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Radiologic examination, knee, arthrography, radiological supervision and interpretation

CPT4 code

Name of the Procedure:

Radiologic Examination, Knee, Arthrography, Radiological Supervision, and Interpretation
Common Name(s): Knee Arthrogram, Knee Joint Arthrography

Summary

A knee arthrogram is a specialized imaging test that uses X-rays, a contrast dye, and sometimes magnetic resonance imaging (MRI) or computed tomography (CT) to provide a detailed view of the knee joint. This procedure helps diagnose issues like ligament tears, cartilage damage, or joint abnormalities.

Purpose

  • Medical Condition or Problem: Diagnoses joint abnormalities, ligament tears, cartilage damage, and other knee issues.
  • Goals/Outcomes: Provide a detailed view of the knee structures to guide further treatment plans.

Indications

  • Persistent knee pain without a clear diagnosis
  • Suspected internal derangements such as ligament tears or cartilage injuries
  • Pre-surgical planning or evaluation of post-surgical complications
  • Monitoring the condition of prosthetic joints

Preparation

  • Pre-procedure Instructions: Patients may be advised to avoid eating or drinking a few hours before the test.
  • Medications: Inform the doctor about any blood thinners or medications that may need adjustment.
  • Diagnostic Tests: Initial knee X-rays or MRIs might be required to evaluate the need for an arthrogram.

Procedure Description

  1. Preparation: Patient lies down on the examination table, and the knee area is sterilized.
  2. Anesthesia: A local anesthetic is applied to numb the knee area.
  3. Contrast Injection: Using a sterile needle, a contrast dye is injected into the knee joint to enhance imaging.
  4. Imaging: X-rays or sometimes MRI/CT scans capture detailed images of the knee. Movement might be required to spread the contrast evenly.
  5. Radiological Supervision: A radiologist analyzes the images in real-time to ensure adequate visualization of the joint structures and captures necessary views.
  6. Completion: The needle is removed, and a bandage is applied to the injection site.

Duration

The entire procedure typically takes about 30 to 60 minutes.

Setting

Usually performed in a hospital's radiology department or an outpatient imaging center.

Personnel

  • Radiologist
  • Radiologic Technologist
  • Potentially a nurse to assist with patient preparation

Risks and Complications

  • Common Risks: Mild pain or discomfort at the injection site, temporary swelling, or bruising.
  • Rare Risks: Allergic reaction to contrast dye, infection, or bleeding within the joint.

Benefits

  • Expected Benefits: Enhanced visualization of internal knee structures for accurate diagnosis.
  • Timeframe: Diagnostic results are often available immediately, with full reports typically provided within a few days.

Recovery

  • Post-procedure Care: Rest the knee for several hours. Ice packs can be applied to reduce swelling.
  • Recovery Time: Typically minimal, with most patients resuming normal activities within a day.
  • Follow-Up: Doctor's appointment to discuss imaging results and next steps for treatment.

Alternatives

  • Other Options: Regular X-rays, MRI, or CT scans without contrast, physical examination, or ultrasound.
  • Pros and Cons: Regular imaging may not be as detailed as an arthrogram. However, non-contrast imaging avoids the small risk associated with dye injections.

Patient Experience

  • During the Procedure: Patients may feel mild discomfort or pressure during the contrast injection but usually no severe pain due to the local anesthetic.
  • After the Procedure: Some soreness or swelling at the injection site is common. Pain management includes over-the-counter pain relievers and rest.

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