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PubMed1991

Evaluation of degenerative lesions of the rotator cuff. A comparison of arthrography and ultrasonography.

A prospective study was performed to determine the accuracy of arthrography compared with ultrasonography in the evaluation of thirty-two patients who had a degenerative lesion of the rotator cuff. Both tests were done preoperatively, and the condition of the rotator cuff was determined intraoperatively. Arthrography was accurate in the diagnosis of twenty-eight (87 per cent) of the thirty-two patients (twenty who had a full-thickness tear, seven who had a partial-thickness tear, and five who had an untorn rotator cuff and tendinitis), while ultrasonography was diagnostic in only twelve (37 per cent). In this specific population of patients, arthrography was found to be superior to ultrasonography.

Adult↗
PubMed1991

Evaluation of the painful shoulder. A prospective comparison of magnetic resonance imaging, computerized tomographic arthrography, ultrasonography, and operative findings.

Twenty-one patients who had had pain in the shoulder for more than three months were evaluated with ultrasonography and magnetic resonance imaging followed by computerized tomographic arthrography. The results of the imaging studies were then compared with the operative findings. Magnetic resonance imaging was found to be the most useful modality for establishment of the etiology of pain in the shoulder due to disease of the rotator cuff, instability associated with abnormality of the glenoid labrum, subacromial impingement, stenosis of the coracoacromial arch, and osteoarthrosis of either the glenohumeral or the acromioclavicular joint. The accuracy of magnetic resonance imaging was found to depend on both the operator and the technique and was decreased in extremely obese patients, due to difficulties in positioning, and in patients who had had a previous operation. Magnetic resonance imaging was more accurate than either computerized tomographic arthrography or ultrasonography in identifying partial-thickness tears (intrasubstance changes in the rotator cuff). Magnetic resonance imaging provided the same level of accuracy as computerized tomographic arthrography in the detection of abnormalities of the glenoid labrum.

Adolescent↗
PubMed1979

[The importance of the combination of the special x-ray with the arthrography in congenital displacement of the hip (author's transl)].

Arthrography is an important method of diagnosis of congenital displacement of the hip. It reveals the interposition of the soft tissue and the correctness of the position of the femur after a reduction of the hip joint. Arthrography only in a anterior posterior position cannot always demonstrate the real relationship between the femur and the pelvis. An x-ray of the arthrography in 45 degrees oblique position (Foramen obturatorium position) can reveal the situation.

Child↗
PubMed1979

Precision in the diagnosis of meniscal lesions: a comparison of clinical evaluation, arthrography, and arthroscopy.

We assessed the accuracy of clinical evaluation, arthrography, and arthroscopy in the diagnosis of meniscal lesions in fifty knees in which arthrotomy was performed for disabling symptoms after evaluation by these three methods. At surgery, forty-seven menisci were removed, of which forty-four were abnormal and three were normal. In three patients with normal menisci, loose bodies were found in two and the exploration was negative in one. In the forty-four knees with a meniscal lesion, a correct diagnosis was made clinically forty time, arthrographically thirty-nine times, and arthroscopically thirty-two times. Most errors occurred in the knees with posterior horn lesions of the medial meniscus. Clinical diagnosis was least accurate for lesions of the lateral meniscus (four missed) and arthroscopy was least accurate for lesions of the posterior horn of the medial meniscus (ten missed). Arthrography appeared to provide collateral evidence of lesions not seen directly. Based on this study it was concluded that even with negative findings by arthroscopy and arthrography it still may be necessary occasionally to remove a meniscus on the basis of the clinical evaluation.

Adult↗
PubMed1983

Double contrast arthrography of the knee in acute injury of the medial collateral ligament.

The double contrast arthrography with horizontal beam method was carried out in 133 cases with acute medial collateral ligament injuries of the knees and its findings were compared with those from arthroscopy and/or surgery. The double contrast arthrography demonstrated the level of the rupture in capsular ligament in relation to the meniscal attachment, accompanying meniscal tear or detachment, and intrusion of the free end of the torn ligament into the joint. It also revealed the magnitude of the medial instability and facilitated to distinguish an isolated from a combined injury. A therapeutic regime can be proposed on the basis of the arthrographic findings. We conclude that the double contrast arthrography for the acute injuries of the medial collateral ligament is indispensable in the selection of the optimal treatment.

Adolescent↗
PubMed1983

[Arthrography following sport injuries to the knee joint].

