Centres/Radiology/CT scan/CT arthrography

CT arthrography and arthrography

CT arthrography in Tunis, Tunisia · Centre Urbain Nord

CT arthrography and arthrography in Tunis: contrast injected into the joint, then images, for the shoulder, knee, wrist or hip.

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What is it?

CT arthrography is a two-step examination. The radiologist first injects an iodinated contrast agent directly into the joint, under X-ray guidance; then a CT scan is performed. The contrast outlines the inside of the joint and shows the cartilage, ligaments, menisci or labrum in fine detail. It is mainly requested for the shoulder (instability, recurrent dislocations, rotator cuff injury), the knee (meniscus, cartilage), the wrist (ligaments), but also the hip, ankle or elbow, often before surgery. Arthrography is the first step (the injection into the joint with X-rays); it can be done on its own, or with distension of the joint (for example the knee), depending on the doctor's request.

When is it indicated?

Unstable shoulder or recurrent dislocations

It shows injuries of the labrum and ligaments before possible stabilisation surgery.

Rotator cuff injury

It clarifies a tear of the shoulder tendons and the condition of the muscles.

Knee meniscus or cartilage

It looks for a meniscal tear or cartilage injury, particularly when MRI is not possible or after surgery.

Wrist ligaments

It examines the small ligaments of the wrist after a fall or with persistent pain.

Painful hip, ankle or elbow

It looks for a cartilage injury or a loose fragment in the joint.

Preparation

1Tell us if you are pregnant or think you might be: a CT scan uses X-rays

2Tell us about any blood-thinning treatment (anticoagulant, antiplatelet): whether to stop it is decided by the doctor, never on your own

3Tell us about any allergy (to iodinated contrast, local anaesthetic or iodine-based disinfectants) or a skin infection near the joint

4No fasting is usually needed

5Plan not to strain the joint on the day of the examination; come with someone if possible for the shoulder or knee

6Bring your referral, previous imaging (CT scan, MRI, X-rays, ultrasound) and any relevant reports

Procedure

You are positioned on the X-ray table; the skin is carefully disinfected (aseptic technique)

A local anaesthetic is given, then the radiologist inserts a fine needle into the joint under image guidance

The contrast agent is injected: a feeling of pressure or tightness in the joint is normal

You then move to the CT scanner, lying down with the limb still, for a few minutes

A dressing is applied; resting the joint for the rest of the day is advised

Duration

About 30 to 45 minutes in total (injection then CT scan)

Results

The images are analysed by a radiologist, who writes a report. The report is given to you with the images and sent to your doctor, who will explain the results and the next steps. You will be told when to expect it on the day of the examination.

Precautions and contraindications

A CT scan uses X-rays: the dose is set as low as possible while still giving useful images, and the examination is only done when it is justified

Pregnancy: a relative contraindication; a CT scan is only performed if it is essential, after medical advice

Pain or discomfort in the joint for one to two days, relieved by rest and a simple painkiller

Joint infection: exceptional thanks to aseptic technique; seek medical advice quickly if you have fever, redness or increasing pain

Allergic reaction to the iodinated contrast agent (if injected): rare and usually mild (redness, itching); serious reactions are exceptional and the team is trained to manage them

Small bruise at the puncture site, especially with anticoagulant treatment

Your doctor and the radiology team will inform you in detail before the examination. Feel free to ask them your questions.

This information is general and does not replace the advice of your doctor, who chooses the examination suited to your situation.