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PubMed1995

Magnetic resonance arthrography of the scapulohumeral joint in dogs, using gadopentetate dimeglumine.

Six scapulohumeral joints (3 normal joints and 3 joints with radiographic evidence of osteochondrosis) underwent conventional magnetic resonance (MR) imaging and MR scapulohumeral arthrography to evaluate delineation of the articular cartilage. The MR arthrography was performed, using 5 ml of 500 microM gadopentetate dimeglumine (Gd-DTPA) as a contrast medium. Delineation of normal articular cartilage and cartilage defects was less accurate after intra-articular administration of Gd-DTPA. Therefore, it was concluded that MR arthrography with Gd-DTPA is unrewarding for evaluation of osteochondrosis lesions.

Animals↗
PubMed1994

[Rotator cuff rupture in the shoulder impingement syndrome. Echography and arthrography: 2 diagnostic methods compared].

After briefly reviewing the shoulder impingement syndrome, the authors investigate the role of two diagnostic imaging methods, i.e., ultrasonography (US) and arthrography, in demonstrating the typical features of this condition. Over a 15 months' period, 190 patients suffering from shoulder pain were examined with arthrography; 50 of them subsequently underwent acromion plastic surgery and rotator cuff stitching. This study was aimed at comparing US and arthrographic results, applying classifiable criteria to make the most accurate diagnosis of rotator cuff tears. The lack of visibility of the rotator cuff at US was the major and clearest sign of tear (100% of cases). The association between cuff thinning and hypo/hyperechoic damaged focal areas was another major sign (in 76.19% of complete tears and in 14.28% of incomplete tears). Hyperechoic focal areas alone proved to be a false-positive finding in 5 cases, while in 11 of 19 cases normal US patterns were a false-negative finding; in 3 cases other conditions were diagnosed. To conclude, the value of US is emphasized in the screening of the painful shoulder and the use of arthrography is suggested when both clinical tests and US fail to yield enough information for a diagnosis to be made.

Aged↗
PubMed1994

[What remains of arthrography?].

At the time of RMI, arthrography appears sometimes old-fashioned. However this exam, which knows a second youth in relation with the supply of CT-scan (arthro-CT) remains the gold-standard in the exploration of many pathologic situations: intra-articular foreign bodies, tears of glenoid or acetabular labrum, precise assessment of chondral or ligamentous lesions (especially of the ankle), sub-scapularis tendon tears, adhesive capsulitis, complications of prosthesis, appreciation of intra-articular position of the needle's tip before injection of a therapeutic drug. Arthrography, completed or not by CT-slices gives, in this indications, excellent spatial resolution images, easy to perform, to read, to understand and to transmit at the clinicians, with a reasonable cost and a minor risk. RMI is a more and more used alternative, especially for the study of meniscus and ligaments of the knee, and rotator's cuff of the shoulder. It's sure that, with the increase of the RMI image's quality, other common indications will slip towards this technique, but nevertheless at this time (and it seams to me, for a long time) arthrography and arthro-CT will remain an excellent diagnostic tool with a very competitive advantages/inconvenience ratio.

Arthrography↗
PubMed1994

Femoral head shape in Legg-Calvé-Perthes disease. Correlation between conventional radiography, arthrography and MR imaging.

Twenty-three children with Legg-Calvé-Perthes disease were examined to determine the femoral head shape. We evaluated and correlated conventional radiography, arthrography and MR imaging. In the a.p. view, measurements were obtained from the center of the femoral head along the bony or cartilaginous outline at 30 degrees intervals. Maximum flattening of the cartilaginous outline appeared laterally, 60 degrees from the center of the baseline of the epiphyseal index and the caput index. Maximum flattening of the bony outline was found at 75 degrees. Arthrography and MR imaging gave the same information about the shape of the femoral head cartilage. The bony femoral head shape on conventional radiographs in the a.p. view did not reflect the cartilage shape obtained by MR and arthrography.

Arthrography↗
PubMed1994

The joint side tear of the rotator cuff. A followup study by arthrography.

A clinical followup study was performed of joint side tears of the rotator cuff to define the pathogenic mechanisms and factors that affect their evolution. From 1982 to 1992, the authors treated 61 joint side tears, diagnosed by arthrography. Among them, 40 tears were follow-up during conservative treatment. Arthrographies were repeated at a mean of 412 days. There were 16 male and 20 female patients, with a mean age of 61 years. Two male and two female patients had bilateral tears. The average shoulder assessment score according to the Japanese Orthopaedic Association rating at the initial visit to the hospital was 68 points, and 80 points at followup time. Followup arthrographies revealed disappearance of the torn portion in four instances, reduction of the tear size in four, enlargement of the tear size in 21, and progress to full thickness cuff tear in 11 patients. Prognosis of the joint side tear appears to be worse with increasing age, larger tear size, and absence of history of trauma.

