Patient perception of magnetic resonance arthrography

Objective. Magnetic resonance (MR) arthrography has been demonstrated to be more accurate than MR imaging alone in the identification of a variety of musculoskeletal pathology. While the complication rate of intra-articular g adolinium: saline injection has been shown to be relatively low, MR arthrog raphy is more invasive, painful, and costly, and less convenient, than MR i maging alone. The purpose of this study was to evaluate patients' perceptio n of the fear and discomfort, and to assess their overall acceptance of the intra-articular gadolinium injection. Design and patients. Between October 1997 and January 1998, 113 out-patient s who were referred to Yale-New Haven Hospital for MR arthrography of the a nkle, elbow, hip, knee, shoulder, or wrist were asked to complete a questio nnaire rating their fear of factors most commonly associated with the proce dure including "pain", "needles", "complications", and "discovery of result s that would lead to surgery". In addition, after having undergone the intr a-articular gadolinium:saline injection, patients were asked to rate their perception of pain. Results. While many patients expressed fear of "pain" and "needles", after having undergone the injection their overall pain rating score was low. Onl y 6% actually found gadolinium arthrography more painful than expected. Conclusion. Despite the fact that patients expressed apprehension about cer tain aspects of MR arthrography, subjects who underwent the intra-articular gadolinium injection considered the discomfort less than expected. Clinici ans should not hesitate to order MR arthrography because the accuracy of th e procedure is high enough that patients accept the discomfort.