Hip Arthrogram, MRI

Yesterday I had the second Hip Arthrogram, MR. You can read about my nightmare experience the first time here.

I won't lie to you, it was bad...maybe I shouldn't say bad, but painful. The experience however, was pleasant. I was surrounded by caring and competent personel and the little things like blankets and pillows and the tech who would pat my feet when I grimmaced to be sure I was ok.

What you should expect, bring and need to know:
First, it's going to take longer than you think. Both times about 3.5 hours.

Wear or bring socks because it is freezing cold in the MRI machine and you will be there about 30 minutes twice.

Bring earplugs in case they don't supply them...the MRI machine sounds like a concrete driller right in your ears.

Bring a book, there's a lot of waiting around.

Take something to calm your nerves if it's possible (or you think you'll need it).

Have someone drive you home. Even if you feel capable, which I doubt, your nerves will be so shot and you'll be so exhausted from answering questions and being rolled around like a lab rat you won't be able to concentrate. Both times my leg was really numb, sore and stiff for a few hours afterwards.

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Now, how does it feel? What do they do? Oh, and by the way...when your doctor sets up this appointment, I would suggest asking if they can please have you go to a hospital. Radiology offices just don't offer the same level of care in my opinion.

You check in, answer lots of questions re what medications you're on, allergies, etc. If you're having a pain test, they will ask you what your level of pain is at that moment, mine was a two. (I chose to not intentionally aggravate my hip before the procedure. I didn't really see the point of making matters worse. After the lidocane, I swung it around like a karate kid and enjoyed the fleeting moments of pain free as a test...more on that later).

So, you'll change into a gown and remove pants and underwear, but still be able to keep shirt, bra on. The best part is you get a little hand towel to wrap between your legs like a sumo wrestler...I guess so your "privates" are covered somewhat. The tech will tell you what to expect and ask more questions then when all is ready they call the doctor in to start the show...if the tech does not tell you what to expect ask! You need to know and you need to tell them if you are afraid. And when the doctor comes in you need to ask him/her to explain what will happen next. More on that coming up...

The actual injection period lasts about 90 seconds or so. First the doctor finds the spot to inject and marks it. A darn right miserable place to get an injection. Best I can describe, if you imagine a modest bikini line, about an inch and a half below that, just a little inside the middle of the front of the leg.

They sterilize the area and give you a little shot of lidocane first and give it a minute to numb the area. This feels like a typical shot...then they push the needle a little deeper and it hurts moderately. Wait a few secs then go deeper...hurts more...they watch this all on x-ray to keep their bearings and if you're lucky(or not) you can watch too. Finally, they have to push through...he used the phrase pop into the final joint space and this hurts like a *******!!! But it's over in a sec and then they release the dye. I found having the doctor tell me before each push what to expect helped immensely. The first guy never spoke a word, so I never knew when the misery would end. I'm not sure this one hurt any less, but I was less anxious and fearful and that does make a difference in your pain level.

Oh, I forgot to add...before the injections you get one round of MRI...then you go back and do it again with the dye...immediately after the injection start testing the pain because the lidocane wears off quick. I hopped off the table and did squats, kicks, stretches and what not...no pain, not even a pinch!! Although oddly, I had this kind of phantom pain...like physically I didn't feel it, but my mind was so accustomed to preparing for it...it would say that hurts! But it didn't...very odd.

Anyway, once the second MRI has been done you go home! When I get the results I will share them.

take care,

Vanessa

24 comments:

louisawb said...

I have visions of you like the karate kid post inj.
Sorry yours hurt, I must've been super lucky, Had 3 in 6 months and felt no worse than a blood test with a deep achy feeling.

Louisa
myfaihippain.blogspot.com

Vanessa Lynch said...

I have a possible theory on why mine hurt sooo bad. But I'm not sure. Almost everytime I've had to get a shot of novacaine at the dentist, it has never really worked. I always have felt a lot of pain...I'm wondering if something about my body doesn't numb up enough or something. Or, maybe it's an area that is more sensitive in some than others...I don't know. But hoping I don't get another one anytime soon! Like as in this lifetime, lol.

Erin said...

I just came across your blog and can't thank you for describing this procedure. My surgery was this past July 1st. I had my arthrogram too and it was definitely painful. I have a blog as well if you ever feel like reading. Now I am gonna go back and see what I wrote about my own lol.

Erin
http://platterpussfai.blogspot.com/

Anonymous said...