Adolescent↗
PubMed1993

[Correlation and discordance between arthrography and arthroscopy of the knee].

We retrospectively compared two series of 50 consecutive arthroscopies, performed in 1980 and in 1990. The age and sex data of the group were essentially the same. The number of arthrographies performed prior to arthroscopy varied only slightly (64% versus 58%), as did the indications, dominated by uncertain clinical findings (58%). One quarter of the procedures constituted useless indications in an obvious clinical context. These 2 groups were studied separately, cumulatively and according to the diagnoses. Analysis showed a better arthrography-arthroscopy correlation in 1990. The arthrographic technique and the technician himself appear to be important factors. Progress in the technique has increased the quality of imaging of certain anatomical structures. This good overall concordance was also observed for analysis of the diagnoses. We therefore conclude that the current indications for arthrography prior to arthroscopy are any uncertain diagnosis after a thorough clinical examination, when meniscal suture is considered, lateral meniscal cyst and a medicolegal context.

Adolescent↗
PubMed1993

Digital subtraction in multi-compartment arthrography of the wrist.

In a series of 23 patients with chronic and unexplained painful wrist, three-compartment arthrography was carried out using digital subtraction. Pathologic conditions were disclosed in 19 patients. Digital subtraction both allowed for a stronger diluting of the dye and for the demonstration of a larger amount of lesions of smaller size than conventional wrist-arthrography, as long as motion artefacts had been avoided. Obtaining successive views without having to wait for complete contrast resorption in the injected compartments represents a significant advantage. The importance of three-compartment injection is stressed and the best way to perform the technique is discussed. As it proved to be a fast and reliable examination procedure the authors advocate using digital subtraction arthrography of the wrist whenever the method is available. However, this relatively new technique does not rule out careful correlation between arthrographic findings and clinical complaints.

Adolescent↗
PubMed1993

[Arthrography in the diagnosis and treatment of idiopathic adhesive capsulitis].

The painful shoulder--i.e., adhesive capsulitis--present two basic symptoms: painful and impaired motion. Clinics allow the diagnosis to be made, but treatment is difficult. In our opinion, shoulder arthrography is very useful to distinguish idiopathic from secondary capsulitis involving bones and joints: moreover, in the patients with adhesive capsulitis, arthrography is useful when removing adhesions by repeated forceful distensions of the joint capsule. January 1990 through December 1991, forty-five patients with adhesive capsulitis were studied with shoulder arthrography; 19 patients with primary adhesive capsulitis underwent forceful distension with lidocain and contrast medium and the intraarticular injection of 40 mg of triamcinolone enantate to eliminate local adhesions. Arthrographic brisement yielded good results: improved motion was observed in all patients, lasting 2 to 7 months. Forceful joint capsule distension is easy to perform and complication-free and yields valuable results; all of the above make the procedure advisable as a good alternative to surgery in primary adhesive capsulitis patients.

Arthrography↗
PubMedDate not supplied

[Echography, magnetic resonance and double-contrast arthrography of the rotator cuff. A prospective study in 30 patients].

Shoulder pain is a common clinical problem with different etiologies. Without a specific diagnosis, treatment could be ineffective, causing functional limitation, chronic pain and atrophy. US and MRI allow in many cases to correctly define the different etiologies causing shoulder pain, often due to rotator cuff conditions. From June to September 1992, thirty patients with clinically suspected acute or chronic rotator cuff lesion were studied with US, MRI and double contrast arthrography. US and MRI findings were evaluated and compared using arthrography and surgery as the gold standard. The overall accuracy of MRI was 93%: the method yielded accurate information about size and number of rotator cuff tears, and about bursal, bone and muscle involvement. US accuracy was 83% in the diagnosis of large tears, 63% in the diagnosis of small and partial tears and only 11% in the diagnosis of tendinitis. Both MRI and arthrography exhibited high accuracy (respectively 91 and 100%) in the detection of rotator cuff tears when their results were compared with surgical findings. A flow chart to be used in the patients with acute or chronic shoulder pain was drawn from the critical analysis of the above results.

Arthrography↗
PubMed1996

Correlation of MR imaging, CT arthrography, and arthroscopy of the shoulder.

