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At least 1,801 records · Page 100Linked to original sources
PubMed1996

The value of arthroscopy in the evaluation of carpal instability.

In a prospective study, arthroscopic examinations were performed on 42 wrists following injury. Clinical findings, radiology, and arthrography were compared to the arthroscopic findings. Only obvious or total ligamentous ruptures found on arthroscopy were considered in the analysis. No direct correlation could be demonstrated with clinical findings or arthrography. The distribution pattern of ligament injury involving the radial and ulnar compartment of the wrist joint in 40% of the cases suggests that carpal dysfunction following injury and ligamentous tears is a more complex problem than usually accepted. The ulnar midcarpal joint seems more prone to injury than the radiocarpal portion of the wrist. This suggests an important biomechanical function of the palmar ligaments inserting on the triquetrum.

Adolescent↗
PubMed1998

Lateral approach for arthrocentesis of the distal interphalangeal joint in horses.

OBJECTIVE: To determine anatomic landmarks for a lateral approach for arthrocentesis of the proximopalmarolateral aspect of the distal interphalangeal (DIP) joint in horses and the likelihood of entering synovial structures other than the DIP joint through this approach. DESIGN: Prospective study. SAMPLE POPULATION: Paired forelimbs of 8 cadavers and 12 horses. PROCEDURE: Anatomic preparations were used to determine anatomic landmarks. Positive-contrast arthrography was used to determine which structures were entered. RESULTS: Landmarks for the lateral approach included a depression in the proximal border of the lateral ungular cartilage and the palmar border of the middle phalanx. Use of the lateral approach for arthrography resulted in deposition of contrast material exclusively in the DIP joint in only 13 of 20 limbs, whereas use of the dorsal approach resulted in deposition of contrast material exclusively in the DIP joint in 20 of 20 limbs. CLINICAL IMPLICATIONS: The lateral approach is an alternative to the conventional dorsal approach to the DIP joint in horses, however, inadvertent entry into adjacent synovial structures is a possible complication. The lateral approach provides an additional portal for through-and-through lavage and arthroscopic access to the palmar aspect of the DIP joint.

Animals↗
PubMed1997

[Useful imaging data before intervention for an unstable shoulder].

Recurrent instability of the shoulder may sometimes be a difficult diagnostic challenge. Bernageau's standard X-rays set, which includes 3 antero-posterior X-rays with medial rotation and 2 glenoid views, is able to confirm the existence of anterior instability events. However, it gives no information on the glenoid labrum and the glenohumeral ligaments. As surgical techniques are more sophisticated, more precise imaging techniques are needed in order to adapt the surgical technique to the anatomical lesions. Although CT arthrography is today the best imaging technique to choose a surgical technique, it will probably be replaced by MR arthrography in the near future. Pros and cons of each imaging techniques are described, together with their implications for the choice of treatment.

Arthrography↗
PubMed2000

Effect of gradient and section orientation on quantitative analysis of knee joint cartilage.

The object of this study was to determine the influence of the gradient and section orientation on cartilage thickness and volume measurements in the knee joint. Eight specimens were imaged with a fat-suppressed gradient-echo sequence, applying sagittal, transverse, and coronal section orientations. Images were additionally acquired with exchanged gradient directions, and with computed tomography (CT) arthrography. After segmentation and three-dimensional (3D) reconstruction, the volume, the mean, and the maximal 3D cartilage thickness were computed. No effect of changes in the gradient orientation was found, suggesting that susceptibility-induced geometric distortion is not a relevant problem in quantitative cartilage imaging. Sagittal images produced similar data to that obtained with transverse (patella) or coronal (tibia) sections, demonstrating that all knee joint cartilages can be accurately quantified from a single sagittal data set. Whereas no significant systematic deviation between magnetic resonance imaging (MRI) and CT arthrography was recorded in the patella, there was a 10%-15% underestimation of tibial cartilage thickness in MRI.

Cartilage, Articular↗
PubMed1991

Bicipital groove dysplasia and medial dislocation of the biceps brachii tendon.

