A shoulder arthrogram is a technique that uses contrast dye to identify specific shoulder injuries. It’s used in X-rays, CT scans, or MRI scans to highlight areas of soft tissue damage. It’s very accurate but poses some risks.

A person lies on a table in preparation for a shoulder arthrogram with a CT scan. A nurse is helping adjust her positioning on the table. Share on Pinterest
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Shoulder injuries are very common. According to experts, studies estimate that about 30% of adults over age 60 and 62% of adults over age 80 have had tears in their rotator cuff muscles.

Healthcare professionals use a variety of imaging techniques to diagnose shoulder injuries, including a procedure called a shoulder arthrogram. It is also called glenohumeral arthrography.

A shoulder arthrogram involves injecting a contrast dye into a joint using a long, thin needle. Doctors then examine the joint with one of several imaging techniques, such as:

  • X-rays
  • fluoroscopy, which is a continuous X-ray video
  • CT scans
  • MRI scans

Your doctor is particularly likely to order a shoulder arthrogram if you have shoulder instability or signs of a labral tear.

In this article, we look at how arthroscopy is used to identify shoulder disorders and what you can expect during the procedure.

Arthrography is typically used to assess structures that cannot be seen clearly without a contrast dye. Your doctor may recommend an arthrogram if another imaging technique, like X-rays or a CT scan, does not reveal the problem.

In recent years, there’s been a rapid increase in the use of magnetic resonance arthroscopy (MRA) over MRI without contrast dye for diagnosing shoulder injuries.

MRA is considered the gold standard for evaluating shoulder instability and labral tear. It’s also used to diagnose conditions such as:

An arthrogram involves injecting a contrast dye into your shoulder and then taking pictures with conventional imaging. The contrast dye allows the imaging test to create a more detailed picture of your shoulder than would otherwise be possible.

MRA is considered the most accurate type of imaging for diagnosing shoulder injuries. It may be able to pick up atypical structures that are not visible on other imaging like X-rays or CT scans. X-rays generally aren’t used to diagnose conditions involving soft tissue like ligaments, tendons, or muscles.

A CT scan can provide more detail than conventional X-rays. Your doctor may recommend a shoulder CT scan if you recently had a traumatic injury to your shoulder or if you have a condition that makes you ineligible for an MRI.

In a 2017 study, researchers found that MRA correctly identified labrum tears in 93% of cases and correctly ruled out labrum tears in 96% of cases.

In a review of studies from 2020, researchers found that MRA was more accurate than MRI for detecting rotator cuff tears. However, the researchers recommended MRI as the first-choice imaging since it’s less invasive and faster, and it had similar results.

The scan itself takes only about 15 minutes and is relatively painless. However, you may feel some discomfort if you need to hold your joint in certain positions. Here’s what else you can expect:

Before your arthrogram

Before your procedure, it’s important to tell the radiographer about:

  • any medications or herbal supplements you’re currently taking
  • any allergies you have, especially to medicines, latex, and contrast dye
  • whether you have a history of a bleeding disorder.

You will need to remove any jewelry or metal objects before the procedure and you’ll probably change into a hospital gown. You will not need to restrict your food or water intake in advance.

Arthrogram procedure

The exact procedure can vary, but it will likely look something like this:

  1. You’ll be asked to lie on the exam table in the procedure room.
  2. You may receive an X-ray before the injection for comparison with the arthrogram image.
  3. Your skin will be covered with sterile drapes and an antiseptic.
  4. A healthcare professional will numb the area around the joint with a local anesthetic using a small needle.
  5. They may need to remove swelling in your joint with a needle and syringe.
  6. The healthcare professional will inject a contrast dye using a long needle. You may feel some pressure when the needle is inserted into your joint. If you feel pain, your healthcare professional can apply more numbing medication.
  7. You’ll be asked to move the joint to help distribute the dye.
  8. The healthcare professional will take multiple images with your shoulder in different positions.

After your arthrogram

You may be asked to rest your joint for a couple of hours after your scan. Your radiographer may suggest applying ice if you develop any swelling. Most people can go home immediately after the procedure.

It’s generally recommended that you avoid driving or exercising for about 24 hours.

Your insurance plan will likely cover at least part of the cost of an arthrogram if it’s used to diagnose a medical condition. Without insurance, arthrograms can range from $500 to $4,000, depending on the type of procedure and costs in your area.

The chances of developing a severe complication after an arthrogram are low. In a 2019 study, researchers reported no serious complications among 1,419 people who received knee or shoulder arthrograms.

Other potential risks include:

  • infection, roughly 1 in 1,000 chance
  • allergic reactions to the dye
  • bleeding
  • damage to the joint
  • post-injection pain

X-rays, fluoroscopy, and CT scans do expose your body to some radiation. Your doctor likely won’t recommend these scans if you’re pregnant or have other risk factors.

A shoulder arthrogram is an imaging technique used to diagnose shoulder concerns. It involves injecting a special dye into your shoulder and then performing imaging with X-rays, CT scans, or MRIs.

Your doctor can provide more details on the benefits and risks of a shoulder arthrogram and help you decide if it’s the right procedure for your condition.