Arthrogram for MRI
1/11/2022
(ANY JOINT INJECTION FOR MRI)
PT OFF BLODTHINNERS ACCORDING TO PROTOCOL
PLACE MARKER ON UNDERSIDE OF FLUORO TOWER IN FIELD OF VIEW
Check with MRI before beginning exam (they may be behind), dress patient with gown open in back
Supplies
Fenestrated Drape
Non-fenestrated Drape
1ml syringe
10ml syringe
20ml syringe
18 x 1” needle (pink)
Band-Aid
25 x 1.5” needle (orange or blue)
Spinal needle
Sterile gauze
21” extension set
Iodine swabs
Glove (for you & Radiologist)
Medications
Lidocaine
Sodium Chloride (Saline)
Omni 300 (240 if they have metal in area of interest)
Multihance
Ask patient if they are on blood thinners, have allergies, or have had surgery. If yes, make sure it is not a contraindication to exam.
Setup
- Place non-fenestrated drape on table
- Drop all supplies
- Attach 18ga needle to 10ml syringe, draw up 10ml lidocaine. Remove 18ga needle. Attach 25 x 1.5” needle (not too tight).
- Attach 18ga needle to 20ml syringe, draw 15ml saline and 5ml Omni. Remove 18ga needle.
- Attach 18ga needle to 1ml syringe, draw up 1ml Multihance. Draw back on 20ml syringe and place needle in syringe and push Multihance into syringe (careful not to push too fast or Multihance will overflow). Place 1ml syringe and needle in sharps container.
- Attach tubing to 20ml syringe. Prime tubing.
- Place hemostats, marker, and sterile gloves on counter for Radiologist. (See radiologist preferences)
Take patient’s arm out of sleeve when ready to place patient on table. Interview patient for history, then fill out consent form and get signature from patient. Have order pulled up for radiologist to view.
Gray and Sabourin: 22ga 1.5in. needle if pt. is thin to average.
Nunes and Sabourin: Always inject 12ml of contrast
Verville: Put arrow on shoulder 3 mm lateral to shoulder joint.
Sud: Always inject 12ml of contrast. No sandbag. Pt. supine, shoulder internal rotation. Pt. supine for hip. Pt. sitting for elbow.
Kyle: Drop on the tray a 10ml syringe of just Omni 300. Wants 25ga 3.5in. spinal needle available.
Faler: Drop on the tray a 12ml syringe of 5ml Omni 300, 5ml saline, and 0.1 of gadolinium.
Shoulder Injection for CT
11/06/2019
PREP: Refer to Lab Work Procedure Page to determine which drugs need to be discontinued and for how long.
Set up is the same as MRI Shoulder, but contrast mixture is DIFFERENT.
Myelogram sterile tray,
ADD: 25½” needle
10ml syringe: 9ml lidocaine
20ml syringe: 10ml Omni 240, 10ml saline
**Since we do not do these often check with Radiologist to confirm contrast amount.
Dr. Sud: Wants 10ml syringe: 10ml lidocaine & 1ml sodium bicarbonate plus 1ml Omni 300
Other Joint Arthrograms for MRI
02/12/2018
KNEE ARTHROGRAM FOR MRI
PREP: Refer to Lab Work Procedure Page to determine which drugs need to be discontinued and for how long.
Check with MRI before starting exam. Dress patient with gown only-open in back. Ask patient history questions and contrast consent form. Have them sign consent form. Position patient on back with affected knee closest to the Radiologist. Pillow folded in half under knee, sandbag against lateral aspect of foot to invert it. PLACE LEAD MARKER
Myelogram tray:
Add one 25 gauge 1 ½ needle, 60ml syringe and 1 ml syringe
10ml syringe: 9ml lidocaine and 1ml sodium bicarbonate
20ml syringe: 15ml saline, 5ml Omnipaque 300, 0.1ml gadolinium
(Use 1ml syringe)
PLEASE BE ACCURATE WITH YOUR GADOLINIUM MIXTURE
Wrist Arthrogram for MRI
Check with MRI before starting exam.
Same mixture as shoulder arthrogram.
[Alternative method (Dr. Kyle): 10ml syringe with 6ml saline, 4ml Omni 300, and 0.05 – 0.1 ml Gadolinium.]
Use butterfly needle 25 ½ ga from MRI. Goes on contrast syringe. Pt. sits in chair at the end of the table.
Try to encourage patient not to watch the injection to reduce the possibility of them fainting. PLACE LEAD MARKER
Elbow Arthrogram for MRI
Check with MRI before starting exam.
Same mixture as shoulder arthrogram.
Use 25 ga 1 ½ needle. Pt. sits in chair at the end of the table.
Try to encourage patient not to watch the injection to reduce the possibility of them fainting. PLACE LEAD MARKER