title: Morbidity of direct MR arthrography.
abstract: OBJECTIVE
  The purpose of this study was to determine the incidence and severity of arthrographic pain after intraarticular injection of a gadolinium mixture diluted in normal saline for direct MR arthrography.
  
  
  METHODS
  From March 2009 until January 2010, 155 consecutive patients underwent direct MR arthrography; 20 patients were lost to follow-up. Patients were contacted by telephone between 3 and 7 days after joint injection. Using an 11-point numeric pain rating scale, patients were asked to report if they had experienced joint pain that was different or more intense than their preinjection baseline, the severity of pain, the duration of pain, time to onset of pain, and eventual resolution of pain.
  
  
  RESULTS
  The incidence of postarthrographic pain was 66% (89/135), with an average intensity of pain of 4.8 ± 2.4 (range, 1-10). Postarthrographic pain lasted an average of 44.4 ± 30.5 hours (range, 6-168 hours). The time to onset of pain after joint injection was on average 16.6 ± 13.1 hours (range, 4-72 hours). There was no significant difference regarding the severity or incidence of postarthrographic pain between groups on the basis of patient age (p = 0.20 and 0.26), patient sex (p = 0.20 and 0.86), contrast mixture contents (p = 0.83 and 0.49), or joint injected (p = 0.51 and 0.47). No patients experienced any other serious side effects.
  
  
  CONCLUSIONS
  Sixty-six percent of patients who undergo direct MR arthrography will experience a fairly severe delayed onset of pain that completely resolves over the course of several days.
authors.affiliation: Department of Radiology, University of California, San Francisco, San Francisco, CA, USA. joseph.giaconi@cshs.org
authors.forename: Joseph C
authors.initials: JC
authors.lastname: Giaconi
authors.forename: Thomas M
authors.initials: TM
authors.lastname: Link
authors.forename: Thomas P
authors.initials: TP
authors.lastname: Vail
authors.forename: Zachary
authors.initials: Z
authors.lastname: Fisher
authors.forename: Richard
authors.initials: R
authors.lastname: Hong
authors.forename: Ravi
authors.initials: R
authors.lastname: Singh
authors.forename: Lynne S
authors.initials: LS
authors.lastname: Steinbach
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003287:Contrast Media / Q000009:adverse effects*; D005260:Female; D019786:Gadolinium DTPA / Q000009:adverse effects*; D006801:Humans; D015994:Incidence; D007270:Injections, Intra-Articular / Q000009:adverse effects*; D007479:Iopamidol / Q000009:adverse effects*; D007592:Joint Diseases / Q000175:diagnosis*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D010146:Pain / Q000453:epidemiology / Q000209:etiology*; D010147:Pain Measurement; D011446:Prospective Studies; D018709:Statistics, Nonparametric
chemical_list: D003287:Contrast Media; D007479:Iopamidol; D019786:Gadolinium DTPA