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PubMed1988

Computed arthrography: its role in the screening of joint diseases in pediatric radiology.

The purpose of this study was to analyse the accuracy of combined arthrography and computed tomography in pediatric radiology. 23 patients were selected and the joints studied (n = 25) were: elbow (1), shoulder (2), knee (8) and hip (14). The contribution of computed arthrography varies according to the joint and the disease concerned. Osteochondritis dissecans of the knee appears to be the best indication.

Adolescent↗
PubMed1997

Iopentol (Imagopaque 300) compared with ioxaglate (Hexabrix 320) in knee arthrography. A clinical trial assessing immediate and late adverse events and diagnostic information.

OBJECTIVES: This trial was designed to compare the incidence of delayed postprocedural pain after administration of iopentol (Imagopaque, Nycomed Imaging AS, Oslo, Norway) 300 mg I/ml versus ioxaglate (Hexabrix, Guerbet, Aulnay-sous-Bois, France) 320 mg I/ml in single-contrast knee arthrography. Other adverse events and radiographic efficacy were also evaluated. METHODS: A randomized, double-blind study was performed in 120 patients. Immediate adverse events were recorded up to 30 min post-injection, and late adverse events, including knee pain and swelling, up to 4 days after the examination (by using a patient questionnaire). Diagnostic information obtained up to 20 min after injection was assessed using a Visual Analogue Scale (VAS). RESULTS: Significantly more patients in the ioxaglate group (50%) than in the iopentol group (30%) reported increased knee pain during the 4 days following the examination (p < 0.05). Adverse events up to 30 min after the examination, and late adverse events other than knee pain, were reported by similar numbers of patients in the two contrast medium groups. The diagnostic information was similar in both groups. CONCLUSION: Both iopentol and ioxaglate are effective and safe contrast media for use in knee arthrography, but iopentol induces less postprocedural pain.

Adult↗
PubMed2004

[Biceps tendon disorders: ultrasound, MR imaging and MR arthrography].

Ultrasound and MR imaging are competitive imaging modalities for the diagnosis of pathologic conditions of the biceps tendon. MR imaging has substantial advantages over ultrasound because biceps tendon lesions are most commonly located in the proximal part where lesions are hidden under the acromion for ultrasound assessment. The value of MR arthrography is substantiated by the capability to assess associated diagnoses which are otherwise difficult to assess. Associated diagnoses include full- and partial thickness tears of supraspinatus and subscapularis tendons, pulley lesions, and adhesive capsulitis (frozen shoulder). Moreover, MR arthrography is the method of choice for the assessment of superior labral anterior posterior (SLAP) lesions.

Arthrography↗
PubMed2006

[Magnetic resonance tomography and arthrography of the hip joint].

Plain film radiographs represent the imaging of choice for the initial evaluation of pathologies of the hip. However, many lesions of the joint itself and surrounding soft tissues are often not visualized by conventional radiographs. Magnetic resonance imaging (MRI) demonstrates most of these pathologies with high sensitivity and specificity. For further assessment of intra-articular lesions such as labral tears, hyaline cartilage lesions, rupture of the ligamentum teres, and loose bodies, direct MR arthrography after intra-articular administration of contrast medium may be indicated. This article summarizes the technical aspects and the most important indications for MRI and MR arthrography of the hip in correlation with typical imaging findings of the most frequent pathologies.

Arthrography↗
PubMed2001

What happens to the triangular fibrocartilage complex during pronation and supination of the forearm? Analysis of its morphology and diagnostic assessment with MR arthrography.

