Magnetic resonance arthrography (MR arthrography)
MR arthrography in Casablanca
MR arthrography takes place in two stages: an injection of contrast agent into a joint, followed by an MRI of that joint. The injected fluid slightly separates the joint surfaces and can seep into any tears. This helps the radiologist analyze very fine structures that are sometimes hard to see on a standard MRI: the labrum of the shoulder, the labrum of the hip, the small ligaments of the wrist or the cartilage.
Duration, report and equipment
Duration
The injection usually takes 15 to 20 minutes, then the MRI itself lasts about 20 to 30 minutes.
Report turnaround
Report within 48 hours. In an emergency, during opening hours, the report is handed over immediately.
Equipment
GE SIGNA Prime 1.5 T
When is this exam needed?
- A shoulder that dislocates repeatedly (instability), to look for an injury to the glenoid labrum.
- Hip pain suggesting a labral injury, for example in femoroacetabular impingement (abnormal friction between the femur and the pelvis).
- Wrist pain after a fall, to examine the triangular fibrocartilage (TFCC) and the ligaments between the carpal bones.
- Detailed assessment of the cartilage before a surgical decision.
- Persistent pain after joint surgery, or uncertainty after a standard MRI.
How the exam is done
The injection takes place in an X-ray room. You lie down with the joint well exposed. The radiologist disinfects the skin, most often gives a local anesthetic, then inserts a fine needle into the joint, guided by fluoroscopy (low-dose X-rays) or by ultrasound, depending on the joint. They then inject the contrast agent: you may feel pressure or a sensation of swelling.
The MRI follows shortly afterwards, while the contrast agent is well distributed. A suitable coil surrounds the joint and you stay still, with headphones on. Afterwards, the joint may feel tight or tender for a few hours, sometimes one to two days. Avoid putting heavy strain on it that same day.
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.
- Tell us if the skin over the joint has a wound or an infection.
- Wear loose clothing and leave your jewelry at home.
- If possible, arrange for someone to accompany you home.
Fasting
No fasting is needed for an MR arthrography: you can eat and drink normally before you come.
Contrast injection
The contrast agent, made of diluted gadolinium, is injected directly into the joint and not into a vein. Depending on the protocol, a small amount of iodinated contrast agent may be used to check the needle position under fluoroscopy.
Contraindications and precautions
- The injection into the joint is often guided by X-rays: you must tell us about any possible pregnancy.
- Infection of the skin or of the joint at the planned puncture site.
- Uncorrected bleeding disorder. Known allergy to iodinated contrast agent or to gadolinium: please tell us.
- Pacemaker or defibrillator (depending on their MRI compatibility), neurostimulator, cochlear implant, implanted pump, older vascular clip, metal fragment in the eye.
- Insulin pump or glucose sensor (such as FreeStyle Libre): to be removed before the exam. Bring what you need to replace it or put it back afterwards.
- Current or possible pregnancy: please tell us. MRI is performed only if it is necessary, preferably after the first trimester, and without gadolinium unless absolutely necessary.
- Breastfeeding: please tell us. It is generally not necessary to stop breastfeeding after a gadolinium injection.
- Severe kidney failure, tattoos, permanent makeup or claustrophobia: to be mentioned before the exam.
Documents to bring
- Prescription stating the joint and the side to be examined.
- Previous X-rays, ultrasound or MRI of this joint.
- List of your medications, especially anticoagulant and antiplatelet medication.
- Surgical report if the joint has already been operated on.
- Implant or medical device card, if applicable.
- Insurance or mutual insurance fund card.
Price and insurance coverage
The price of an MR arthrography takes into account the joint examined and the injection into the joint that precedes the images.
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 injection into the joint painful?
Thanks to the local anesthetic, the needle prick usually feels like a blood test, followed by a feeling of pressure as the fluid fills the joint. Tenderness may persist for a few hours, sometimes one or two days, and generally eases with rest and the painkillers (pain medication) recommended by your doctor.
How is it different from a standard MRI of the joint?
On a standard MRI, fine structures such as the labrum of the shoulder sometimes remain stuck to the surrounding tissues. The injected fluid separates them and fills small tears, which can make them more visible. Your doctor and the radiologist choose the exam suited to the clinical question.
What if I can't have an MRI?
If MRI is contraindicated for you, a CT arthrography may be offered: the injection into the joint is done in the same way, but the images are obtained with a CT scanner, and therefore with X-rays. The radiologist discusses this with your doctor depending on the joint concerned.
What should I watch for in the following days?
Moderate discomfort and a feeling that the joint is full are common. Contact the center or your doctor if you have a fever, redness, warmth or increasing swelling, or if the pain gets worse instead of better: infection is very rare, but it must be treated quickly.
MR arthrography in Casablanca: how much does it cost?
The price of an MR arthrography takes into account the joint examined and the injection into the joint that precedes the images. 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.