I just wanted to share this with you guys because I had a really positive experience with my MRI Arthrogram of my hip today.

I had the injection and scan done at the Pediatric Imaging Center in Milwaukee. The Radiologist, Dr. Wells, came highly recommended to me and they have no problem accepting adults as patients.

I have to admit that, after reading so many horror stories beforehand, I was very nervous going into the whole thing. I am no scaredy cat, but the whole idea of someone sticking a large needle into my joint just did not sound appealing to me.. So before I went in I took a Xanax (0.5mg) to calm the nerves and then another one once I got there because it didn't seem to have the same effect on me that it seems to have on my boyfriend :-D While he said he would have been knocked out, I was wide awake and with it but positively less anxious.

At first, they did a couple of scans without contrast to determine whether the contrast was really necessary. Once they had decided that yes - we needed the contrast, I was brought into the flouro room. The tech removed the tegaderm and the LMX numbing cream that they had applied earlier, and then prepped my groin with Betadine. The Radiologist then went to numb the skin with a 30 gauge (very small!) needle and Xylocaine. He then proceeded to use the spinal needle, which was also surprisingly small (small as in thing - 25 gauge), to numb the tract further. He would advance it a little bit, numb it, advance it again, numb it again, and so on until he was in the joint space. I did not even feel the puncturing of the capsule. All I felt was a little pressure and a little discomfort, but nothing that I would call pain. He filled up the joint space with contrast and lidocaine for more numbing until I told him that it felt full enough and that the pressure was starting to get uncomfortable. I never even felt him remove the needle.

From there I went straight back to the MRI scanner where they did another series of scans with lasted about 30min. I had some numbness down to my knee and my shin which causes my knee to give in a little when I got off the table, but no complaints otherwise and it subsided within about an hour, two hours..

Now, 8 hours later, I still feel fullness and some stiffness in the joint which they say will subside tomorrow once the body has reabsorbed the excess fluid. It is somewhat uncomfortable but not so bad that I would have to take any pain medications.

To anyone who might need an MRI Arthrogram in the future and is nervous about it - I would really recommend calling a few different places and asking them what their procedure is. Also, don't be afraid to call up a pediatric place - they tend to be much gentler and much more focused on pain-control. I say that from my own experience - not only from today, but also from working as a pediatric nurse and having had several tests done at the Children's Hospital I work at because we get discounted prices there.

So: Don't be afraid. Speak up for yourself and tell them your concerns and needs and they will try to accommodate you. Most places will offer you Xanax or something for your nerves ;-)

I hope this helps!
Nicola

Vanessa said...

Nicola,
What a great idea!! My children have both been to Vanderbilt Children's Hospital a few times and I've always been so impressed by the quality of care.
After a bad trip to the dentist, the arthrogram and a lidocaine shot, it has been confirmed by an anethesioligist (i talked to the day of my hip scope) it seems I do not respond to any of the "caine" medicines. Maybe why mine were so painful both times.

Thanks for sharing your very helpful comment!

Vanessa:)

Anonymous said...

Sorry your experience was so terrible. We do these at our Radiology Clinic and it takes less than an hour for the injection and the MR imaging. Although some hips are already inflamed and painful, most injections go quickly and relatively painlessly. We mix some Marcaine into the gad/saline mix and that offers some relief too. Although we do not have meds such as Valium or Xanax, we do encourage patients to speak to their physicians about pain and relaxing meds. I hope others reading this site will be sure to talk to their refering physicians and the radiologists and technologists before their exam. I think they will feel more confident about having the exam done.

Anonymous said...

Just had my MRI arthrogram and do agree with the above comment regarding inflammation. When a tissue is inflammed it does not respond very favorable to anesthesia(I have experienced this during a dental procedure, gingivectomy and is NO FUN!) My arthrogram itself was really good. My hip feels a bit bigger and heavier, but is good in general. The MRI was okay, though 40 minutes inside one of those is not entertaining, I think I even fell asleep, which wasn't bad, but I twitch when I fall asleep and they said I couldn't move :S
But I will always recommed asking the Radiologist to ask if they numb you some before the injection.

Anonymous said...

Had this procedure last week and after reading all these awful stories I was a bit nervous. And I have to say it was nothing, but a bit uncomfortable and that's it!!!! It was cold so I was glad I had socks. So anyone who has to get one anytimes soon, there is no reason to be scared.

Anonymous said...

