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PubMedDate not supplied

Arthrography for the diagnosis of acute lateral ligament injuries of the ankle.

Arthrography was used for diagnosis of ruptures of lateral ligaments in 589 acutely injured ankles that were treated operatively. The accuracy of the method was tested comparing the findings of arthrography with those at operation. We found arthrography to be almost 100% reliable for diagnosing a fresh anterior talofibular ligament rupture. The best criterion for detecting calcaneofibular ligament rupture was filling of the peroneal tendon sheath with contrast medium. Leakage below and behind the lateral malleolus, when present with peroneal tendon sheath filling, confirms the diagnosis of calcaneofibular ligament rupture, but these findings without peroneal tendon sheath filling are too rare to base the diagnosis on them alone.

Adolescent↗
PubMedDate not supplied

Meniscal repair in the goat model. The use of healing adjuncts on central tears and the role of magnetic resonance arthrography in repair evaluation.

We evaluated the effect of adjunctive healing measures on central tears of the adult goat medial meniscus and the role of magnetic resonance arthrography in the assessment of menisci that have undergone a repair. Peripheral tears were made unilaterally in the medial menisci of seven goats in Group I and repaired with nonabsorbable suture. Six Group II goats had central medial meniscal tears repaired as in Group I plus an exogenous fibrin clot. Eight Group III goats had central tears plus abrasion of the parameniscal synovium and tear edges. Six months after surgery, a magnetic resonance imaging scan and a magnetic resonance arthrogram were obtained and the menisci were examined grossly. Group I goats showed healing in all seven knees. Central tears repaired with a fibrin clot (Group II) showed healing in one of six knees (17%). Central tears repaired with abrasion (Group III) showed healing in seven of eight knees (87.5%). Magnetic resonance arthrography was 100% accurate in detecting the presence or absence of complete residual tears. This study supports the current trend of using adjunctive measures for repair of central tears. Furthermore, abrasion of the parameniscal synovium and the tear edges appears to be more effective than the use of an exogenous fibrin clot. Magnetic resonance arthrography is useful in the evaluation of menisci that have undergone repair.

Animals↗
PubMed1988

Arthrography of the metatarsophalangeal joint.

Arthrography has been an extremely useful tool in the diagnosis of various intra-articular disorders of multiple joints. To date, little has been written regarding the technique and value of arthrography of the metatarsophalangeal (MTP) joints of the foot. The purpose of this paper is to briefly describe the technique, demonstrate a normal arthrogram of the MTP joint, and provide case descriptions in which arthrography has been useful in diagnosis of intra-articular problems related to the MTP joint.

Arthrography↗
PubMed2003

MR arthrography of anterior cruciate ligament reconstruction grafts.

OBJECTIVE: Our objective was to determine the accuracy of MR arthrography for identification of tears of anterior cruciate ligament reconstruction grafts and for detection of localized anterior arthrofibrosis and impingement. MATERIALS AND METHODS: We retrospectively identified 27 patients (mean age, 31 years; range, 18-45 years) with anterior cruciate ligament reconstruction who had undergone MR arthrography followed by arthroscopy within 1 year. Three radiologists independently reviewed the MR arthrograms for the presence or absence of graft tear, localized anterior arthrofibrosis, and impingement. RESULTS: Graft tears were identified with 100% sensitivity by all three reviewers with specificities of 100%, 89%, and 94%. Localized anterior arthrofibrosis was identified with 100% sensitivity by all reviewers, with specificities of 79%, 71%, and 38%. Impingement was detected with sensitivities and specificities of 83% and 100%, 83% and 52%, and 33% and 90% by the three reviewers, respectively. Interobserver agreement was almost perfect for detection of graft tear (kappa = 0.83, 0.92, and 0.83), was fair to moderate for detection of localized anterior arthrofibrosis (kappa = 0.50, 0.32, and 0.22), and was slight to fair for detection of impingement (kappa = 0.40, 0.08, and 0.35). CONCLUSION: MR arthrography can accurately depict the presence of anterior cruciate ligament graft tears. Localized anterior arthrofibrosis and graft impingement were less accurately detected and showed greater observer variability.