Rotator cuff tears and instability of the glenohumeral joint are a common cause of chronic shoulder pain and disability. Currently CT arthrography is the method of choice to evaluate the extent of osseous and soft tissue abnormalities. This study was undertaken to determine if magnetic resonance imaging was able to depict post-dislocation abnormalities and rotator cuff pathology and if MRI can replace CT arthrography. Sixty four patients, who were operated on for the first time (arthroscopy or arthrotomy) between November 1986 and July 1991, were compared in a blinded fashion with the results of MR imaging in 40 cases and of CT arthrographies in 24 cases. For the evaluation of rotator cuff tears MRI proved to have a sensitivity of 83.3% and an accuracy of 90.3%. Labral pathology was depicted with a sensitivity of 69.2% and an accuracy of 87.1%. In cases involving a Hill-Sachs lesion the sensitivity of MRI was 90% and the accuracy 95%. MR imaging is an accurate method in the evaluation of rotator cuff pathology and to some extent labral abnormalities.

Adolescent↗
PubMed1997

-Arthrography of the hip-.

Painful hip with normal X-rays (including false-lateral view of both hips) is the main indication for hip arthrography, searching for focal chondropathy. In the presence of moderate hip degenerative arthritis contrasting with increasing disability, a labrum lesion must be investigated. Such lesions are of two kinds, mainly degenerative (of the superior labrum) or post-traumatic (of the posterior labrum). Arthrography allows the diagnosis of cystic changes located in the acetabulum. It also allows the diagnosis and evaluation of the extent of synovial osteochondromatosis or villonodular synovitis. In three indications, computed tomographies must be added to plain arthrography: posterior labrum lesions, osteochondromatosis (looking for foreign bodies in the acetabular fossa) and cystic changes in the acetabulum (with density measurements). In all cases, a complete conventional radiological assessment must be available. Strict asepsis must be ensured. When osteochondromatosis is suspected, evaluation of articular capacity must be systematic.

Acetabulum↗
PubMed2002

Sonography of the shoulder after arthrography (arthrosonography): preliminary results.

PURPOSE: The purpose of this study was to verify whether arthrosonography improves diagnostic accuracy in diseases of the shoulder and provides additional information for therapeutic planning, compared with conventional sonography. METHODS: We prospectively studied 113 consecutive patients with chronic shoulder pain. Sonography was performed before and after arthrography, with the radiologist blinded to the results of arthrography. When a rotator cuff tear was detected sonographically, its type, location, and size were recorded; we also evaluated any changes in the subacromial-subdeltoid bursa and any abnormalities in the biceps tendon sheath. The diagnostic accuracy of conventional sonography and arthrosonography was compared with that of arthrography for rotator cuff tear. Changes in the subacromial-subdeltoid bursa and biceps tendon sheath seen on conventional sonography were also compared with those seen on arthrosonography. RESULTS: The sensitivity and specificity of conventional sonography in the diagnosis of rotator cuff tear were 86% (25/29) and 95% (80/84), respectively; for arthrosonography, the values were 97% (28/29) and 95% (80/84), respectively. The differences in sensitivity and specificity for the 2 sonographic techniques were not statistically significant (p > 0.05). The accuracy in localizing the tear was also not significantly different between the 2 sonographic techniques. Synovial proliferation was more easily detected with arthrosonography than it was with conventional sonography in the subacromial-subdeltoid bursa (p < 0.01) and in the biceps tendon sheath (p < 0.0001). CONCLUSIONS: Our preliminary results suggest that although arthrosonography was not superior to conventional sonography in the diagnosis of rotator cuff tears, it may provide a better assessment of the size of tears and additional information about synovial proliferation in the subacromial-subdeltoid bursa and the biceps tendon sheath.

Female↗
PubMedDate not supplied

Gamekeeper thumb: diagnosis of ulnar collateral ligament injury using magnetic resonance imaging, magnetic resonance arthrography and stress radiography.

