The patient does not need to prepare for arthrography with steps such as limiting food or drink. However, the patient should inform the physician about any allergies, especially to iodine or medication. The most common contrast agent used in conventional and computed tomographic (CT) arthrography contains a large percentage of iodine, and local anesthetics are typically used in the area of the injection. Physicians who are alerted of any potential allergy risks may choose to use different contrast mediums or anesthetics.

Arthrography is typically performed in a clinic or physician’s office by a radiologist (a physician who specializes in the interpretation of x-rays). It begins with the administration of a local anesthesia. A contrast medium is then injected into the joint with a narrow needle. The medium may be liquid, air or both. The use of both liquid and air produces a double contrast image. In conventional arthrography and CT arthrography, a radio-opaque liquid (one that blocks radiation), usually a standard 60 percent iodine contrast, is employed. In magnetic resonance (MR) arthrography, a gadolinium-based contrast is used.

Typically, the placement of the needle and site of injection is guided by a device called a fluoroscope. This device is connected to a screen on which the physician has an x-ray view of the joint’s bones.

At this point, synovial fluid (the fluid that lubricates the joints) may be aspired (drawn out) for diagnostic or therapeutic purposes.

The joint will typically be manipulated, either by the physician or the patient, to distribute the contrast medium evenly inside of it. The fluoroscope may be used again to ensure that the contrast has spread through the entire joint.

Before the body absorbs the contrast medium, imaging tests are performed on the prepared joint. An x-ray is performed in conventional arthrography, a CAT scan (computed axial tomography) in CT arthrography and MRI (magnetic resonance imaging) in MR arthrography.

After arthrography, the joint and injection site may be sore and painful, but this usually goes away in about a day. There is a small risk of infection associated with the procedure.

Typically, the radiologist will interpret the test results and send them with a report to the patient’s physician. The physician will review the results with the patient at a follow-up appointment and, as necessary, recommend further tests or treatment.