73040 Radiologic examination, shoulder, arthrography, radiological supervision and interpretation

Name of the Procedure:

Radiologic Examination, Shoulder Arthrography (Medical Imaging of the Shoulder Joint with Contrast Medium and Guided by X-ray)

Summary

The radiologic examination of the shoulder, also known as shoulder arthrography, is a diagnostic imaging procedure that involves injecting a contrast dye into the shoulder joint and taking X-ray images to assess joint structure and function.

Purpose

This procedure helps in diagnosing issues within the shoulder joint, such as tears, degeneration, or abnormalities. It aims to provide a clear view of the inner workings of the shoulder to aid in treatment planning.

Indications

• Persistent shoulder pain or discomfort
• Suspected rotator cuff tears
• Joint instability or dislocation
• Detection of cartilage damage or labral tears
• Evaluation of shoulder joint after a surgical procedure

Preparation

• Patients may be advised to avoid eating or drinking for a few hours before the procedure.
• Any blood-thinning medications may need adjustment.
• Pre-procedure tests might include blood work and prior imaging studies.

Procedure Description

1. The patient lies down on an X-ray table.
2. The shoulder area is cleaned and sterilized.
3. Local anesthesia may be administered to numb the area.
4. A needle is inserted into the joint space, and contrast dye is injected.
5. X-ray images are taken from various angles to capture detailed views of the shoulder structure.
6. The needle is removed, and the area is cleaned and bandaged.

The procedure utilizes fluoroscopy to guide the needle accurately into the joint. Local anesthetic may be given to minimize discomfort.

Duration

The procedure usually takes about 30 to 60 minutes.

Setting

Shoulder arthrography is typically performed in a hospital radiology department or an outpatient imaging center.

Personnel

• Radiologist (performs the procedure and interprets the images)
• Radiologic technologist (assists with imaging)
• Nursing staff (provides patient care before and after the procedure)

Risks and Complications

• Common: Mild pain or discomfort at the injection site, temporary joint stiffness.
• Rare: Infection, allergic reaction to contrast dye, bleeding, or injury to surrounding structures.

Benefits

• Provides detailed images of shoulder joint compartments.
• Aids in accurate diagnosis and subsequent treatment planning.
• Benefits are typically realized soon after imaging results are reviewed.

Recovery

• Patients are usually able to move the shoulder soon after the procedure.
• Mild pain may be managed with over-the-counter pain relievers.
• Light activity is generally recommended for a day or two.
• Follow-up appointments may be scheduled to discuss results and further treatment options.

Alternatives

• Standard X-ray (less detailed)
• MRI or CT scan (may be less invasive but provide different levels of detail)
• Ultrasound (no contrast needed, but less comprehensive for joint structures)

Patient Experience

During the procedure, the patient may feel a slight sting from the needle and some pressure as the contrast dye is injected. Afterward, there might be mild discomfort, which can be managed with pain relievers and ice packs if needed. Most patients can resume normal activities within 24-48 hours.