What is an MRI arthrogram?
An MRI arthrogram is a two-part diagnostic study that examines the inside of the joint (e.g., shoulder, knee, wrist, ankle) to assess an injury or a symptom your child may be experiencing. The first part of the study is the arthrogram, in which contrast dye is injected into the joint with the help of an X-ray; the second part is the magnetic resonance imaging (MRI) scan. Injecting the contrast dye before the MRI helps provide a clearer image of the joint. The arthrogram is done using image guidance by an interventional radiologist.
Risks of arthrogram
Arthrograms are considered low-risk procedures. The risk may increase depending on your child's condition, age, and health.
The risks of an arthrogram include:
- allergic reaction
- infection at the needle puncture site or in the joint that was injected
- pain and discomfort in the joint
- bleeding
Visiting the clinic before the study
Your child will have a clinic consult a few days before the study. During the consult visit, you should expect the following:
- A health assessment to make sure your child is healthy.
- An overview of the procedure, and a review of the consent form with an interventional radiologist.
- A quick ultrasound of the affected joint.
Giving consent before the procedure
Before the procedure, the interventional radiologist will go over how and why the procedure is done, as well as the potential benefits and risks. They will also discuss what will be done to reduce these risks, and will help you weigh any benefits against the risks. It is important that you understand all of these potential risks and benefits of the arthrogram and that all of your questions are answered. If you agree to the procedure, you can give consent for treatment by signing the consent form. A parent or legal guardian must sign the consent form for young children. The procedure will not be done unless you give your consent.
How to prepare your child for the procedure
Before any treatment, it is important to talk to your child about what will happen. When talking to your child, use words they can understand. Let your child know that medicines will be given to make them feel comfortable during the procedure.
Children feel less anxious and scared when they know what to expect. Children also feel less worried when they see their parents are calm and supportive.
If your child becomes ill within two days before the procedure
It is important that your child is healthy on the day of the procedure. If your child starts to feel unwell or has a fever within two days before the arthrogram, let your doctor know. Your child's procedure may need to be rebooked.
Food, drink and medicines before the procedure
- Your child's stomach must be empty before receiving general anaesthetic. Fasting during local anaesthesia, however, is not required.
- If your child has special needs during fasting, talk to your doctor to make a plan.
- Your child can take their regular morning medicine with a sip of water two hours before the procedure.
- Medicines such as acetylsalicylic acid (ASA), naproxen or ibuprofen, warfarin or enoxaparin may increase the risk of bleeding. Do not give these to your child before the procedure. If your child is taking any of these medicines, please discuss this with your doctor and the interventional radiologist.
On the day of the MRI arthrogram
Arrive at the hospital two hours before the planned time of your child's procedure. Once you are checked in, your child will be dressed in a hospital gown, weighed, and assessed by a nurse. You will also be able to speak to the interventional radiologist who will be doing the arthrogram.
During the MRI arthrogram, you will be asked to wait in the waiting room.
Your child will have medicine for pain
Children are given medicine for treatments that may be frightening, uncomfortable or painful. This includes local anaesthesia, sedation or general anaesthesia. The type of medicine that your child will have for the study will depend on your child's condition. An arthrogram typically only needs localized anaesthesia, which means your child will not be put to sleep.
How is an MRI arthrogram done?
During the arthrogram, contrast dye is injected into the joint by an interventional radiologist. Fluoroscopy (a type of X-ray) is used to guide the needle into the joint. The injection is normally done with the aid of local anaesthesia.
Once the arthrogram is completed your child will be moved to the MRI department to complete the second half of the study.
The arthrogram takes 15 to 30 minutes.
The MRI scan may take 30 to 45 minutes, depending on the joint being scanned.
After the MRI arthrogram
Once the MRI is complete, your child will return to the interventional radiology department where they will be assessed by a nurse and seen by an interventional radiologist before being discharged home.
Results
Your referring doctor will receive the results of your child's MRI. You will need to make an appointment with them to discuss the results.
For more details on how to care for your child after an arthrogram, please see Arthrogram: Caring for your child at home after the procedure.
At SickKids
At SickKids, the interventional radiologists work in the Department of Image Guided Therapy (IGT). You can call the IGT clinic at (416) 813-6054 and speak to the clinic nurse during working hours (8:00 to 15:00) or leave a message with the IGT clinic nurse.
For more information on fasting see Eating and drinking before surgery.
For more information on preparing your child for their procedure, see Coming for surgery.