23350 Injection procedure for shoulder arthrography or enhanced CT/MRI shoulder arthrography

Name of the Procedure:

Injection Procedure for Shoulder Arthrography or Enhanced CT/MRI Shoulder Arthrography

Summary

Shoulder arthrography involves injecting a contrast dye into the shoulder joint to enable detailed imaging during a CT scan or MRI. This helps healthcare providers visualize the soft tissues, cartilage, or abnormalities within the joint more clearly.

Purpose

Shoulder arthrography is used to diagnose conditions such as rotator cuff tears, labral tears, or other joint abnormalities. The contrast dye enhances the imaging quality, allowing for more accurate diagnosis and better treatment planning.

Indications

• Persistent shoulder pain or dysfunction.
• Suspected rotator cuff or labral tear.
• Unclear MRI or X-ray results requiring enhanced imaging.
• Pre-surgical planning to provide detailed joint information.

Preparation

• Patients may need to fast for a few hours prior to the procedure.
• Inform the medical team of any allergies, especially to contrast dyes or iodine.
• Discontinuation of certain medications may be required as per doctor’s advice.
• Any recent illnesses or infections should be reported.

Procedure Description

1. The patient is positioned either sitting or lying down.
2. The shoulder area is cleaned and sterilized.
3. A local anesthetic is administered to numb the injection site.
4. Using fluoroscopy (live X-ray) or ultrasound guidance, a needle is inserted into the shoulder joint.
5. Contrast dye is injected through the needle.
6. The needle is removed, and the patient may move to an MRI or CT scanner.
7. Imaging is performed, capturing detailed images of the shoulder joint.

Duration

The injection process takes about 15-30 minutes; additional time is required for the imaging, making the total duration approximately 1-2 hours.

Setting

The procedure is typically performed in a radiology department, outpatient clinic, or hospital.

Personnel

• Radiologist or orthopedic surgeon to perform the injection.
• Radiologic technologist to assist with imaging.
• Nursing staff for support and patient care.

Risks and Complications

• Mild pain or discomfort at the injection site.
• Allergic reactions to the contrast dye.
• Infection or bleeding at the injection site.
• Rarely, joint damage or exacerbation of symptoms.

Benefits

• Enhanced imaging clarity for accurate diagnosis.
• Better treatment planning and decision-making.
• Can prevent unnecessary exploratory surgery.
• Immediate results often available and discussed with a healthcare provider.

Recovery

• Mild soreness or discomfort may be felt, managed with over-the-counter pain relievers.
• Patients are usually advised to rest the shoulder for 24 hours.
• Follow-up appointments may be scheduled to discuss results and treatment plans.
• Strenuous activities should be avoided for a few days.

Alternatives

• Standard MRI or CT scan without contrast (less detailed).
• Ultrasound imaging.
• Diagnostic arthroscopy (more invasive).
• Physical therapy or conservative treatments for less severe conditions.

Patient Experience

Patients may feel a pinch or slight pressure during the injection. Most experience minor discomfort afterward, which resolves within a day. Pain management and comfort measures are provided to ensure a smooth recovery.