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Injection procedure for elbow arthrography

CPT4 code

Name of the Procedure:

Injection procedure for elbow arthrography
Common Name(s): Elbow Arthrography, Elbow Joint Imaging
Technical Term: Elbow Arthrogram

Summary

Elbow arthrography is a diagnostic imaging procedure where a contrast dye is injected into the elbow joint, followed by imaging studies, typically MRI or CT scans, to provide detailed views of the joint structures, including cartilage, ligaments, and tendons.

Purpose

Conditions Addressed: Joint pain, arthritis, suspected tears, and other structural abnormalities.
Goals: To diagnose joint disorders, assess the integrity of joint structures, and guide treatment plans.

Indications

Symptoms/Conditions: Persistent elbow pain, swelling, limited range of motion, suspected ligament or cartilage tears, unexplained joint dysfunction.
Patient Criteria: Patients experiencing ongoing joint issues despite conservative treatments or those needing detailed joint evaluation before surgery.

Preparation

Instructions: Avoid eating or drinking for a few hours before the procedure if sedation is used. Inform the doctor of any allergies, especially to contrast dyes or iodine.
Diagnostic Tests: Blood tests or allergy tests may be conducted if there are concerns about the contrast dye.

Procedure Description

  1. Positioning: The patient lies down with the elbow extended.
  2. Cleaning: The skin around the elbow is cleaned with an antiseptic solution.
  3. Local Anesthesia: A local anesthetic is injected to numb the area.
  4. Contrast Injection: Using fluoroscopy (live X-ray), a needle is inserted into the elbow joint, and a contrast dye is injected.
  5. Imaging: Once the dye is injected, MRI or CT scans are taken to capture detailed images of the joint.
  6. Completion: The needle is removed, and a bandage is applied.

Tools/Equipment: Needles, syringes, contrast dye, fluoroscopy machine, MRI or CT scanner.
Anesthesia: Local anesthesia, with potential sedation for patients who are anxious or children.

Duration

Approximately 30–60 minutes.

Setting

Performed in a hospital radiology department or an outpatient imaging center.

Personnel

Radiologist, radiologic technologists, nurses, and possibly an anesthesiologist if sedation is used.

Risks and Complications

Common Risks: Pain at the injection site, mild bleeding, or bruising.
Rare Complications: Infection, allergic reaction to the contrast dye, temporary pain or swelling, needle injury to the joint structures.

Benefits

Expected Benefits: Accurate diagnosis of joint abnormalities, which aids in effective treatment planning. Improvements in symptoms may be noticed shortly after the procedure if it leads to appropriate treatment interventions.

Recovery

Post-Procedure Care: Keep the injection site clean and dry. Apply ice if there is swelling.
Expected Recovery Time: Most patients can resume normal activities within 24 hours. Avoid strenuous activities involving the elbow for at least 1-2 days.
Follow-up: The doctor will discuss the imaging results and potential next steps.

Alternatives

Other Options: Standard X-rays, ultrasound, or MRI without contrast dye. Pros and Cons: Non-contrast methods are less invasive but may not provide as detailed imaging as arthrography.

Patient Experience

During the Procedure: Mild stinging or pressure during needle insertion and dye injection. The procedure is generally well-tolerated.
After the Procedure: Mild soreness or discomfort at the injection site. Ice and over-the-counter pain medications can help manage any discomfort.

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