If you’re experiencing joint pain or stiffness or have had joint surgery and want to follow up on the outcomes, a magnetic resonance arthrogram can help you get the answers you need. Our guide covers everything you need to know about this imaging technique, from the conditions and injuries they can help identify to what happens during the scanning procedure.
What is an MRI arthrogram?
An MRI arthrogram is an imaging technique that combines magnetic resonance imaging (MRI) with arthrography (joint scanning). It can help doctors get detailed images of the joints and their structures. It can help identify small tears or injuries that may be hard to spot on a standard MRI, helping your doctor pinpoint the exact reason for the pain or stiffness and recommend the proper treatment.
Arthrograms can help doctors deliver medication, such as steroids, to precise areas inside a joint. They can also be a helpful way to check that joint tissues are working well after surgery.
Several other types of arthrography don’t use MRI, so if you can’t have an MRI, it is still possible for doctors to take a closer look at your joint. These include:
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Fluoroscopic arthrography uses X-rays and fluoroscopy (continuous X-rays in real-time - almost like a film).
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CT arthrography uses computed tomography imaging.
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Ultrasound arthrography uses sound waves to create images.
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Digital subtraction arthrography uses X-rays with computerised image processing.
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Dual-energy CT arthrography uses two different X-ray energies to create images.
MRI arthrograms are sometimes confused with MRAs (magnetic resonance angiograms) because of the similarities in their acronyms, but they are different imaging procedures. A magnetic resonance angiogram is a type of MRI specifically used for imaging of the blood vessels.
Where can an arthrogram be used?
In short, anywhere you have a joint. Arthrograms are commonly used to get detailed images of joint cartilage, ligaments and tendons in the following joints:
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shoulders
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wrists
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hips
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elbows
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knees
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ankles
However, arthrograms can also be used to look at small joints in the fingers and toes, the joint at which your jawbone connects to your skull and joints in the feet, among others.
What is an arthrogram used to diagnose?
Here are some specific conditions and injuries that an MRI arthrogram can help identify.
Labral tears
The labrum is a ring of cartilage that surrounds the socket of ball-and-socket joints, such as the hip and shoulder. It helps keep the ball of the joint in place and allows smooth movement in the joint.
A labral tear can occur due to an injury or even wear and tear over time. You may experience pain in the joint, a sensation of the joint ‘clicking’, and your range of motion in the joint may be reduced. Labral tears are hard to see on a standard MRI scan, but the contrast dye used in an MRI arthrogram can help to show them much more clearly.
Rotator cuff injuries
The rotator cuff is a group of muscles and tendons surrounding the shoulder joint, which keep the upper arm bone firmly in the shoulder socket. Injuries can range from tendinitis to partial or complete tears in the tendons or muscles.
You may experience shoulder pain, weakness in the joint, and difficulty with some arm movements. MRI arthrograms can show the detailed structure of the tendons, while the contrast dye can highlight small tears or areas where the tissues have degraded.
Cartilage damage
Cartilage is the smooth, rubbery tissue that covers the ends of the bones in your joints, allowing smooth movement. You can damage the cartilage through injury, wear and tear, or conditions like osteoarthritis.
You may experience pain and stiffness in the joint and notice swelling. MRI arthrograms are valuable for assessing cartilage damage because the contrast dye can outline the cartilage surface, allowing doctors to see small defects or areas of thinning cartilage.
Ligament injuries
Ligaments are the tough bands of tissue that connect bones and help make your joints stable. Ligament damage can vary in severity from strains and sprains to complete tears.
Common ligament injuries include tears in the knee or injuries in the elbow. The contrast dye in MRI arthrograms can clearly outline the ligaments, showing any damaged areas.
SLAP tears
SLAP stands for Superior Labrum Anterior and Posterior, referring to a specific type of labral tear in the shoulder. This injury affects the area where the biceps tendon attaches to the labrum.
If you have a SLAP tear, you may experience deep shoulder pain, a sensation of ‘popping’, and reduced strength in the joint. With other imaging techniques, SLAP tears can be hard to diagnose, but the contrast dye used in MRI arthrograms can seep into the tear, making it more visible.
MRI arthrograms can also be helpful when standard X-rays don't show enough detail. They're suitable for:
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Confirming what the doctor thinks might be wrong.
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Checking if a broken bone has been put back in the right place.
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Seeing small pieces of broken bone more clearly.
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Making sure broken bones are held together correctly after treatment.
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Identifying loose fragments of bone or foreign objects floating around in the joint.
What happens during an MRI arthrogram?
Before your appointment, let your doctor know if you might be pregnant. Also, talk about any health issues you've had lately, any ongoing medical problems, and any medicines you're taking. It's important to mention if you've ever had allergic reactions, particularly to contrast dyes used in scans.