The purpose of this study was to investigate the plain film finding of dysplasia of the lesser tubercle of the humerus and its relationship to medial dislocation of the tendon of the long head of the biceps brachii muscle as diagnosed by shoulder arthrography. Of 55 patients referred for arthrography of the shoulder because of undiagnosed shoulder pain, 12 demonstrated flattening of the medial wall of the bicipital tendon groove. Of these, 58% had medial dislocation of the biceps tendon, and 43% of patients with dislocation of the biceps tendon were also shown to have a tear of the rotator cuff. Since biceps tendon pathology has long been implicated in shoulder pain and weakness, assessment of the bicipital groove may provide important information in evaluating patients with potential abnormality of the biceps tendon.

Female↗
PubMed1981

Capsular constriction of the hip: arthrographic and clinical considerations.

Orthodox radiological examination of patients presenting with disorders of the hip, usually on account of pain and limitation of movement, may vary in diagnostic value. As a supplementary study we have employed arthrography. During this procedure we have, since 1970, routinely assessed the capacity of the joint capsule. The normal capacity varies from 20 ml in a large adult male to 14 ml in a small adult female. Significant reduction of this volume has been observed as a secondary complication of certain organic lesions, including four cases of synovial chondromatosis, one case of an intra-articular loose body, and one case of osteoid osteoma of femoral neck. In these secondary cases, the only common feature visible on the plain film was regional osteopenia. In these patients symptoms persisted until adequate surgical measures had been performed. (Descriptive term proposed: secondary capsular constriction of the hip: SCCH). In another group of seven patients, in whom orthodox radiological studies were unrewarding, arthrography was undertaken on account of persistent pain and limitation of movement. Similar reduction in the capacity of the joint was found, but in each case spontaneous resolution of the symptoms took place, without surgical intervention, in periods varying from three to 18 months. This self-limiting syndrome appears to be analogous to that of the "frozen shoulder" and, like the latter, is associated frequently with barbiturism.

Adult↗
PubMed1982

The value of computed tomography scanning in chondromalacia patellae.

Sixty seven patients with pain in the knee were studied. A compound tomography (CT) score indicating chondromalacia was devised, based on the results of CT after arthrography. This score takes account of the regularity, the congruity, and the imbibition of contrast material. Thus the patients could be divided into four groups: those who definitely have chondromalacia (++), probably (+), probably not (+/-), and definitely not (-). These results were compared with the clinical diagnosis based on clinical signs, arthroscopy, or operation. Eighteen patients had clinically proved chondromalacia, CT scored 14++, 3+ and 1+/-. Twenty nine patients had no chondromalacia, CT scored 19-, 8+/-, and 2+. Twenty patients had an uncertain clinical diagnosis. Arthrography was less accurate in detecting chondromalacia.

Adolescent↗
PubMed1982

Synovial plicae of the knee.

This report describes the anatomy, pathophysiology, clinical, and radiographic findings, and treatment of the synovial plicae of the knee joint. The suprapatellar plica is a synovial fold present in the suprapatellar pouch of the knee joint in approximately 20% of the population. This fold may become symptomatic after injury and cause symptoms similar to other common internal derangements of the knee. Double contrast arthrography of the knee can be used to identify the presence of plicae. Although arthrography can identify the presence of a plica, its clinical significance requires close correlation with symptoms and an accurate clinical examination.

Humans↗
PubMed1977

[The traumatology of the articular disc of the wrist (author's transl)].

Roentgenological signs, which seems typically for a posttraumatic lesion of the articular disc of the wrist in case they appeared together with a corresponding clinical manifestation, were found in arthrographies of wrist by 89 patients with posttraumatic troubles. Four different types of roentgenolo-ic alterations and the difficulties by examinating them were described. In our opinion arthrography of the wrist is a successfull method to apprehend a lesion of the triangular disc.

Connective Tissue↗
PubMed1977

[The traumatology of the articular disc of the wrist (author's transl)].