OBJECTIVE: To evaluate the dynamic morphologic changes of the triangular fibrocartilage complex (TFCC) during pronation and supination of the forearm using high-resolution MR arthrography in cadavers and to evaluate the impact of these changes on the diagnostic assessment of the normal and abnormal TFCC. DESIGN AND SPECIMENS: High-resolution MR arthrography of 10 wrists of cadaveric specimens was obtained in maximum pronation, in the neutral position, and in maximum supination of the forearm. The structures of the TFCC were evaluated by two musculoskeletal radiologists and correlated with anatomic sections. The position of the forearm that allowed the best visualization of normal structures and lesions of the TFCC was determined. RESULTS: The shape and extent of the articular disc as well as the radial portions of the radioulnar ligaments did not change with pronation and supination. The articular disc was horizontal in the neutral position and tilted more distally to align with the proximal carpal row in pronation and supination. The fibers of the ulnar part of the radioulnar ligaments (ulnar attachment of the articular disc) revealed the most significant changes: their orientation was coronal in the neutral position and sagittal in positions of pronation and supination. The ulnomeniscal homologue was largest in the neutral position and was reduced in size during pronation and supination. The extensor carpi ulnaris tendon was centered in its groove in the neutral position and pronation. In supination this tendon revealed subluxation from this groove. The dorsal capsule of the distal radioulnar joint was taut in pronation, and the palmar capsule was taut in supination. The preferred forearm position for analysis of most of the structures of the TFCC was the neutral position, followed by the pronated position. The neutral position was rated best for the detection of ulnar and radial detachments of the TFCC, followed by the pronated position, except for two central perforations of the TFCC which were best seen with supination. CONCLUSION: The articular disc and the surrounding radial portions of the radioulnar ligaments form a rigid, unified complex with the radius without change in their shape in positions of pronation and supination of the forearm, while the ulnar attachment of the TFCC shows important dynamic changes. The neutral forearm position is the best position to analyze both the normal and the abnormal TFCC.

Arthrography↗
PubMed2003

MR appearance of cartilage defects of the knee: preliminary results of a spiral CT arthrography-guided analysis.

The aim of this study was to determine signal intensity patterns of cartilage defects at MR imaging. The MR imaging (3-mm-thick fat-suppressed intermediate-weighted fast spin-echo images) was obtained in 31 knees (21 male and 10 female patients; mean age 45.5 years) blindly selected from a series of 252 consecutive knees investigated by dual-detector spiral CT arthrography. Two radiologists determined in consensus the MR signal intensity of the cartilage areas where cartilage defects had been demonstrated on the corresponding reformatted CT arthrographic images. There were 83 cartilage defects at spiral CT arthrography. In 52 (63%) lesion areas, the MR signal intensity was higher than that of adjacent normal cartilage with signal intensity equivalent to (n=31) or lower than (n=21) that of articular fluid. The MR signal intensity was equivalent to that of adjacent normal cartilage in 17 (20%) lesion areas and lower than that of adjacent cartilage in 8 (10%) lesion areas. In 6 (7%) lesion areas, mixed low and high signal intensity was observed. The MR signal intensity of cartilage defects demonstrated on spiral CT arthrographic images varies from low to high on fat-suppressed intermediate-weighted fast spin-echo MR images obtained with our equipment and MR parameters.

Adolescent↗
PubMed2004

Direct magnetic resonance arthrography.

Magnetic resonance (MR) arthrography has gained increasing popularity as a diagnostic tool in the assessment of intra-articular derangements. Its role has been studied extensively in the shoulder, but it also has been explored in the hip, elbow, knee, wrist and ankle. This article reviews the current role of direct MR arthrography in several major joints, with consideration of pertinent anatomy, techniques and applications.

Adult↗
PubMed2006

Rotator cuff tears: assessment with MR arthrography in 275 patients with arthroscopic correlation.

We assessed the diagnostic performance of magnetic resonance (MR) arthrography in the diagnosis of articular-sided partial-thickness and full-thickness rotator cuff tears in a large symptomatic population. MR arthrograms obtained in 275 patients including a study group of 139 patients with rotator cuff tears proved by arthroscopy and a control group of 136 patients with arthroscopically intact rotator cuff tendons were reviewed in random order. MR imaging was performed on a 1.0 T system (Magnetom Expert, Siemens). MR arthrograms were analyzed by two radiologists in consensus for articular-sided partial-thickness and full-thickness tears of the supraspinatus, infraspinatus, and subscapularis tendons. At arthroscopy, 197 rotator cuff tears were diagnosed, including 105 partial-thickness (93 supraspinatus, nine infraspinatus, three subscapularis) and 92 full-thickness (43 supraspinatus, 20 infraspinatus, 29 subscapularis) tendon tears. For full-thickness tears, sensitivity, specificity, and accuracy were 96%, 99%, and 98%, respectively, and for partial tears 80%, 97%, and 95%, respectively. False negative and positive assessments in the diagnosis of articular-sided partial-thickness tears were predominantly [78% (35/45)] observed with small articular-sided (Ellman grade1) tendon tears. MR arthrography is highly accurate in the diagnosis of full-thickness rotator cuff tears and is accurate in the diagnosis of articular-sided partial-thickness tears. Limitations in the diagnosis of partial-thickness tears are mainly restricted to small articular-sided tears (Ellman grade 1) due to difficulties in differentiation between fiber tearing, tendinitis, synovitic changes, and superficial fraying at tendon margins.