Adolescent↗
PubMed2005

Micro-CT arthrography: a pilot study for the ex vivo visualization of the rat knee joint.

OBJECTIVE: In our study, we evaluated the potential of micro-CT for the assessment of the rat knee joint using ex vivo micro-CT arthrography. The aims of the study were to introduce the technique of micro-CT arthrography and to visualize the normal anatomy of the rat knee. The secondary aims were the quantification of retropatellar cartilage thickness and the analysis of microstructural cancellous bone parameters within the tibial epiphysis. CONCLUSION: Micro-CT arthrography is a novel technique for the indirect visualization of the distinct features and structural analysis of the rat knee joint. This technique represents an additional imaging and analysis tool in small-animal research.

Animals↗
PubMed1988

Double contrast arthrography of the knee. A comparison to clinical diagnosis and arthroscopic findings.

The accuracy of pre-arthroscopic double contrast arthrography was evaluated in 100 consecutive patients. Meniscal tears were correctly diagnosed arthrographically in 76% of cases, and clinically in 85% of cases. Although reasonably accurate in determining the location of the meniscal tear, arthrography was significantly inaccurate in the evaluation of the type of tear. The status of the anterior cruciate ligament was correctly interpreted by arthrogram in 76% of cases; the integrity of the ligament was correctly assessed in 94% of cases by clinical examination without anesthesia. It appears, therefore, when compared to initial clinical examination, double contrast arthrography is of limited usefulness as a pre-surgical aid to the diagnosis of intra-articular knee pathology.

Arthrography↗
PubMed1992

Ultrasonographic guidance of needle placement for shoulder arthrography.

We describe a technique using high resolution ultrasonography for needle placement for shoulder arthrography employing the posterior approach, which to our knowledge has not been reported previously. Twenty-four patients with clinical suspicion of rotator cuff lesion underwent shoulder arthrography under sonographic control. Patients ranged in age from 26 to 72 years (mean, 57 years). Accuracy of the needle placement using this technique was 100%. There were no injuries to adjacent structures and no extravasation outside the joint. Although fluoroscopic control of needle placement during shoulder arthrography is the technique of choice, sonographic control using the posterior approach may be useful in certain situations (e.g., if the patient is concerned about radiation dose or if there is soft tissue injury at the anterior of the shoulder.

Adult↗
PubMed1992

[Value of puncture-arthrography in the diagnosis of infection of total hip arthroplasty].

Arthrography with hip aspiration was performed in 143 patients with hip arthroplasties to determine its effectiveness as a technique for diagnosing infection. Thirty-three cases of infection were found. On 26 occasions the germ responsible was isolated in the joint fluid. In six other cases infection was revealed from cytologic or arthrographic findings, or from both. Only once was a diagnosis of infection not arrived at. In this series of patients, except in cases of evolutive inflammatory rheumatism, cytologic examination of the joint fluid was a discriminative factor in diagnosis. Hip aspiration arthrography had a sensitivity of 79 per cent for the diagnosis of infection in arthroplasty with isolation of the germ and a specificity of 100 per cent. The sensitivity of the diagnosis rose to 91% when any one of the following features was observed: leucocytosis of the joint fluid higher than 10,000 elements/mm3; presence of a fistula or of fistulization on arthrography; isolation of the germ in the joint fluid or the rinsing liquid.

Arthrography↗
PubMed1991

The role of arthrography in the diagnosis of meniscal tears.

The authors discuss the value of arthrography as a supplement to arthroscopy in the diagnosis of meniscal tears. Arthrography is superior to arthroscopy in its ability to detect lesions of the posterior horn of the medial meniscus, which are the most common meniscal tears. Moreover, arthrography can be done on an out-patient basis and at low cost. In any case, the best screening remains thorough clinical examination supplemented, if necessary, by imaging studies.

