MRI arthrograms

This is an imaging test done to get a more detailed picture of the inside of a joint - commonly the shoulder, knee, hip, or shoulder. A dye is injected into the joint before the MRI scan. Please allow at least an hour for the combined procedure.

What is an MRI scan?

MRI scanners produce cross-sectional pictures through any part of the body. The magnet is a circular tube open at both ends. The information from the scanner passes to a computer that produces a picture of your internal structure. The pictures are then displayed on a computer screen in the scanning control room.

There is no preparation for this examination, you may eat and drink normally.

Please try to wear clothes without any metal zips, fastenings or eyelets as this can prevent the need to get changed into a gown for the MRI scan.

You may continue to take your normal medication unless otherwise instructed; however, if you are on any medication which thins the blood (e.g. aspirin, clopidogrel, warfarin, rivaroxaban, dabigatran, apixaban) we ask you to call the Imaging Department using the number on your appointment letter as we may need to adjust your medication before undergoing this procedure.

What are the risks associated with an MRI arthrogram?

Generally it is a very safe procedure. Potential complications are uncommon. They include:

• Bleeding or haematoma (a bruise under the skin): this should settle down by itself.
• Infection – contact your GP if you experience any redness or tenderness at the injection site.
• An allergic reaction – please inform the doctor if you have any allergies. There is less than 0.2% risk of this occurring (two in a thousand people).
• The procedure uses X-rays and the amount of radiation used is small, however if you think you may be pregnant please inform the Imaging department before attending the appointment using the number on your appointment letter.

What are the risks associated with an MRI scan?

MRI does not use any form of X-rays and so is considered to be safe. MRI is now the alternative choice for many X-ray and some operative tests. The images produced are very detailed showing both bones and tissues. However, it may not be possible to have an MRI scan if you have any of these:

• Cardiac pacemaker/ defibrillator.
• Surgical clips in your head (particularly aneurysm clips).
• Some artificial heart valves.
• Metal fragments in your eyes.
• Electronic stimulators.
• Implanted pumps.

Please let the MRI unit know as soon as possible if you have an implanted device. The phone number is on your appointment letter.

Before the scan you will be asked some questions to check that it is safe for you to enter the scan room.

Those with dental fillings, bridges, joint replacements or cardiac stents (if more than 6 weeks since the operation) can be scanned safely.

The radiographers will need to know about these things to minimise the effect they have on your images.

• You will arrive at Gate 18 an a member of the Imaging team will take you through to the fluoroscopy waiting room.
• Following confirmation of your details and history you will be shown into the X-ray room and introduced to the staff performing the procedure. You will be cared for by a small team including a radiologist, radiographer and an imaging support worker.
• Please inform us if you are allergic to anything.
• Before the examination begins the radiologist will explain what they are going to do. You will be given the opportunity to ask any questions you may have.
• If you are happy to proceed you will then be asked to lie on the X-ray table. The skin will be cleaned and the radiologist will inject a small amount of local anaesthetic under the skin. This stings for a few seconds and the area then goes numb.
• The radiologist will then direct a very fine needle into the affected joint using the X-ray machine and inject the dye.

After the radiologist has completed the injection you will be escorted to the MRI scanner, where the radiographers will then complete the second part of your test.

• From reception you will be directed to the MRI waiting area. From here you will be taken to the MRI preparation room.
• If you are wearing clothes with metal zips or fastenings you may need to get changed into a gown.
• You will have to remove any jewellery, piercings, your watch, phones, credit cards and coins (a safe space is provided in the MRI scanner area). It is not necessary to remove your wedding ring.
• A small team which will include a radiographer and an imaging support worker will care for you.
• They will assist you to lie down and make you comfortable. The couch top will then move you into the scanner.
• The radiographer will leave the room before the scan begins, but we can see you at all times from the control room. You will also be provided with a buzzer that you can press at any time which will bring the radiographers immediately into the scan room.
• The scanner will make a series of loud noises as the scans are being taken so you will be provided with ear defenders.
• You will need to lie as still as possible when instructed by the radiographer. By keeping very still during the scan you can improve the quality of the images we take.
• The scan will not be painful and you won’t feel any discomfort.
• There are no side effects and you can continue as normal once you are informed that your examination is complete.

If you are pregnant at the time of your scan appointment there is no problem in scanning you as long as you are past your first 3 months.

If you are pregnant at the time of your MRI scan, this should be discussed with your referrer. If it is deemed necessary to still have your scan while you are pregnant, this will be discussed with the radiologist and the appropriate safety precautions taken.

If you have experienced claustrophobia, or have trouble in enclosed, small spaces you may contact the MRI department before your appointment date to discuss it.

For mild claustrophobia, we find that we can help you to relax by talking you through the procedure.

If your claustrophobia is severe you may need a sedative prescribed by your GP You should not drive after taking such drugs, so arrange a safe way to get home.

Your MRI scan will take approximately 30 minutes.

While we will endeavour to ensure you are seen at your appointed time sometimes emergencies may have to take priority. We ask for your patience and understanding should this happen. If there is a delay you will be kept informed.

Please rest the joint for 12 - 24 hours, as you may feel swelling or discomfort after the procedure. You may apply ice if the joint swells. You could use a bag of frozen peas, or crushed ice in a bag. Don’t use ice for more that 20 minutes at a time. Place a plastic bag or a damp cloth between the ice or frozen peas and your skin.

We advise patients not to drive after this test. Please arrange for someone to bring you and take you home.

You will not get an indication of the result at the time of the examination, as analysis of the images will take place after you have left the department.

The radiologist will report on your examination at the earliest opportunity and this will be sent to your consultant, who will discuss the results with you at your next appointment.

Finally we hope this information is helpful. If you have any questions either before or after the procedure the staff in the Imaging department will be happy to answer them.

The phone number for the Imaging department can be found on the appointment letter.