Adolescent↗
PubMed1999

Real-time MR-guided joint puncture and arthrography: preliminary results.

The purpose of this study was to evaluate interactive MR-guided joint puncture with intra-articular application of contrast agent. MR-guided arthrography of the shoulder joint was successfully performed in three patients using an interactive guidance system implemented in an open-configuration MR system. Visualization of the needle pathway and contrast inflow was comparable to that with conventional X-ray fluoroscopy. The position of the intra-articular needle tip was accurately confirmed and subsequent MR arthrography was diagnostic in all cases.

Adult↗
PubMed2000

Morphologic changes of the ankle in children as assessed by radiography and arthrography.

Chronological changes in the morphology of the ankle, a joint that consists primarily of chondral components in children, were investigated by arthrography and plain radiography. Arthrography was performed in 57 ankles of 40 patients with normal ankles (aged from 2 months to 3 years, 4 months; mean, 1 year, 7 months), and plain radiography was performed on 183 joints of 126 patients with normal ankles (aged from 3 years, 6 months to 14 years, 5 months (mean, 7 years, 8 months). The angle of the distal tibial joint surface was then measured on each radiograph. Despite being evident at birth, valgus inclination in the ankle rapidly changed during the first and second years of life. Thereafter, change continued gradually and spontaneously, and the ankles were in the neutral position by 3 years of age. However, the morphology of the ankles did not change much after that time. Normal ankles show valgus inclination at birth, but this configuration is changed naturally over time, and the ankles are in the neutral or slightly varus position by the age of bone maturity.

Adolescent↗
PubMed1988

Temporomandibular joint arthrography without fluoroscopy.

An arthrographic technique for the temporomandibular joint that can be performed in a dental surgical room is described. This technique utilizes a dental radiographic unit and extraoral cassettes for visualization of the needle tip in the inferior synovial space for arthrography. The radiographic visualization is combined with tactile discernment of the needle tip on the mandibular condyle. The successful application of these two methods makes fluoroscopy unnecessary. After an initial success rate of 81% (34 of 42 attempts), we have used the technique successfully in more than 100 cases. Most of the problems encountered with this technique can be attributed to initial operator inexperience. This technique is not suggested as a replacement for fluoroscopy. However, it is a convenient, economical technique that can be used in the dental surgical room by trained clinicians when arthrography is indicated to determine meniscal-condylar relationships and meniscal perforations.

Arthrography↗
PubMed1994

Observer performance and diagnostic outcome in diagnosis of the disk position of the temporomandibular joint using arthrography.

Observer performance and diagnostic outcome in the diagnosis of the disk position of the temporomandibular joint by arthrography were investigated. Three different radiographic techniques were studied: fluoroscopy, fluoroscopy in combination with lateral transcranial radiography, and fluoroscopy in combination with corrected sagittal tomography. Seven observers were asked to assess 30 joints representing three diagnoses, namely superior disk position and anterior disk position with and without reduction. The intraobserver agreement was high for all three techniques. The interobserver agreement of the seven observers when the disk position was diagnosed by fluoroscopy in combination with lateral transcranial radiography (Kappa index 0.68) was higher than that with fluoroscopy alone (Kappa index 0.54) and that with fluoroscopy in combination with corrected sagittal tomography (Kappa index 0.56). The sensitivity, specificity, and predictive values of fluoroscopy in combination with lateral transcranial radiography were also higher than those of the other radiographic techniques. Judged from this study, the observer agreement and the diagnostic outcome for arthrography with the use of the three examined techniques are high when well-defined criteria and reference images are applied.

Adolescent↗
PubMed1986

Elbow arthrography in the evaluation of posterior interosseous nerve compression in rheumatoid arthritis.

This is a case report of a fifty-nine-year-old rheumatoid arthritic woman who developed lack in finger extension bilaterally. These deficits had two completely different aetiologies, Posterior Interosseous Nerve (PIN) Syndrome and extensor tendon rupture. No previous report in the literature has used elbow arthrography as a diagnostic tool in a patient with PIN Syndrome. Elbow arthrography confirmed the abnormality at this joint and aided in appropriate management.

Arthritis, Rheumatoid↗
PubMed1986

Morbidity associated with temporomandibular joint arthrography in clinically normal joints.