At 89 Patients with painfull wrist and clinical symptoms like a lesion of the triangular disc, arthrography of the radiocarpal joint was performed. In 18 cases with corresponding arthrographical findings removal of the disc results in clear recovery respectively painlessness. That simple operation seems to be an alternative to the resection of the ulna and a replaceable method if symptomatology and arthrography are accordingly. The described proceeding becomes important because no recovery was seen by conservative treatment.

Adult↗
PubMed1983

Chondral fracture of the anterior intercondylar groove of the femur.

A case of purely chondral fracture of the anterior intercondylar groove of the femur producing a loose body is demonstrated by single contrast arthrography in a boy who also presented a classical osteochondritis dissecans of the medial femoral condyle. This case demonstrates that an arthrography of the knee should always include a study of the patellofemoral joint even if there are no patellofemoral complaints.

Adolescent↗
PubMed1987

[Sonography as a screening method in suspected rupture of the rotator cuff].

We have found ultrasonography of the shoulder in differentiating between normal rotator cuff and rotator cuff lesion according to trauma a very helpful method. In comparison to arthrography it is a quick and painless method without any risk. Whereas other authors report a sensitivity of 100% and a specificity of 94% in shoulder disease we recommend ultrasonography in acute shoulder trauma as a screening method. Pathological findings in ultrasonography will make the decision for arthrography easy. The major diagnostic pitfall is the calcified tendon of the rotator cuff.

Calcinosis↗
PubMedDate not supplied

Painful shoulder syndromes: diagnosis and management.

Painful shoulder conditions are common primary care problems. Providers should learn the topographical landmarks about the shoulder and understand shoulder mechanics. A careful clinical evaluation will usually provide a likely diagnosis. In unclear cases with marked pain, weakness, and reduced mobility, or with a suspected rotator cuff tear or rupture, arthrography or MRI will usually establish a diagnosis. Therapy of bursitis/tendinitis consists of a steroid injection into the inflamed subacromial area or a 14-day trial of an NSAID. Therapy of bicipital tendinitis, largely empiric because definitive studies are unavailable for any specific treatment, includes judicious peritendinous steroid injections and avoiding aggravating activities. In the management of patients with suspected tendon tears or rupture, primary care practitioners can confirm the diagnosis by ordering MRI or arthrography before referring these patients to an orthopedist for definitive surgical therapy. Optimal management of adhesive capsulitis remains unclear, but an intraarticular steroid injection appears beneficial at least in temporarily diminishing pain. Pendular motion exercising is also an integral part of therapy. Deleterious effects of peribursal or intraarticular steroid infiltration appear minimal; but injections into the tendon or frequent, repetitive injections are contraindicated. Each shoulder condition has a variable course, depending on the structure(s) and extent of involvement.

Anti-Inflammatory Agents, Non-Steroidal↗
PubMed2006

[MR imaging of the shoulder. Impingement and instability-related abnormalities].

In addition to the case history and the clinical examination, MR imaging has an important role in the diagnosis and differential diagnosis of numerous shoulder abnormalities and in the investigation of chronic shoulder pain. Important indications for MR imaging are any conditions or symptoms making assessment of the rotator cuff and the labrocapsular complex necessary. Assessment of the rotator cuff muscles, in particular, is crucial. The value of MR arthrography, which is still controversial, is discussed. The greatest potential benefit of MR arthrography is the accurate evaluation of subtle rotator cuff abnormalities and shoulder instability-related lesions, and the assessment of pathologic conditions of the long biceps tendon. This paper describes the most common pathologic findings of the shoulder joint and describes how the relevant findings are reported and quantified for the orthopaedic shoulder surgeon.

Humans↗
PubMed1996

[Diagnosis of shoulder impingement syndrome].

