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Magnetic resonance (eg, proton) imaging, any joint of upper extremity; without contrast material(s), followed by contrast material(s) and further sequences

CPT4 code

Name of the Procedure:

Magnetic resonance imaging (MRI) of any joint in the upper extremity without contrast material(s), followed by contrast material(s) and further sequences.

Common name(s): MRI with contrast of the shoulder, elbow, wrist, etc.

Summary

An MRI scan uses powerful magnets and radio waves to create detailed images of a joint in the upper extremity. The procedure initially captures images without contrast material, and then additional images are taken after a contrast dye is injected to enhance visibility of specific structures.

Purpose

This procedure is used to evaluate joint conditions such as tears, inflammation, tumors, or infections. By using a contrast dye, it helps to provide clearer images and more accurate diagnoses.

Indications

  • Chronic joint pain or swelling.
  • Suspected ligament or tendon injuries.
  • Detection of tumors or cysts.
  • Evaluation of previous joint surgeries.
  • Unexplained joint dysfunction.

    Preparation

  • Fasting may be required for a few hours before the procedure.
  • Removal of any metal objects (jewelry, hearing aids).
  • Informing the doctor about any medical implants, allergies, or claustrophobia.
  • Pre-procedure assessment might include blood tests to check kidney function.

Procedure Description

  1. You will lie on a movable examination table that slides into the MRI machine.
  2. Initial images are taken without any contrast material. It involves lying still for several minutes.
  3. A radiologist will then inject a contrast dye into your bloodstream.
  4. Further sequences are captured after the dye has circulated.
  5. The entire process involves multiple sets of images to ensure a thorough examination.

Duration

The procedure typically takes about 45 to 90 minutes.

Setting

It is usually performed in a hospital radiology department or an outpatient imaging center.

Personnel

  • A radiologist (specialist in interpreting medical images).
  • Radiologic technologist (operates the MRI machine).

Risks and Complications

  • Claustrophobia due to the enclosed space of the MRI machine.
  • Allergic reaction to the contrast dye (rare).
  • Infection at the injection site (very rare).
  • Potential impacts on individuals with kidney problems.

Benefits

  • Provides high-resolution images for accurate diagnosis.
  • Helps in planning appropriate treatment strategies.
  • Non-invasive with no exposure to ionizing radiation.

    Recovery

  • Most patients can resume normal activities immediately after the procedure.
  • Drink plenty of fluids to help flush out the contrast dye.
  • Follow-up appointments may be necessary to discuss results.

Alternatives

  • X-rays: Less detailed, exposure to radiation.
  • CT scans: Good for bone structures, involves radiation.
  • Ultrasound: Useful for soft tissues, but less detailed.

    Pros and cons of alternatives vary based on specific patient needs and conditions.

Patient Experience

  • You might feel a cold sensation or slight discomfort from the contrast dye injection.
  • Loud noises from the MRI machine may require ear protection.
  • Minimal discomfort; pain management is usually not necessary.

Medical Policies and Guidelines for Magnetic resonance (eg, proton) imaging, any joint of upper extremity; without contrast material(s), followed by contrast material(s) and further sequences

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