Medicine or meddling? use of arthrography in rheumatology

In the wardrobe of diagnostic procedures for the arthritic patient, the arthrogram is like a tuxedo. It produces striking images in black-and-white, it can be slightly uncomfortable, and there are times when it can be just the right thing. However, like the tuxedo, the arthrogram should be reserved for infrequent special occasions. Although arthrography can show changes which are characteristic of arthritis, it can seldom differentiate one type of synovitis from another. It may be useful to determine whether or not a synovial disorder is present, but this will not be necessary for the great majority of patients. Its most important uses are in the evaluation of masses in and around joints, and of the pseudothrombophlebitis syndrome. In selected cases, it may help to elucidate the stage and mechanism of disease.