Thank you those who posted unpainful stories. I had one when I was 16 in my shoulder and it was very painful. So now I am 22 and getting one on my hip. Very nervous!!! expecially after reading some bad stories but you guys made me feel better. Thank you!

Anonymous said...

I had a hip arthrogram today! What I read online really scared me and it took me 4 months to get my guts up to do it.
It was a breeze seriously!
If you have to get one don't be scared! I did take some valium for nerves which helped most for keeping me mellow while I laid in the MRI machine for 1 1/2 hours. The dye injection was all of 3 minutes. No sweat and very very minimal pain. The dentist is worse. I am sore right now but sure I will be fine in 24 hours.

Anonymous said...

I got one of these on my left hip when I was 15 and I had a horrible experience. First I found out that I was allergic to morphine and then they almost had to strap me to the table because I guess I was shaking so bad from the pain because I practically had no pain medicine. I was wondering if maybe that since I am 18 now if it would hurt any less and what kind of pain medicine would they give me because that I am allergic to morphine?

Anonymous said...

Even this "good" experience is pretty dramatic, I think, but still an interesting and informative post! I have had 2 hip arthrograms and they were absolutely nothing compared to the pain I am in that is the reason for the arthograms. I was absolutely terrified before going into my first one -- the prep time is honestly the worst part. When they put the needle in it's basically a feeling of pressure in the area of the joint. Personally for me, I was fine to drive myself (I had to go right back to work) but I went on my first walk in years to see if the lidocaine took away the pain. It did, but then about 4 hours later it feels pretty sore, for me. But you should definitely be fine to drive yourself, it's not as exhausting an experience as this post makes it sound.

Anonymous said...

I'm getting my second hip arthogram done next week and they are not fun. I just wish they will have something better then we dont know what's going on.

I had a hip replacement done 5 yrs ago this Jan. on my left hip and everything has gone down hill from their now the right is going out. I have AVN and I did nothing to bring it on and the doc that did my hip replacement 5 yrs ago screwed up and put to big a hip in and my legs were an 1 1/2 longer then the other and it was a nightmare I was only 23.

I had to make him redo it and I was out of work for 4 months. I just hope this second one says something so I can get to my old self again :(

Anonymous said...

I have a bilateral arthrogram in the morning and feel very nervous about the potential pain with the needles; the posts here have helped me to understand and prepare for the procedure and I really appreciate people taking the time to document their experience. Onward! Jennifer

Anonymous said...

I had a bilateral hip MRI arthrogram last week; having a low pain threshold and having read posts about the procedure, my anxiety was high.

It's over and I have to say I was pleasantly surprised. Take the Xanax if they offer you one and ask for it if they don't; the radiologist talked to me the entire process, telling me exactly what was happening or going to happen - he told me to shut my eyes and breathe in my nose and out my mouth - he was extraordinarily quick and the pain I felt was minimal; the lidacaine to numb the leg before the bigger needle goes into the joint TOTALLY numbed me. I felt little pressure or heaviness in the joint after the procedure and in fact passed the "pain test" with flying colors as I was able to move my hips/legs in ways that typically leave on the floor - that euphoria lasted 12 hours and it reminded me of how my life used to be before this now-going-on-22 months of chronic pain.

Take socks into the MRI tube and your own CD to listen to, they can pipe it in to you.

My post-procedure stiffness didn't set in until the following day, late in the afternoon. It lasted a night.

Hope this helps someone else who is about to go through this procedure. J

Kerri said...

Thank you Vanessa for all your helpful information...I am wondering if you, or anyone else here, has had to have the MRI - A without local anasthesia. I'm allergic to most of them and am going to do the injection without...just want to prepare. Sounds like it hurts like *$&#! even with the lydocaine...Thanks all.

Anonymous said...

i JUST HAD MINE DONE TODAY, AND YES I DID ASK QUESTIONS AND KNEW WHAT TO EXPECT, BUT HELL, IT HURTS LIKE A LONG 16D NAIL GOING INTO YOUR LOWER BIKINI AREA IN THE LEG THEN IT GOES IN FURTHER THEN THE DOC GOES ONE MOR TIME AND THE DYE IS RELEASED, I WAS STILL SO TENSE I HAD PROBLEMS WITH BEING CALM,NEVER ,FREAKIN AGAIN,NEVER!! AFTER I HAD APPOSLATELY NO PROBLEM WITH MY LEG OR PAIN. HOPE THIS HELPS. AND GOOD LUCK TO ANYONE THAT NEEDS THIS DONE.