Don't wear jewellery or body piercings to your appointment, and wear comfortable, loose-fitting clothes. You shouldn’t need to restrict food or drink before the scan. When you arrive for your scan, your technician will review an MRI Safety Questionnaire with you, and they might ask you to change into a hospital gown. Let the staff know if you're claustrophobic; they can help make you comfortable.
The procedure is divided into two parts. First, in an ultrasound or x-ray room, a consultant radiologist will numb your skin and joint with a local anaesthetic, then inject an MRI contrast dye into the joint. This makes tiny structures in the joint easier to see. Next, you'll move to the MRI scanner, where you'll lie on a table that moves slowly into a large cylinder-shaped tube surrounded by a circular magnet.
The scan usually takes 20 to 30 minutes. Your technician will give you earplugs or headphones to protect your hearing from the loud scanner noise and a buzzer to call for help if you need it. It's crucial to remain still during the scan to produce clear images.
After the procedure, you can change back into your clothes and go home. Your joint may be numb for a few hours, and you can take paracetamol for any pain. Moving the joint or applying an ice pack may also help. You shouldn't drive or operate machinery for the rest of the day and avoid heavy lifting for three to four days.
Is MR arthrogram painful?
There is a small risk that you might experience temporary joint-related pain or discomfort due to the injection of the contrast dye. That’s why you’ll first need a local anaesthetic to numb the area.
One small risk to be aware of with MRI arthrograms is the special contrast dye they use, called gadolinium. This dye helps make the pictures clearer but can sometimes cause problems.
Gadolinium is a type of metal that can be risky for some people. In rare cases, it might cause a severe skin problem, especially in people with kidney issues. This problem is called nephrogenic systemic fibrosis.
About 3 in every 1,000 people who get this dye might have a reaction that has symptoms similar to an allergy, such as itching or hives. Sometimes, the joint where the dye was put in might hurt for a few days after the test. That’s why your radiologist or doctor will always ask if you’ve had a reaction to a contrast dye in the past.
What is the difference between an MRI and an MRI arthrogram?
MRI and MRI arthrogram are both ways to take pictures of the inside of your body, especially your joints. They use the same basic technology, but they have a key difference. A standard MRI uses magnetic fields and radio waves to create detailed images of the inside of your body. It's good at showing soft parts like muscles, ligaments, and cartilage, as well as bones. You don't need any injections for this, and it's used for many medical problems.
An arthrogram MRI goes a step further. Before taking the pictures, a doctor injects a special dye directly into your joint. This dye makes certain parts of the joint appear more clearly in the images. It's particularly good at showing things like tears in the soft tissue around your joint or other minor problems inside the joint that might not show up as well on a standard MRI.
The main advantage of an MRI arthrogram is that it can show more detail inside the joint. This makes it especially useful for finding specific joint problems that are hard to see otherwise. For example, it's good at spotting shoulder injuries or hip problems.
How long does an MRI arthrogram take?
MR-arthrography typically takes about 30 to 60 minutes to complete. This includes the time involved in administering a local anaesthetic and injecting the contrast agent into the joint space before the scan itself.
How much does an MR arthrogram cost?
The cost of an MR arthrogram can vary depending on the provider and where you live in the UK, but you can expect to pay between £600 and £800 for the procedure.
MRI arthrograms are a valuable diagnostic tool that combine detailed MRI imaging with contrast dye for better joint visibility. This method is especially useful for detecting small tears, cartilage damage, and subtle joint injuries that a standard MRI might miss.
Don’t worry if you’re still unsure whether a private MRI scan is best for you or the difference between an MRI and an MRI arthrogram. All Scan.com bookings include two clinical consultations. One happens before the scan to ensure your clinician recommends the best scan for you in light of your symptoms. The second consultation happens after the scan, where your clinician will clearly explain the results and the next steps. When you book with Scan.com you’ll find the process easy and quick, at a price to suit your budget.
Sources
Albers CE et al. (2017). Preoperative planning for redirective, periacetabular osteotomies. https://academic.oup.com/jhps/article/4/4/276/4158215
Arthrogram. (2024). https://my.clevelandclinic.org/health/diagnostics/arthrogram
Arthrogram(MRI). (2023). https://radiopaedia.org/articles/arthrogram-mri?lang=gb
Direct Arthrography. (2024). https://www.radiologyinfo.org/en/info/arthrog
MRI Arthrogram. (2023). https://www.stgeorges.nhs.uk/wp-content/uploads/2023/01/RAD_ART_LP.pdf
SLAP Tears. (2024). https://orthoinfo.aaos.org/en/diseases--conditions/slap-tears/
