodine) is first injected into the shoulder joint. Imaging is then used to inject medication (cortisone) and a local analgesic, in order to distend the joint capsule of the shoulder and allow you to resume regular movements.
Unless otherwise directed by your referring physician, it is recommended that you consult a physiotherapist in order to learn the exercises to perform after your examination.
Knee – Synvisc injection
A healthy joint is comprised of cartilage and synovial fluid, which protect the bone against shock and friction. In an arthritic joint, the cartilage crumbles and the synovial fluid cannot play a protective role. This results in friction between the bones that causes pain, joint stiffness and swelling.
An injection of Synvisc helps protect the knee joint by forming a pad that protects and lubricates the joint optimally. The injected product thus has the ability to reduce the pain of arthritis in a prolonged and significant manner.
The benefits of Synvisc:
- Lubrifies and protects the joint
- Reduces the pain and discomfort of arthritis
- Helps protect against cartilage damage
- May delay the need for a complete knee replacement
- May help to resume normal activities
This examination allows the injection of a medication (cortisone) accompanied by a local analgesic, in the periphery of the facet joints, located on either side of the spine. The goal is to relieve recurring pain.
* This procedure is done by computed tomography (CT-Scan) in Westmount Square
This examination allows the injection of a medication (dexamethasone) accompanied by a local analgesic near a foramen (small opening through a nerve located on each side of the spine). The goal of this procedure is to relieve recurring pain often caused by compression on the nerve.
This exam enables a cortisone injection between two vertebral bodies in the epidural space, the area which surrounds the sac containing the nerve roots.
The purpose of this infiltration is to inject a minimal quantity of anti-inflammatory cortisone to reduce inflammation between the nerve and intervertebral disc. This infiltration is performed in a prone position. After prepping the skin under sterile conditions, a needle is introduced between two vertebrae at the level of the lumbar spine, into the space surrounding the sac containing the nerve roots (epidural space). In general, this procedure is not very painful.
At our Westmount Square clinic, we also perform infiltration of the pudendal nerve; this procedure is performed with a CT-scan.
Fast three (3) hours before the examination.
Covered in part by the RAMQ, the patient should add incidental expenses