A magnetic resonance imaging (MRI) scan of the arm is a noninvasive method to create detailed pictures of the upper and lower arm, including the elbow, wrist, hands, fingers, and the surrounding muscles and other tissues.
Unlike x-rays and computed tomographic (CT) scans, which use radiation, MRI uses powerful magnets and radio waves. The MRI scanner contains the magnet. The magnetic field produced by an MRI is about 10 thousand times greater than the earth's.
The magnetic field forces hydrogen atoms in the body to line up in a certain way (similar to how the needle on a compass moves when you hold it near a magnet). When radio waves are sent toward the lined-up hydrogen atoms, they bounce back, and a computer records the signal. Different types of tissues send back different signals.
Single MRI images are called slices. The images can be stored on a computer or printed on film. One exam produces dozens or sometimes hundreds of images.
You may be asked to wear a hospital gown or clothing without metal fasteners (such as sweatpants and a t-shirt). Certain types of metal can cause inaccurate images.
You will lie on a narrow table, which slides into the middle of the MRI machine. Small devices, called coils, may be placed around your arm. These devices help send and receive the radio waves, and improve the quality of the images.
You will be asked to place your arms by your side. For some views, you may need to place your arms above your head.
Some exams require a special dye (contrast). The dye is usually given before the test through a vein (IV) in your hand or forearm. The dye helps the radiologist see certain areas more clearly.
During the MRI, the person who operates the machine will watch you from another room. Several sets of images are usually needed, each taking 2 - 15 minutes. Depending on the type of equipment, the exam may take 1 hour or longer.
You may be asked not to eat or drink anything for 4 - 6 hours before the scan.
Before the test, tell the radiologist if you currently undergo dialysis, as this may affect whether you can have IV contrast.
If you fear confined spaces (have claustrophobia), tell your doctor before the exam. You may be given a medicine to help you feel sleepy and less anxious, or your doctor may recommend an "open" MRI, in which the machine is not as close to the body.
The strong magnetic fields created during an MRI can interfere with certain implants, particularly pacemakers. Persons with cardiac pacemakers cannot have an MRI and should not enter an MRI area.
You may not be able to have an MRI if you have any of the following metallic objects in your body:
- Brain aneurysm clips
- Certain artificial heart valves
- Inner ear (cochlear) implants
- Recently placed artificial joints
- Some older types of vascular stents
Tell your health care provider if you have one of these devices when scheduling the test, so the exact type of metal can be determined.
Before an MRI, sheet metal workers or any person that may have been exposed to small metal fragments should receive a skull x-ray to check for metal in the eyes.
Because the MRI contains a magnet, metal-containing objects such as pens, pocketknives, and eyeglasses may fly across the room. This can be dangerous, so they are not allowed into the scanner area.
Other metallic objects are also not allowed into the room:
- Items such as jewelry, watches, credit cards, and hearing aids can be damaged.
- Pins, hairpins, metal zippers, and similar metallic items can distort the images.
- Removable dental work should be taken out just before the scan.
An MRI exam causes no pain. Some people may become anxious inside the scanner. If you have difficulty lying still or are very anxious, you may be given a mild sedative. Excessive movement can blur MRI images and cause errors.
The table may be hard or cold, but you can request a blanket or pillow. The machine produces loud thumping and humming noises when turned on. You can wear ear plugs to help reduce the noise.
An intercom in the room allows you to speak to the person operating the scanner at any time. Some MRIs have televisions and special headphones that you can use to help the time pass.
There is no recovery time, unless you need sedation. After an MRI scan, you can resume your normal diet, activity, and medications.
This test provides detailed pictures of the arm. It provides clear pictures of parts of the arm that are difficult to see clearly on CT scans.
Your doctor may order this test if you have:
- A mass that can be felt on a physical exam
- An abnormal finding on an x-ray or bone scan
- Bone infection (osteomyelitis)
- Bone pain and fever
- Broken bone
- Decreased motion or "locking up" of the wrist or elbow joint
- Fluid buildup in the elbow or wrist joins
- Redness or swelling of the wrist or elbow joints
- Signs of cancer or a tumor
- Signs of injury to the arm muscle, cartilage, or ligaments
- Unexplained arm or wrist pain that does not get better with treatment
Your doctor may also order an arm MRI to:
- Evaluate an infection or abscess
- Identify a mass or tumor, including cancer
- Monitor your progress after arm, elbow, or wrist surgery
Results are considered normal if the organs and structures being examined are normal in appearance.
Results depend on the part of the body being examined and the nature of the problem. Different types of tissues send back different MRI signals. For example, healthy tissue sends back a slightly different signal than cancerous tissue.
Abnormal results may be due to:
Bursitis of the elbow or wrist
Broken bone or fracture
- Ganglion cyst in the wrist
- Infection in the bone
- Ligament, tendon, or cartilage injury in the wrist or elbow
- Muscle damage
- Osteonecrosis (avascular necrosis)
- Tumor or cancer in the bone, muscle, or soft tissue
Consult your health care provider with any questions and concerns.
MRI contains no ionizing radiation. To date, there have been no documented significant side effects of the magnetic fields and radio waves used on the human body.
The most common type of contrast (dye) used is gadolinium. It is very safe. Allergic reactions to the substance rarely occur. The person operating the machine will monitor your heart rate and breathing.
MRI is usually not recommended for acute trauma situations, because traction and life-support equipment cannot safely enter the scanner area and the exam can take quite a bit of time.
People have been harmed in MRI machines when they did not remove metal objects from their clothes or when metal objects were left in the room by others.
Tests that may be done instead of an MRI of the arm include:
A CT scan may be preferred in emergency cases, since it is faster and usually available right in the emergency room.
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Bearcroft PPW. Joint Disease. In: Grainger RC, Allison D, Adam, Dixon AK, eds. Diagnostic Radiology: A Textbook of Medical Imaging. 4th ed. New York, NY: Churchill Livingstone; 2001:chap 50.
Grainger AJ, Davies M. Techniques and Imaging of Soft Tissues. In: Grainger RC, Allison D, Adam, Dixon AK, eds. Diagnostic Radiology: A Textbook of Medical Imaging. 4th ed. New York, NY: Churchill Livingstone; 2001:chap 45.
Sanders, TG. Imaging Techniques. In: DeLee JC, Drez D Jr, Miller MD, eds. DeLee and Drez’s Orthopaedic Sports Medicine. 2nd ed. Philadelphia, Pa: Saunders Elsevier; 2003:chap 16.