Advanced Musculoskeletal Imaging

MR Arthrography

In MR arthrography, a small amount of contrast (gadolinium) is injected directly into the joint of interest (e.g. hip, shoulder, knee). This allows for detailed evaluation of structures that are difficult to see by conventional MRI examination. Structures particularly well evaluated by this technique include the joint capsule, ligaments, tendons and labrum.

Imaging-Guided Musculoskeletal and Spinal Injections

Using imaging guidance with either conventional real-time X-ray (fluoroscopy) or CT, injection of medication (often a combination of anesthetic for pain relief and steroid as anti-inflammatory) can be performed for both diagnosis and treatment.

Procedures offered by Hoag include:

  • Discography (Discogram)
  • Epidural steroid injection
  • Facet or sacroiliac joint injection
  • Joint injection
  • Piriformis muscle injection

How to Prepare

When you schedule your appointment, we will inform you about any specific preparations depending upon the specific procedure your doctor has ordered. Please contact the Scheduling Department at 949/764-5573 if you have any questions.

Beginning several days before the procedure, you will need to discontinue certain medications.

  • If you are taking Plavix, Coumadin, Warfarin or Pradaxa, you must stop 5-7 days prior to your procedure but you MUST check with the prescribing physician first before stopping to see if your doctor has an alternative medication or instructions for you.
  • If you are taking Aspirin, Naprosyn, Ecotrin, Ibuprofen, Advil, Motrin, Aleve, Naproxen or Celebrex on a regular basis, we ask you to stop 5-7 days before your exam procedure but you MUST check with the prescribing physician first before stopping to see if your doctor has an alternative medication or instructions for you.
  • If you take Lovenox, you must stop 12 hours before your procedure.
  • Stop taking fish oil, flax seed oil, and vitamin E 5 days prior to your procedure.
  • Tylenol or acetaminophen are not an issue if you are currently taking them.

If you have prior studies outside of Hoag for a comparison, please bring them to your appointment.

If your physician has ordered your procedure with radiographic contrast:

  • You should inform your physician if you have any allergies. If you have been told you are allergic to contrast or have ever had a reaction to Iodine or any form of contrast media, your doctor may prescribe medications to reduce the risk of an allergic reaction. A Radiology nurse should contact you. If you have not been contacted by a Radiology nurse at least 24 hours prior to your appointment, please contact the Imaging Scheduler immediately.
  • If you have diabetes, kidney problems, lupus, surgery on your kidneys or multiple myeloma, you must have lab work that includes a BUN and Creatinine performed within 30 days of your exam. If you are over the age of 65, you must have lab work within 90 days of your exam. This provides us with information regarding your current kidney function. Please call your physician if you have not had this blood work.
  • If you have been diagnosed with diabetes and/or you are currently taking any of the following medications: Metformin, Gluicophage, Glucophage XR, Fortamet, Riomet, Metaglip, Glucovance, Actoplus Met, Avandament or Junamet, stop taking your medication for a total of 48 hours after your exam. You must contact your physician for alternative medications and instructions prior to your exam.
  • If you are currently receiving Dialysis; please schedule your dialysis to follow your procedure with Contrast or the following day. It is imperative you have dialysis no later than the following day after you have received contrast for your procedure.
  • We encourage you to hydrate with oral fluids at least 24 hours prior to your study. You may have only clear liquids as well as your necessary medications 2 hours before your exam.

You may receive additional specific instructions when you schedule your appointment depending upon the type of procedure that will be performed.

Please complete, print out and bring with you the following forms to your appointment:


Locations where Hoag provides Advanced Musculoskeletal Imaging services:

Hoag Hospital - Irvine
Hoag Hospital - Newport Beach
Hoag Health Center - Huntington Beach
Hoag Health Center Irvine – Sand Canyon
Hoag Health Center - Newport Beach