MRI Arthrogram PRINT
Pre-Call Questions -Joint Injections & Arthrograms
I. Equipment (May vary between sites) (mL’s based on hip arthrogram – adjust appropriately according to anatomy)
a. Contrast
i. Isovue 300/ Omnipaque 240
ii. Gadolinium (MRI to provide)
b. 1% lidocaine (10ml’s)
c. Preservative free sterile saline (10ml’s)
d. Sterile tray
i. Sterile Mayo Stand Cover
ii. Syringes – (20mL), (10mL), (2(5mL)), (1mL)
iii. Needles – (25G and 18G)1.5”, (22G 3.5”)
iv. Chlora Prep
v. Drapes- Tower drape x 2, Patient drape with hole
vi. 4×4 gauze
vii. Extension tubing
e. Sharpie and hemostat
f. 2” tape to move any excess tissue/ panniculus
g. Band-Aid
h. Mask
II. Personnel
a. Radiologist/RA
i. Reviews order
ii. Responsible for obtaining consent (ask about dental visits, infection, & antibiotics)
iii. Performs exam and evaluates patient’s pain level following injection
b. Hospital Technologist
i. Prints order for radiologist/RA review
ii. Documents patient history and pregnancy status prior to exam
iii. Assists the radiologist or physician extender during procedure
iv. Provides patient with aftercare instructions and transports patient to MRI
III. Procedure
a. Physician extenders must review all INPATIENT arthrogram requests with an MSK radiologist
i. Please review any pertinent prior imaging
ii. Please use the call center to connect with an available MSK rad (720-493-3777)
b. Consent
c. Time out
d. Identify and mark the injection site using fluoroscopy (Mask)
e. Prepare the injection site using aseptic technique
f. Local anesthetic
g. Needle placement (do not aspirate)
i. If purulent fluid spontaneously flows back from the needle hub, aspirate, and consult an MSK radiologist
h. Inject 1-2mL’s Isovue/Omnipaque to confirm intraarticular needle placement (SAVE IMAGE)
i. Inject dilute Gad/Saline mix (1:200) (0.1 mL gad in 20 mL saline) (1-2mL’s of saline may be substituted with 1% lidocaine)
j. If anesthetic is administered with contrast, obtain pre- and post-injection pain scores
k. Record pain score after MRI
l. Reserve drafted dictation for the consulted MSK radiologist
IV. Required Images
a. Save image with contrast
V. Special Considerations
a. Follow contrast allergy protocol
b. Contraindications- Dental visit 3 days prior to injection, feeling ill or having a known infection, currently on antibiotics, recent Covid vac. (see Joint Injection/ Arthrogram Technologist Pre-Call Questions)