Name of the Procedure:

Radiologic Examination, Wrist, Arthrography, Radiological Supervision and Interpretation

• Common names: Wrist Arthrogram, Wrist Joint Arthrography
• Technical terms: Radiographic wrist arthrography, Fluoroscopic wrist examination

Summary

Wrist arthrography is a specialized imaging procedure used to visualize the detailed structure of the wrist joint. It involves the injection of a contrast dye into the joint space followed by X-ray imaging to produce clear pictures of the joint's internal structures.

Purpose

Wrist arthrography addresses issues related to wrist joint structures, such as ligaments, cartilage, and synovial fluid.

• Goals: Diagnose conditions like ligament tears, cartilage damage, joint infections, or cysts.
• Expected outcomes: Accurate diagnosis and detailed imaging of wrist joint abnormalities.

Indications

• Symptoms: Persistent wrist pain, swelling, decreased range of motion.
• Conditions: Suspected ligament injuries, cartilage damage, unexplained wrist pain, or wrist joint infections.
• Criteria: Non-responsive to initial conservative treatments, unclear MRI or X-ray results.

Preparation

• Follow fasting instructions if sedation is planned.
• Adjust medications as directed by the doctor.
• Complete necessary pre-procedure assessments like blood tests or allergy tests for the contrast dye.

Procedure Description

1. The patient is positioned so the wrist is accessible.
2. Local anesthesia is administered to numb the wrist area.
3. A needle is inserted into the wrist joint to inject a contrast dye.
4. X-rays or fluoroscopy are used to monitor the dye's distribution in the joint.
5. Detailed images of the wrist joint are captured.
   • Tools/Equipment: X-ray machine, fluoroscope, contrast dye, sterile needles and syringes.
   • Anesthesia: Typically involves local anesthesia; mild sedation may be used if necessary.

Duration

• The procedure typically takes about 30 to 45 minutes.

Setting

• This procedure is usually performed in a hospital radiology department or an outpatient imaging center.

Personnel

• Radiologist (specialist in imaging procedures)
• Radiology technician
• Nursing staff (if sedation is used)

Risks and Complications

• Common risks: Mild pain or discomfort, temporary swelling, mild allergic reactions to the contrast dye.
• Rare complications: Infection, severe allergic reactions, bleeding in the joint.
• Management: Monitoring for signs of infection or allergic reactions, with prompt medical response if necessary.

Benefits

• Expected benefits: Detailed and accurate imaging of wrist joint structures, aiding in precise diagnosis.
• Realization time: Immediate visualization during the procedure, with results usually reviewed soon after.

Recovery

• Post-procedure: Apply ice to the wrist to reduce swelling and pain, rest the joint for 24 hours.
• Recovery time: Most patients can resume normal activities within 1-2 days.
• Follow-up: A follow-up appointment may be scheduled to discuss results.

Alternatives

• MRI: Non-invasive, no radiation exposure, but may be less detailed for certain joint abnormalities.
• CT Scan: More detailed than standard X-rays but involves higher radiation exposure.
• Ultrasound: Useful for soft tissue evaluation but less detailed for internal joint structures.

Patient Experience

• During: Mild discomfort during the injection of contrast dye, minor pressure or pain.
• After: Mild soreness or swelling in the wrist, manageable with over-the-counter pain relievers and ice.