MRI Arthrogram

This leaflet tells you what the examination involves. Please read this leaflet carefully to ensure you successfully prepare for the examination.

This test is in great demand, and we would be grateful if you could ensure that you arrive for your appointment in plenty of time. If for any reason you are unable to keep your appointment, please let us know as soon as possible.

What is an Arthrogram and Magnetic Resonance Imaging Scan (MRI)?

This diagnostic test is a joint test using an MRI scanner. In order for your joint to show up properly, a contrast medium, this is a liquid dye that shows up on X-rays and MRI scans, needs to be injected directly into your joint using fluoroscopy (real time X-rays).

Flouroscopy

During the real time X-ray procedure. The area to be examined will be cleaned and covered with a sterile paper cover. Local anaesthetic will be used to numb the area, which may sting a little at first. A very fine needle will be used to inject some contrast medium into the joint space. The real time X-rays are used during the procedure for guidance. This part of the examination will take approximately 15 minutes.

MRI

An MRI scan is the next part of the test which uses a powerful magnet and a computer to produce detailed images of any part of the body. The MRI scanner does not use X-rays. This part of the examination will be performed by a radiographer and will take approximately 30 minutes.

What does the machine look like?

The equipment may look intimidating but there is no need to be nervous.

The MRI scanner looks like a large, elongated polo mint, which is well lit and open at both ends. The scanner remains open and you are never totally enclosed. Some scans require you to be placed head first in the scanner and sometimes, feet first.

What happens during the scan?

Throughout the procedure you will be asked to lie on a firm couch which moves in and out of the scanner, all you need to do is relax and stay still. You will be offered some earplugs to help reduce the noise of the scanner (a loud knocking noise). You will also be given a small air-filled bulb to hold which, when squeezed, alerts the Radiographer.

Cautions

The powerful magnetic field of the scanner will attract certain metallic objects known as “ferromagnetic” objects, causing them to move suddenly and with great force towards the centre of the scanner. It is vital that you remove metallic objects before an MRI exam, including watches, jewellery, and items of clothing that have metallic threads, underwires or fasteners. It would be best to leave watches, jewellery or anything made from metal at home if possible. 

You will also need to remove any bank cards and electrical items from your person such as mobile phones as the scanner will interfere with them and stop them from working.

You may need to get changed into scrubs for your MRI scan.

Please complete the enclosed safety questionnaire and bring it with you to your appointment.

It is recommended that you do not drive for the remainder of the day so you will require someone to drive you to and from your appointment.

Medication

Please continue with your medication as normal. Please bring any sprays or inhalers that you are taking with you to your appointment.

What do I need to tell you about?

For all patients between the ages of 12 and 55 who have ovaries, the X-ray department has a legal responsibility to ensure that this examination is performed within TEN DAYS of the first day of your menstrual period. Please contact the X-ray department if you are pregnant or if this appointment is beyond the TEN-DAY requirement, and another appointment will be arranged for you.

Radiation dose and risk

X-ray uses ionising radiation which can cause cell damage that may, after many years or decades, turn cancerous. The risk of this happening is very small compared to the lifetime risk of developing cancer which is 1 in 2. We are also all exposed to background radiation every day. The risk of long-term effects is considered when the healthcare team decides whenever someone needs an X-ray examination and radiation doses are kept as low as possible. For this examination radiation dose levels are typically equivalent to 6 to 12 months of background radiation. The associated risk is 1 in 10,000 – very low.

Contrast

The contrast mediums used are considered to be safe. As with all drugs and medication there is a slight risk of allergic reaction This may vary from a rash, to, very rarely, a more severe reaction.

Severe allergic (anaphylactic) reactions to gadolinium (MRI) contrast medium have occurred but are extremely rare. These severe reactions, which might involve difficulty breathing and swelling of the lips and mouth, occur in around 1 in every 10,000 people who have gadolinium. 

If you have had a history of a previous allergic reaction to a gadolinium contrast injection, or a severe allergic reaction to some other material, please tell your referring doctor and the MRI radiographer as this will affect whether a further gadolinium injection is recommended.

Radiographers are trained to deal with any emergency and there is always a doctor close by.

Nephrogenic Systemic fibrosis (NSF) is a rare condition associated with gadolinium contrast agent given to patients with severe renal (kidney) disease. It is may start within days, weeks or months after receiving gadolinium, with almost all cases occurring within 6 months of the last dose. Since radiology facilities began routinely screening patients for kidney disease, and withholding gadolinium from those with severe renal disease, NSF has become extremely uncommon.

If you do have a history of kidney disease, please be sure to tell the staff, so that they can check whether the disease is severe enough to mean that you should not receive gadolinium. This might involve a simple blood test for kidney function.

Recent research has recognised that a very small amounts of gadolinium contrast medium (about 1% of the injected dose) are retained in the tissues, mostly in the bones; with tiny amounts in the brain. At this stage, there are no known adverse effects from these very small amounts of retained gadolinium, but radiologists are now more careful in recommending gadolinium contrast.  You will only have it if it is necessary to aid your diagnosis or treatment.

There is a small risk of introducing infection with the procedure. The risk is 1 in 1000.

How do I get my results?

As soon as the scan is finished, you can go home. The results will be sent to the doctor who referred you and they will contact you with a follow-up appointment.

If you have to bring children requiring supervision with you for your appointment, please ensure that they have someone to supervise them whilst you are having your scan.

Staff within the department are unable to assist with the supervision of young children. In these instances, you may be asked to rebook your appointment to a time more suitable for you to have childcare arrangements in place. 

Contact Numbers

If you need further advice, or have any problems, please contact the appropriate number below:

The James Cook University Hospital

Interventional Radiology and Fluoroscopy
Telephone: 01642 282639
Monday to Friday, 9:00am to 5:00pm
Email: [email protected]

University Hospital of North Tees

North Tees MRI Unit
Telephone: 01642 624547
Monday to Saturday, 9:00am to 5:00pm
Email: [email protected]

Patient Experience Team (PET)

North Tees and Hartlepool NHS Foundation Trust and South Tees Hospitals NHS Foundation Trust would like your feedback. If you would like to share your experience about your care and treatment or on behalf of a patient, please contact The Patient Experience Team who will help you to do this.

This service is based at the University Hospital of North Tees and at James Cook University Hospital but also covers The University Hospital of Hartlepool, The Friarage Hospital in Northallerton, our community hospitals and community health services.

Out of Hours
If you wish to speak to a senior member of Trust staff, please contact the hospital switchboard (numbers below).