Arthrography is a diagnostic test that uses an injected contrast medium to enhance imaging of a joint. The procedure makes it easier to identify normal and damaged structures and demonstrates the integrity of structures. Arthrography is commonly performed on the knee, shoulder, wrist, hip and ankle joints.

Arthrography may employ standard x-rays, CAT scan (computed axial tomography) or MRI (magnetic resonance imaging). Regardless of the technique used, arthrography is superior to plain imaging because it demonstrates soft tissues (e.g., muscles, tendons, ligaments) in addition to bone.

Magnetic resonance (MR) arthrography is considered the most useful form of arthrography because it best reveals internal structures. However, it is expensive, and its use of MRI may make it ill advised in certain circumstances, such as when the patient has a pacemaker. Computed tomographic (CT) arthrography, though not as refined as MR arthrography, also provides a three-dimensional image, revealing many structures that would be blocked in a conventional x-ray arthrography. CT arthrography may also be used when MR arthrography is unavailable, such as in some rural areas.

Arthrography may be used to provide an image to examine damaged joint structures (e.g., torn tendons and ligaments), in the diagnosis of certain conditions (e.g., frozen shoulder), pre- and post-operatively, and in the monitoring of conditions and medications. Synovial fluid (lubricant inside joints) may be removed during arthrography for laboratory analysis.

In arthrography, the contrast medium is usually injected under local anesthesia, guided by an x-ray device called a fluoroscope. In conventional and CT arthrography, the medium used is a liquid or gas that blocks radiation – generally an iodine solution. In MR arthrography, a gadolinium contrast is used. Once the medium has been allowed to flow throughout the joint, the x-ray, CAT scan or MRI is used.

After the procedure, the joint and the injection site may be sore for about a day. The most common complication is irritation of the synovium by the iodine contrast. The risk of infection is generally very low.