Alicia said...

I had a terrible experience. No one prepared me and I was told it is like a cortisone injection, which is a lie. Dr. No Bedside Manner put novocain in first. Then again. And then a 3rd time. I screamed in pain with the first needle and started to cry. Nurse and Dr. were not very caring. I had to wait 30 minutes to get my MRI afterwards.

I have had 3 cortisone injections and none of them felt like that. Glad you had caring people!

Anonymous said...

I also had a terrible experience and no one prepared me! Wish I would have read these post prior to going. Make sure to ask for pain meds before the procedure. I ended up passing out during because it was so painful! I don't like to take medication and I begged for something to take away the pain so I could handle the 1 hour MRI procedure after. I had the procedure 2 days ago and still feel a lot of cramping and pressure in my hip/pelvis. I wasn't told how invasive this procedure was and hope to never have to have another!

Tammy said...

It is so amazing how your story is just like mine. I have had 3 MRI's with the dye and you think you would be use to it by the third time. But no. They try to keep you covered as much as possible but in reality you are pretty much lying there uncovered! The Dr. said on my last one, I gave you lots of freezing. Boy did he. I was numb from the waist to my knee for about 2 hours. Trying walking out of the hospital with a numb leg that you are trying to drag behind you. Looked a little funny.

Anonymous said...

I had this done and had similar results. The MRI portion not bad...just like usual (but it does get cold so socks--very good idea - maybe a pair of gloves too). The dye injection was done in the MRI offices by a live-xray guided technician. Didn't hurt - really. The lidocane shot preceded each new 'tunnel' for the dye injection....no pain. Blissfully numb. HOWEVER> when the lidocaine wore off -- on my way home -- I was unable to bear weight on my leg at all. Couldn't move it by muscle control or even manual movement. Pain was un-freaking-believable. Fortunately I had crutches at home that allowed me to get around for the first 12 hours or so. Then the dye begins to absorb into the body and the hip joint begins to move again without additional pain. Odd thing for me is that now it clicks with every step. They told me this would wear off, but it's been over a month and it still does it. I guess we shall see. Advice? 1. Take a friend to drive you -- it's better to be prepared. 2. Have a cane or crutches ready at home to help you get around. 3. Have icepacks (multiple) and antiinflammatory meds available as well. The procedure -- not a big deal at all...The time after? Not amazing. But back to normal within 24 hours with no residual effects (except the clicking...which I am told is simply an oddity).

Anonymous said...

So glad to read this last post. Did not see anyone else who had incredible pain after the procedure. I actually had a CT scan with contrast dye so the injection was exactly the same. I agree, the actual process of getting the dye in wasn't soo bad, but when I tried to get up to change back into my pants, my leg buckled with such pain that I needed a wheelchair to get back to the scan room. After the scan, I felt some better, but by the time I got to the car, the pain set in again. They told me this pain would only last a couple of hours and here I am 7 hours later and still unable to put weight on that leg. I feel so much better knowing that someone else has had a similar experience.

John Fox said...

Hi,

Sorry to hear you had a bad experience in the MRI. They make me claustrophobic.

I got a bi-lateral hip MRI yesterday and I have a question. Do you know if breathing during it is bad? They put this square-shaped device on my hips and I breathed the whole time, sometimes moving my torso and this thing resting on top of me a lot when "loud noises were being made" --pictures being taken? I am afraid my images are blurry.

Any feedback would help,

Cool site!!!

Anonymous said...

Just had a left hip mr arthrogram yesterday. After an hour on the table with the radiologist trying to get the contrast in the joint, he was unable to get it into the joint as was evident with the fluoroscope. I can't tell you how many sites he tried. All I know is that the lidocaine eventually wore off as he was not succeeding in getting the dye in after some time. I received another shot of lidocaine and then several additional attempts to inject the contrast ....to no avail via xray. (they took like 20 images). The doc decided to put me through the first round of the mri with hopes that some of the dye got into the hipjoint. After 15 minutes, I was taken out from the MRI machine and told, "No luck. The contrast was not in the joint. The test was suboptimal and I would have to come back when the contrast got reabsorbed" I was told my hip had an 'odd shape' to it and that perhaps it was inflamed with this being the reason he was unsuccessful. Of course, I am reluctant to go back. They were looking for a labral tear. I suppose I will wait a month and retry, but I am not a happy camper.

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