Adolescent↗
PubMed1991

[Postoperative results of arthrography following suturing of ruptured rotator cuff].

The authors examined 41 shoulder joints by arthrography after the patients had undergone surgery for rotator cuff tears. In 26 cases the arthrographic findings were negative; that is to say the region of the tendon suture was tightly closed. In 10 of these 26 cases the underside of the rotator cuff had a rather irregular border. The arthrograms were positive for 12 of the other 15 patients who had undergone surgery. In 3 cases contrast medium leakage into tendinous tissue on the joint side was seen. The postoperative results, ascertained with reference to the assessment guidelines proposed by Neer and Patte, were largely unrelated to the arthrographic findings. In patients with contrast medium leakage from the rotator cuff only the muscular strength was slightly reduced. There was no correlation with the clinical symptoms. In the comparison of all patients who had undergone postoperative arthrography with the total study population a lower number in the index was striking. It may be that patients with symptoms persisting after surgery were more prepared to undergo control arthrography.

Adult↗
PubMed1990

[Use of digital subtraction arthrography in lesions of the rotator cuff--comparison with ultrasound].

60 patients with suspected lesion of the rotator cuff were examined by digital subtraction arthrography and the results were compared to ultrasound. The dynamic study of digital subtraction arthrography visualised in 22 of 23 complete or incomplete cuff tears the exact location of the extravasation of the contrast medium. All diagnoses were confirmed by surgery. Problems of conventional arthrography were not seen by the digital method.

Acromioclavicular Joint↗
PubMed1990

Arthrography of the prosthesetized painful hip: the importance of imaging and functional testing.

Thirty-four patients with painful prosthesetized hips were submitted to arthrography in order to evaluate the correlation between pain and the anatomical situation between the implants and the host bone. By injecting a local anaesthetic together with the contrast medium it was possible to perform functional tests comprising passive movements of the hip and full weightbearing for at least 5 minutes in order to ascertain whether or not the pain persisted. This yielded different results varying from total relief to persistence, depending on the type of mobilisation demonstrated by arthrography. In particular, pain was reduced in cases of mobilisation of the acetabular component, and persisted when mobilisation was in the femoral component. A correlation between functional testing, arthrography and bacteriological examination for possible low grade infection allowed for a closer study of the origin of pain, and more accurate planning of surgery when re-prosthesetization was being considered.

Aged↗
PubMed1989

[Evaluation of inferior joint space arthrography for type III temporomandibular arthrosis (internal derangements of temporomandibular joint)].

Inferior joint space arthrographies for the 37 patients with internal derangements of temporomandibular joint or joints were examined clinically. All arthrograms showed various problems of postural and morphological findings of the disc. Clinical diagnosis for the existence of internal derangements of the temporomandibular joint was completely confirmed by lower joint space arthrography. It must be considered, however, that clinical diagnosis for the morphological changes of the disc associated with internal derangements of temporomandibular joint is difficult. Inferior joint space arthrography was very useful to evaluate optically the discal formation in the cases.

Arthrography↗
PubMed1989

The intracapsular therapeutic modalities in conjunction with arthrography: case reports.

Manipulation and lavage of the temporomandibular joint has been shown to add an important therapeutic dimension to arthrography. These therapeutic modalities were prescribed by the primary treating practitioner in conjunction with diagnostic arthrography in a group of patients. The therapeutic modalities consisted of joint mobilization (Farrar manipulation or distraction) augmented by (1) increased hydraulic pressure in the superior compartment, or (2) with small amounts of contrast in both compartments, and/or (3) with lavage of the superior joint compartment. The therapeutic modalities were prescribed in association with the arthrography as a logical extension of the arthrographic technique. The result of the mobilization and lavage was an increase in the mandibular range of motion (ROM) and a decrease in pain in cases with adhesions as well as those with anteriorly displaced disks without reduction. Patients with anteriorly displaced disks with reduction, redundant tissue in the fossa, osteochondritis, and adhesive capsulitis also showed benefit, although patient populations treated with these conditions were small. There were no adverse sequelae. Manipulation and lavage should now be viewed as one more tool in the treatment of intracapsular pathology.