This article reviews the pathogenesis and clinical and imaging findings in shoulder impingement syndrome. Shoulder impingement is caused by compression of the supraspinatus tendon underneath the coracoacromial arch, mainly in forward flexion of the arm. Different stages of impingement syndrome are described. Stage I relates to edema and hemorrhage of the supraspinatus tendon. Stage II is characterized by bursal inflammation and fibrosis, as well as tendinopathy. In stage III there is a tear of the rotator cuff. Clinical signs may overlap. Moreover, calcifying tendinitis, fractures and pain originating from the cervical spine may mimic shoulder impingement syndrome. Imaging is important for the exact diagnosis. Standard radiographs are the basis of imaging in shoulder impingement syndrome. They may demonstrate subchondral sclerosis of the major tuberosity, subacromial spurs, and form anomalies of the acromion. They are also important in the differential diagnosis of shoulder impingement syndrome and demonstrate calcifying tendinitis, fractures and neoplasm. Ultrasonography has found acceptance as a screening tool and even as a final diagnostic method by many authors. However, there is a high interobserver variability in the demonstration of rotator cuff tears. Its usefulness has therefore been questioned. MR imaging is probably the method of choice in the evaluation of the rotator cuff and surrounding structures. Several investigations have demonstrated that differentiation of early findings, such as tendinopathy versus partial tears, may be difficult with MR imaging. However, reproducibility for fullthickness tears appears to be higher than for sonography. Moreover, specificity appears to be superior to sonography. MR arthrography is not universally accepted. However, it allows for more exact differentiation of discrete findings and may be indicated in preoperative planning. Standard arthrography and CT have a limited role in the current assessment of the rotator cuff.

Diagnosis, Differential↗
PubMed2003

Ultrasound of intrinsic wrist ligament and triangular fibrocartilage injuries.

OBJECTIVE: The objective of this study was to evaluate ultrasound as a diagnostic tool for investigating scapholunate and lunatotriquetral ligamentous and triangular fibrocartilage (TFC) tears. Ultrasound findings were compared to conventional arthrogram findings, as the reference gold standard. DESIGN AND PATIENTS: In total 26 patients, 17 males and 9 females ranging in age from 17 to 35 (mean age, 34), were evaluated on referral for investigation of wrist pain. All patients were examined by high resolution ultrasound, using a 9-13 MHz transducer. All wrist ultrasound examinations were also compared to conventional tricompartmental arthrography, as the diagnostic gold standard reference. RESULTS: All ten scapholunate tears confirmed on arthrography were detected on ultrasound. Two of 8 lunatotriquetral and 7 of 11 TFC tears were correctly diagnosed on ultrasound. Sensitivity of ultrasound diagnosis ranged from 25% for lunatotriquetral tears to 100% for scapholunate tears. No false positive results were recorded for any of the three examined structures. CONCLUSION: The study results suggest that sonography is accurate for scapholunate tears, but is not accurate for evaluation of lunate-triquetral tears. It has intermediate accuracy for triangular fibrocartilage tears.

Adolescent↗
PubMed2005

Imaging findings of spontaneous detachment of the deltoid muscle as a complication of massive rotator cuff tear.

A tear at the origin of the deltoid muscle is uncommon and usually occurs as a complication of shoulder surgery. We report a case of spontaneous deltoid detachment as a complication of massive rotator cuff tear in a 70-year-old woman evaluated by standard radiographs, ultrasound, arthrography and MR-arthrography. We present the multimodality imaging findings with review of the literature. We found that ultrasound is an accurate modality in detecting and assessing spontaneous detachment of the deltoid muscle. As ultrasound is a noninvasive, low-cost, and universally available imaging modality we suggest using ultrasound as the first modality for evaluation of spontaneous detachment of the deltoid muscle.

Aged↗
PubMed2005

Primary synovial osteochondromatosis presenting as constrictive capsulitis.

Primary synovial chondromatosis of the joints can present as capsular constriction with peri-articular osteopenia. This rare presentation is highlighted in three cases (two hips and one shoulder). The diagnosis in all the patients was made on arthrography and/or MRI/CT and was confirmed histologically. Synovial chondromatosis should be considered in patients with this presentation. Arthrography is the best imaging modality to confirm the cause (synovial chondromatosis) and effect (constrictive capsulitis).

Adult↗

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