The arthrography is one of the most important diagnostic methods of sport injuries of the knee joint. The examination must give an exact information to the surgeon; a good technique and standard X-rays are an absolute postulate. The submitted examinations are based on 6687 arthrographies during a period of 5 years. The arthrography should not be carried out before the acute symptomatology has ceased, usually after an interval of 2-3 weeks. Most frequently are the meniscus injuries by rotary traumas of the knee-joint. Football as the most popular sport is responsible for more than 50% of the injuries, followed by skiing, handball and jogging.

Adolescent↗
PubMed1984

Ankle arthrography in acute injuries.

Ankle arthrography has proved to be a simple, quick, and useful method in evaluating the ligamentous ruptures in connection with ankle injuries. The observations of the present authors are based on almost 5000 arthrographies . On the lateral side, the ligamentous ruptures spring up in an anteroposterior direction so that the FTA ligament is ruptured first, and, in a continuing injure mechanism, the FC ligament is the next to be ruptured. Isolated ruptures of the FC ligament do not occur. The rupture of the FTP ligament does not appear in arthrography. The rupture of the deltoid ligament is rarer and it usually appears in connection with a pronation lateral rotation injury, especially if the patient has a high fibular fracture and there is no simultaneous fracture of the medial malleolus. The ruptures of tibiofibular ligaments are connected with pronation lateral injuries and fractures of the fibula, if the fracture is situated at the level of the talo-crural joint line or cranial to it.

Acute Disease↗
PubMed1983

Double-contrast Arthrography of the shoulder.

Although single-contrast arthrography has been advocated since 1933 it is the use of water-soluble contrast agents together with the simultaneous injection of air which have made shoulder arthrography a rather painless procedure yielding much additional information. Double-contrast arthrography has been used at our institution to demonstrate or exclude lesions of the rotator cuff, the biceps tendon, the capsule, the articular surfaces of the joint and adhesive capsulitis. In this review the technique and results in 58 consecutive cases are presented.

Adult↗
PubMed1980

[Significance of arthrography of the knee joint (author's transl)].

A survey on the double-contrast arthrographie of the knee is given. Speical problems of the method and the interpretation of the films are presented. Besides the delineation of the pathological alterations of the menisci, which is possible in about 85 to 95%, the possibility of delineation of other knee joint damage is discussed, their significance being far beyond that of the meniscal lesions. At last the post-operative changes of the knee joint following meniscectomy are summarized including the evaluation of plain films and repeat arthrography. Own investigations on 117 meniscectomized patients are presented. 35 patients had symptoms, on 23 of them a repeat arthrography could be performed. The symptoms could essentially be explained by meniscal remnants and degeneration of the cartilage at the operated site of the knee.

Arthritis↗
PubMed1981

Arthrography of the temporomandibular joint.

The temporomandibular joint is anatomically and functionally complex. Some of its internal secrets may be delineated by careful arthrography. However, the arthrographer must pay as much attention to the dynamic joint as to static images. At the very least, TMJ arthrography has shown that there are anatomic abnormalities which account for many components of the syndrome of TMJ pain and dysfunction. Clicks, locks, perforations, and detachments, as well as their many variations, can be easily documented. As a diagnostic tool, TMJ arthrography is still in its infancy, but it should help in planning rational conservative and surgical intervention. The future for this technique is exciting.

Cartilage, Articular↗
PubMed1993

Rapid triple-compartment wrist arthrography with diluted contrast medium.

Triple-compartment wrist arthrography is currently considered the optimal technique for evaluating carpal instability, because injection of contrast agent into the radiocarpal joint alone can fail to reveal ligamentous disruption due to a ball-valve tear. Unfortunately, triple-compartment arthrography can be time consuming for both the patient and the radiologist. This report describes a technique for rapid triple-compartment wrist arthrography with standard (as opposed to digital subtraction) fluoroscopy. This technique reduces the time necessary to perform the study to 30 to 45 minutes without sacrificing diagnostic accuracy.

Diatrizoate↗
PubMed1998

Magnetic resonance imaging arthrography of the ankle.

Magnetic resonance imaging (MRI) arthrography of the ankle is a useful diagnostic modality in the detection and staging of lateral ankle ligament tears, particularly in patients who fail to respond to conservative management. MRI arthrography also may be helpful in determining the extent of ligamentous injury in professional athletes, for whom immediate surgical repair may be the initial treatment. Preoperative planning is optimized with MRI arthrography. Frequently, alternative diagnoses may be made for conditions that can simulate lateral ligamentous injury, thus obviating the need for diagnostic arthroscopy.

