Preparing the MR arthrography contrast mixture

The essence of arthrography is administering some sort of contrast solution into the joint. Here's what we use and how we mix it up:

  1. Withdraw 0.1 ml of gadolinium-based contrast in a 1 ml syringe. Be sure that there is contrast in the syringe -- not just air!
  2. Inject that 0.1 ml of gadolinium-based contrast into a 10 ml vial of 1% lidocaine.
  3. Withdraw all 10 ml of the gadolinium-lidocaine mixture into a 20 ml syringe.
  4. Aspirate about 10 ml of iodinated contrast into the same 20 ml syringe for a total volume of 20 ml.
  5. Insure that the mixture within the syringe is thoroughly mixed.
  6. Connect the 20 ml syringe to your tubing. Flush the contrast through the tubing to eliminate any visible gas bubbles. Injected bubbles can mimic intra-articular bodies.