Ulnar collateral ligament (UCL) tears may be nondisplaced or displaced relative to the adductor pollicis aponeurosis. Nondisplaced tears typically heal with immobilization whereas displaced tears require surgery. Nineteen patients with UCL injuries were evaluated using MR Imaging (MRI), MR arthrography, and stress radiography (SR) to determine the efficacy of these techniques in differentiating nondisplaced from displaced UCL tears. Nineteen patients with UCL Injuries were evaluated. MRI was utilized in 5 patients, and MR arthrography in 14, with 12 of these 14 undergoing SR. They were followed until resolution of symptoms; those without relief, and those with suspected displaced UCL tears were surgically explored. Surgery and imaging was correlated. Eight patients underwent surgical repair. SR was abnormal in six patients treated surgically, but was negative in four of six conservatively treated patients with MR findings of nondisplaced tears. All patients with MR or MR arthrographic findings interpreted as being normal or as having a nondisplaced tear improved after conservative treatment. Based on surgical findings and clinical followup, MR arthrography accurately diagnosed 13 of 14 UCL injuries, with one false-positive interpretation. SR is often falsely negative. MR imaging with or without intra-articular contrast injection proved to be accurate in a small series of patients with UCL injuries.

Adult↗
PubMed1994

The value of contrast arthrography in assessing loosening of symptomatic uncemented total hip components.

Twenty-five patients with symptomatic uncemented total hip components were studied with contrast arthrography prior to surgical exploration. All but one had uncemented femoral stems and 16 had an uncemented acetabular component. As judged by the findings at surgery, on the femoral side the sensitivity, specificity, and accuracy of arthrography were 57%, 60%, and 58% respectively. There was a relatively high incidence of both false positives (17%) and false negatives (25%). On the acetabular side sensitivity, specificity, and accuracy were 29%, 89%, and 62.5%. False negatives were common (31%), while there was only one false positive. The results in this small series show that arthrography has distinct limitations in identifying the fixation status of uncemented total hip components.

Adult↗
PubMed1985

Combined radionuclide and radiocontrast arthrography for evaluating hip arthroplasty.

Twenty-two patients had combined radiographic and radiocolloid arthrography. The two procedures were in agreement in 86% of the patients as to whether the femoral component was loose or not. Fourteen patients has surgical revision of the prosthesis and in 3 (23%) radiographic arthrography was falsely negative. No false negative results were obtained with radiocolloid arthrography thus far. The radionuclide method cannot be used to assess the acetabular component.

Colloids↗
PubMed1987

The correlation of arthrography with the results of treatment in late diagnosed congenital dislocation of the hip.

The aim of this study was to assess the value of arthrography of the hip in the investigation of late diagnosed congenital dislocation. The results of the treatment of 109 hips were related to the findings at arthrography. The hip radiographs at follow-up were normal in all cases where the arthrogram had demonstrated a congruent reduction (86). When the arthrogram had indicated a block in reduction the results were less favourable, and dysplasia or subluxation was present at follow-up in 19 cases, despite repeated conservative or operative treatment. Four hips appeared normal after operation. Arthrography gave valuable information and showed good correlation with the results of treatment.

Child, Preschool↗
PubMed1998

Evaluation of articular cartilage thickness of the humeral head and the glenoid fossa by MR arthrography: anatomic correlation in cadavers.

OBJECTIVE: To evaluate the accuracy of MR arthrography in determining the thickness of articular cartilage of the humeral head and glenoid fossa. DESIGN AND PATIENTS: MR arthrography of the glenohumeral joint was performed in 17 cadaveric shoulders. Articular cartilage thickness was measured on the MR arthrographic images and corresponding anatomic sections. RESULTS: The correlation coefficients for MR arthrographic measurement versus anatomic measurement of the cartilage thickness were 0.7324 and 0.8757 for humeral head and glenoid fossa, respectively. With regard to the humeral head, there was a tendency to overestimate regions of thin cartilage and underestimate regions of thick cartilage. This tendency was not found in the assessment of glenoid cartilage. The mean of the absolute value of MR-anatomic differences was similar on the glenoid side (0.27 mm) and the humeral side (0.29 mm). The accuracy of measurement was significantly better on the glenoid side (Fisher's r-to-Z transformation: Z=5.21, P=0.000001). CONCLUSION: MR arthrography causes a moderate degree of error in the naked-eye measurement of the cartilage of the glenohumeral joint. The accuracy is higher on the glenoid side than on the humeral side.

Aged↗
PubMed1998

Indirect MR arthrography: techniques and applications.

Indirect MR arthrography is a relatively new MR technique improving articular and periarticular contrast. It is achieved by injection of paramagnetic MR contrast media intravenously instead of intra-articular injection as in direct MR arthrography. After the injection exercising the joint results in considerable signal intensity increase within the joint cavity. Fat saturated MR sequences then yield arthrographic images. The method is less invasive than direct MR arthrography and first results showed comparable sensitivities and specificities for rotator cuff and glenoid labrum pathology. In this article the technique, established and potential future indications, drawbacks and limitations of the method are reviewed.

Contrast Media↗