Hip arthrogram injection (fluoroscopic guided)
Updates to Case Attributes
Arthrogram techniques, contrast agents and injectates will differ at different institutions.
Before commencing these procedures, it is important to familiarise to local practices, in particular to syringe selection. Many of the solutions used are clear therefore the different syringes will help the practitioner identify which syringe contains which agent. Using the same for each procedure will minimise confusion in cases when there are interruptions.
The syringe selection in this case is as follows
- 5mL syringe for 1% lidocaine and attached to a 25G needle
- 10mL for contrast agent and attached to extension tubing
- 20mL syringe for the arthrogram injectate.
Attaching the syringe and needle will help further identify the injectates. Contrast will come in different strengths, used in this study is Omnipaqueiohexol 300. The arthrogram mixture used in this case is 0.1mL gadobutrol, 10mL 0.9% saline, 3mL Omnipaqueiohexol 300 and 7mL 0.5% ropivacaine; 10mL of the arthrogram solution was injected in total. The 0.5% ropivacaine is an important diagnostic component of the injectate because if. If patient experiences pain relief after the procedure for the duration of the ropivacaine (7-8 hours) it is deemed the injected joint inis the pain generator.
-<p>Arthrogram techniques, contrast agents and injectates will differ at different institutions. </p><p>Before commencing these procedures, it is important to familiarise to local practices, in particular to syringe selection. Many of the solutions used are clear therefore the different syringes will help the practitioner identify which syringe contains which agent. Using the same for each procedure will minimise confusion in cases when there are interruptions. </p><p>The syringe selection in this case is as follows</p><p>- 5mL syringe for 1% lidocaine and attached to a 25G needle</p><p>- 10mL for contrast agent and attached to extension tubing</p><p>- 20mL syringe for the arthrogram injectate. </p><p>Attaching the syringe and needle will help further identify the injectates. Contrast will come in different strengths, used in this study is Omnipaque 300. The arthrogram mixture used in this case is 0.1mL gadobutrol, 10mL 0.9% saline, 3mL Omnipaque 300 and 7mL 0.5% ropivacaine; 10mL of the arthrogram solution was injected in total. The 0.5% ropivacaine is an important diagnostic component of the injectate because if patient experiences pain relief after the procedure for the duration of the ropivacaine (7-8 hours) it is deemed the injected joint in the pain generator.</p>- +<p>Arthrogram techniques, contrast agents and injectates will differ at different institutions. </p><p>Before commencing these procedures, it is important to familiarise to local practices, in particular to syringe selection. Many of the solutions used are clear therefore the different syringes will help the practitioner identify which syringe contains which agent. Using the same for each procedure will minimise confusion in cases when there are interruptions. </p><p>The syringe selection in this case is as follows</p><p>- 5mL syringe for 1% lidocaine and attached to a 25G needle</p><p>- 10mL for contrast agent and attached to extension tubing</p><p>- 20mL syringe for the arthrogram injectate. </p><p>Attaching the syringe and needle will help further identify the injectates. Contrast will come in different strengths, used in this study is iohexol 300. The arthrogram mixture used in this case is 0.1mL gadobutrol, 10mL 0.9% saline, 3mL iohexol 300 and 7mL 0.5% ropivacaine; 10mL of the arthrogram solution was injected in total. The 0.5% ropivacaine is an important diagnostic component of the injectate. If patient experiences pain relief after the procedure for the duration of the ropivacaine (7-8 hours) it is deemed the injected joint is the pain generator.</p>