Ankle Injuries↗
PubMed1998

MR arthrography of the Hip

This article discusses the use of MR arthrography for the evaluation of mechanical derangement of the hip. This technique is used primarily to evaluate the acetabular labral tears; however, the articular cartilage and joint capsule also are visualized. MR arthrography and hip arthrography have had a significant impact on the diagnosis and treatment of patients with mechanical hip pain.

Journal Article↗
PubMed1991

Diagnostic potential of double contrast arthrography of the knee with the digital technique.

Experience with digital radiography applied to double contrast arthrography of the knee performed with a photostimulable phosphor plate is reported. The image processing technique used to improve the digital image is described, and some theoretical considerations are discussed. A preliminary comparison is also made between arthrographic images obtained with conventional screen-film systems and the digital system, especially in respect of the image quality and visualization of the soft tissue structures least well demonstrated with conventional arthrography.

Arthrography↗
PubMed1991

Venous air embolism during knee arthrography. A case report.

A 34-year-old man developed a nonfatal venous air embolism during arthrography of his post-traumatically contractured knee joint. From the arthrographic findings, injected air was assumed to have entered the great saphenous vein via the venous opening in the knee joint. Venous air embolism is an extremely rare complication of knee arthrography, but can occur. As it is potentially fatal, prompt recognition and appropriate positional and supportive therapy are essential.

Adult↗
PubMed1993

Clinical value of combined contrast and radionuclide arthrography in suspected loosening of hip prostheses.

Combined contrast and radionuclide arthrography was performed in 71 cemented, non-cemented and hybrid hip arthroplasties for diagnosis of component loosening. In 31 cases, either one or two prosthesis components were clearly loose upon clinical and radiological diagnosis, with subsequent intraoperative confirmation. The other 40 cases had doubtful component loosening, with discrepancy between clinical and radiological findings, and were investigated for clarification. Contrast and radionuclide arthrograms were compared with sequential plain radiographs and their ability to indicate component loosening was evaluated. The combined contrast and radionuclide arthrograms proved in 90.9% of the cases whether a loose component existed as confirmed by intraoperative findings. They had a high sensitivity, specificity and predictive accuracy for both the acetabular and the femoral component. Sensitivity and predictive accuracy were remarkably precise in comparison to those of plain radiographs on the acetabular side. In nearly all patients with contradictory clinical and radiological findings, conclusive diagnosis was possible on the basis of the contrast and radionuclide arthrograms. Coinciding positive results in both contrast and radionuclide arthrograms were verified in each operated case. The combination of contrast and radionuclide arthrography is an useful method to diagnose doubtful loosening of hip arthroplasty components, especially in addition to routine sequential plain radiographs.

Adult↗
PubMed1995

Prognostic significance of posterior subtalar joint arthrography following fractures of the calcaneus.

Nineteen patients with 22 intra-articular fractures of the calcaneus were investigated by posterior subtalar joint arthrography after 6 (2-15) months following injury, and their clinical symptoms were compared with the arthrographic findings. The arthrograms were classified into four types based on the findings of the joint space of the posterior subtalar joint in Anthonsen's view. The classification correlated significantly (P = 0.03) with the clinical results which were assessed after 23 (9-41) months following injury. We conclude that posterior subtalar joint arthrography has prognostic value in assessing patients with fractures of the calcaneus.

Adolescent↗
PubMed1989

Arthroscopy and arthrography. A combined procedure.

Arthrography and arthroscopy are invasive diagnostic procedures performed on all main joints of the human body. Both procedures are effective, with differing methods of visualizing intra-articular structures. Whereas the arthrogram reproduces a black-and-white, two-dimensional picture of a spatial structure (an indirect procedure), arthroscopy provides a colored picture facilitating a three-dimensional assessment of the joint cavity, palpation, and the arthroscopic operation. However, both procedures have their weaknesses. False-positive and false-negative results may occur in arthrographic techniques, whereas in arthroscopy, the inability to visualize particular joint regions resulting from the anatomical features of the joints is known. Arthroscopy and arthrography are complementary procedures in joint diagnosis. The present paper is based on experience gathered in 5188 arthroscopies of the six large human joints. Prior to all hand and hip arthroscopies, arthrographic examinations were performed. They provided essential information in 30% of all ankle-joint arthroscopies and in 10% of all knee arthroscopies, but in only a few elbow and shoulder arthroscopies.

Ankle Joint↗