Arthrography combined with computed tomography (CT arthrography)
CT Arthrography in Casablanca
CT arthrography combines two steps: an injection of iodinated contrast agent directly into the joint, followed by a CT scan. The contrast agent spreads through the joint space and outlines the cartilage, ligaments, menisci or labrum, depending on the joint. The exam can cover the shoulder, elbow, wrist, hip, knee or ankle. It helps clarify a lesion that X-rays or MRI could not describe well enough, or replaces MRI when MRI is not possible.
Duration, report and equipment
Duration
Allow 20 to 40 minutes in total in general, including the joint puncture and the CT acquisition.
Report turnaround
Report within 24 hours. In an emergency, during opening hours, the report is handed over immediately.
Equipment
GE Revolution
When is this exam needed?
- Shoulder that dislocates repeatedly, to look for a lesion of the labrum (ring of cartilage around the edge of the joint).
- Shoulder pain with a suspected rotator cuff tear (tendons surrounding the joint).
- Locked or painful knee: search for a meniscus or cartilage lesion.
- Painful wrist after a fall, to examine the ligaments of the wrist bones (carpus).
- Painful hip in a young adult, to look for a lesion of the labrum (the rim of cartilage of the hip).
- Search for a loose fragment in the elbow or ankle, or check after joint surgery.
How the exam is done
You lie on the table with the joint well exposed. The skin is carefully disinfected, then the radiologist, most often after a local anesthetic, inserts a fine needle into the joint using imaging guidance. The iodinated contrast agent is injected slowly: a feeling of pressure or swelling in the joint is normal, real pain is rare.
You are then asked to move the joint a little to spread the contrast agent well. The CT scan is done within the following minutes, while you stay still, in a position that depends on the joint: arm along the body for the shoulder, often arm stretched above the head for the elbow or wrist. The acquisition itself is very short.
Preparation
- Tell us when you book about any anticoagulant or antiplatelet medication. Never stop it on your own: the radiologist will tell you whether it needs to be adjusted, together with the doctor who prescribed it.
- Do not apply any cream or ointment to the skin of the joint on the day of the exam.
- Wear loose clothing that easily exposes the joint concerned.
- If possible, arrange for someone to accompany you home, especially for a hip, knee or ankle.
Fasting
No fasting is needed, even if an injection is planned. Drink normally.
Contrast injection
The iodinated contrast agent is injected directly into the joint with a needle, under imaging guidance and in strict sterile conditions (disinfection, sterile equipment). A local anesthetic is often used beforehand.
Contraindications and precautions
- Previous reaction to an iodinated contrast agent: tell us when you book; a preparation or another exam may be offered.
- Allergy to local anesthetics or to the skin disinfectant.
- Infection of the skin or joint at the puncture site, or unexplained fever.
- Known bleeding disorder (hemophilia, for example).
- Current or possible pregnancy: you must tell us before the exam. A CT scan uses X-rays: it is performed during pregnancy only if it is essential.
- Breastfeeding: please tell us. It is generally not necessary to stop breastfeeding after an iodinated contrast injection.
Documents to bring
- Prescription specifying the joint and the side
- Previous X-rays, ultrasound or MRI of the joint
- List of your medications, especially anticoagulant and antiplatelet medication
- Surgical report if the joint has already been operated on
- Insurance or mutual insurance fund card
Price and insurance coverage
The price of CT arthrography takes into account the joint examined and the injection of iodinated contrast agent into the joint under imaging guidance.
The center accepts coverage from insurance companies and the main mutual insurance funds. You submit the coverage request to your insurer or fund yourself. For AtlantaSanad and Sanlam, the center takes care of it.
No prices are shown on this site: Kenza gives you the exact price on WhatsApp, along with the coverage procedure for your situation.
Frequently asked questions
Is the joint puncture painful?
It is generally well tolerated. The local anesthetic makes the needle prick barely noticeable, and the injection mainly gives a feeling of tightness in the joint. Some discomfort may persist for a few hours, sometimes a day or two, and is most often relieved by a simple painkiller.
Can I resume my activities after CT arthrography?
It is advisable to rest the joint on the day of the exam and the next day: no sport, no carrying heavy loads, no prolonged effort. Driving may be discouraged right afterwards, especially for a joint of the leg. Everyday movements remain possible.
What signs should alert me in the following days?
A joint infection is rare but must be recognized quickly. Contact the center or your doctor without delay in case of fever, redness, warmth or painful swelling that gets worse. A simple feeling of swelling on the first day, however, is normal.
Why CT arthrography rather than MRI?
The choice is made by the referring doctor and the radiologist. CT arthrography shows the cartilage and certain lesions of the ligaments or labrum in fine detail. It is also useful when MRI is contraindicated (certain implants, severe claustrophobia) or when a previous MRI was not enough.
CT Arthrography in Casablanca: how much does it cost?
The price of CT arthrography takes into account the joint examined and the injection of iodinated contrast agent into the joint under imaging guidance. The center accepts coverage from insurance companies and the main mutual insurance funds. No prices are shown on this site: Kenza gives you the exact price on WhatsApp, along with the coverage procedure for your situation.