Adolescent↗
PubMed1989

[Determining the position of the prosthesis using arthrography of the wrist joint].

During the last twelve months twelve patients with different silicone prostheses of the wrist region underwent examination with arthrograms two to twenty-four months after the operation. The arthrography showed the relation of the implant to its surrounding structures. For either radiocarpal or intercarpal arthrography a very distant access was used. In eight patients the prostheses were surrounded entirely by contrast medium. There was no contrast-medium on one side of the implant in two patients. In one patient a complete disconnection from the capsule to the site of the prosthesis was seen. In one other patient there was evident shrinking of the capsule. Wrist arthrography was very helpful for the evaluation of further clinical proceeding and control of wrist-function.

Arthrography↗
PubMed1989

[Double-contrast arthrography in secondary popliteal cysts].

The diagnosis of a popliteal cyst is usually made on the basis of a history of discomfort and pain in the medial portion of the popliteal region, together with the finding of a palpable mass in the popliteal fossa. The clinical diagnosis can be confirmed by knee arthrography, if the cyst communicates with the knee joint; in recent years, however, noninvasive US has also become an important diagnostic aid to the radiologist. The S. Anna Hospital (Ferrara) experience is here reported in the diagnosis of symptomatic popliteal cysts, with no valve mechanism at the connection with the joint cavity. Arthrography was performed on 438 patients with popliteal cysts to determine their extent and size in relation to the symptoms and to the presence of underlying knee pathology; only 76 patients from this group were then submitted to surgery. The authors confirm that popliteal cyst is a frequent occasional finding during knee arthrography which almost completely lacks any clinical relevance in most cases. Moreover, taking arthrographic findings as a starting point, the authors describe the different anatomotopographic patterns of popliteal cysts.

Aged↗
PubMed1988

Diagnostic arthroscopy of the knee joint: comparison of the accuracy of physical examination, contrast arthrography and arthroscopy.

A group of 474 patients was retrospectively studied to assess the value of physical examination, arthrography and arthroscopy in the diagnosis of knee pathology. In 54% of cases, the correct clinical diagnosis was made from the patient's history, physical examination and standard radiology. The diagnosis at arthrography, especially in chondropathy and synovitis, appeared to be unreliable (only 46% corresponded to the definitive diagnosis). Contrast-arthrography of the knee joint is an invasive technique which provides relatively little extra (reliable) information, and is therefore not suitable as a standard procedure. Diagnostic arthroscopy is a superior and safe technique. Apart from the essential clinical assessment of patients with acute or chronic knee complaints (patient history, physical examination and standard radiology), there is a wide range of indications for diagnostic arthroscopy.

Adolescent↗
PubMed1995

[Conventional arthrography in comparison with magnetic resonance tomography and arthroscopy in internal knee joint injuries: are there specific indications?].

Twenty-one patients with suspected internal knee joint lesions were examined prospectively. In all patients an MRI was carried out first and was followed within two weeks by an arthrography and an arthroscopy. Lesions of the menisci, cruciate ligaments, hyaline cartilage, and synovial tissues were evaluated. Arthroscopy findings were defined as the "gold standard". MRI achieved an accuracy of 96.4%, a sensitivity of 93.6%, and a specificity of 92.5%, whereas arthrography achieved an accuracy of 67.8%, a sensitivity of 66.6%, and a specificity of 71.4%. These statistical data as well as the single findings revealed no special indications for arthrography in suspected knee joint lesions.

Acute Disease↗