Arthrogram or joint injection (CW)

What is an arthrogram?

An arthrogram is a special X-ray procedure where X-ray contrast is injected into your joint and X-ray pictures are then taken. You will then go to MRI for further scans.

What is a joint injection?

This is an injection of local anaesthetic and/or steroid into the joint under X-ray guidance. Joint injections are usually done to treat inflammation and reduce pain or discomfort.

Risk and benefits

You will benefit from this procedure because it will help us investigate your symptoms and possibly treat them. It is a safe and quick procedure and it is done on an outpatient basis so will not require a hospital bed.

These are common procedures that have little risk. However it is possible to have a small amount of bruising or minor bleeding into the joint. There is a small risk of an infection in the joint.

Rarely the needle tip might cause damage to the cartilage in the joint. We will discuss all of the risks and benefits with you in detail before your procedure.

What happens on the day of my appointment?

Please take all your usual medication. If you are diabetic, take your regular insulin. If you use inhalers or glyceryl trinitrate (GTN) spray, bring them with you.

Please come to the X-ray reception (1st Floor, Lift Bank D) at least 20 minutes before your appointment time. If you are late, it may not be possible to carry out your procedure and it will have to be rebooked.

If you are a private patient, please come even earlier and go to the private patients cashiers (4th Floor, Lift Bank D) first, and bring the receipt with you to X-ray.

You will be booked in for your procedure and asked to take a seat by our reception staff.

Arthrogram patients—please book in at MRI Reception as you need to have a MRI safety checklist done before we do the injection.

During the procedure

You will be brought into the X-ray room and you will be introduced to the team and have your identity confirmed.

All females of childbearing age need to sign consent to be X-rayed to confirm that there is no chance that you could be pregnant. We cannot proceed with the procedure if there is a chance of pregnancy.

The procedure will be explained to you by the radiologist. You will have the opportunity to ask any questions.

You will then lie on a special X-ray table. The joint will be cleaned with antiseptic fluid and you will be covered with a sterile sheet.

You will be given local anaesthetic to numb the skin. This stings initially and then the skin will go numb.

The radiologist will then insert a needle into your joint and inject contrast while taking X-rays. A steroid to reduce inflammation and local anaesthetic may also be injected into the joint at this point if requested by your referring doctor. The procedure usually takes 15 minutes but may take longer.

Arthrogram patients are then escorted to MRI for the next part of the procedure.

After the procedure

• Arthrograms: For a few hours afterwards your joint may feel uncomfortable
• Joint injection: Your joint may be numb for several hours

Once the anaesthetic has worn off, you may experience more pain before things start to improve. Take usual pain relief such as ibuprofen or paracetamol.

If you are diabetic and had a steroid injection, monitor your blood sugars more closely over the next few days. If abnormal, contact your GP.

Things to avoid

Continue to use your joint to avoid it becoming stiff but avoid heavy exercise or placing excessive strain on the injected joint in the first week afterwards.

Contact information

Interventional Radiology Department
Imaging Department
Chelsea and Westminster Hospital
369 Fulham Road
London
SW10 9NH

T: 020 3315 8570/8582