To document the short- and long-term morbidity of arthrograms done on clinically normal temporomandibular joints, 62 arthrograms were performed on 31 asymptomatic volunteers. All subjects kept a record of any joint pain they experienced during the next five days and were examined by one of the authors at five days and again at two months. Maximum interincisal opening distance was recorded before the arthrogram and at both postarthrographic evaluations. No subjects complained of severe (grade 3) joint pain. Sixteen joints were recorded as moderately painful (grade 2), 32 as mildly painful (grade 1), and 14 as not painful (grade 0). Ten of 31 subjects described transient changes in occlusion one week after arthrography but none of the changes persisted until the two-month examination. Maximum interincisal distance was significantly decreased at one week but not at two months. These findings, although gained from asymptomatic subjects, suggest that complications of arthrography are probably minor and transient when performed by an experienced arthrographer.

Arthrography↗
PubMed1991

The value of arthrography in the decision-making process regarding surgery for internal derangement of the temporomandibular joint.

In this study, the clinical and arthrographic findings from 43 internally deranged temporomandibular joints (TMJs) were compared with the intra-surgical observations. In 40 of 43 joints, arthrography did not provide any additional information useful for diagnosis or treatment. In six joints, the problem was misdiagnosed. Only in three joints did arthrography demonstrate the existence of perforation in the posterior attachment that had not been suspected during the clinical examination. Because of the doubtful importance of arthrographic information for the decision-making process, it is suggested that the method be applied only in cases in which clinical examination and plain radiographs have failed to uncover the signs and symptoms indicative of a TMJ disorder.

Adolescent↗
PubMedDate not supplied

Value and limits of arthrography in the study of pathological mediopatellar plicae of the knee; a comparison with arthroscopy.

The results from arthroscopy and arthrography were compared in a prospective study of the mediopatellar plicae in 100 knees with internal disorders. With reference to arthroscopy, the sensitivity and specificity of arthrography for the detection of mediopatellar plicae were, respectively, 83.6 and 88.8%. The arthrographic signs of pathological plicae were: a thick plica, thicker than the internal condylar cartilage (sensitivity: 72%; specificity: 84%) and an interposed plica (sensitivity: 85%; specificity: 81.8%). Statistically the arthrographic signs agreed with the arthroscopic signs. The two methods did not differ significantly in their contribution to the diagnosis of pathological plicae.

Adolescent↗
PubMed2004

Chronic labral tears: value of magnetic resonance arthrography in evaluating the glenoid labrum and labral-bicipital complex.

PURPOSE: In the magnetic resonance (MR) evaluation of the glenoid labrum, all studies to our knowledge have included mixed populations of patients, those with acute shoulder injuries as well as patients with chronic shoulder disorders. The focus of this investigation was to assess the effectiveness of MR arthrography in patients with chronic labral tears, excluding those with acute injuries. TYPE OF STUDY: Prospective case series. METHODS: Conventional MR images and MR arthrograms were obtained in 36 patients from April 1994 to April 1997. A single experienced musculoskeletal radiologist read all MR images. Each patient subsequently underwent shoulder arthroscopy performed by a single highly experienced shoulder arthroscopist. Detailed arthroscopic reports were then reviewed and compared with the MR findings documented before surgery, with arthroscopic findings being the standard of reference for comparison. Inclusion criteria required greater than 6 months of shoulder symptoms before imaging, thus eliminating acute injuries. RESULTS: SLAP lesions were diagnosed at the time of surgery in 11 of 36 patients (31%). The sensitivity was 100% (11 of 11 patients) and the specificity was 88% (22 of 25 patients). Accuracy for SLAP lesions was 92% (33 of 36 patients). Anterior labral tears were diagnosed surgically in 12 of 36 patients (33%). The sensitivity was 86% (12 of 14 patients) and specificity was 86% (19 of 22 patients). Accuracy for labral tears was 86% (31 of 36 patients). CONCLUSIONS: MR arthrography is an accurate technique for assessing the glenoid labrum in patients with chronic labral tears. LEVEL OF EVIDENCE: Level I.

Adult↗
PubMed2004

Does the procedure of arthrography affect the range of movement in patients with locking of the temporomandibular joint?

The aim of this study was to investigate whether arthrography itself altered the range of mandibular movements, in a group of patients with locking of the temporomandibular joint (TMJ). The clinical records of a series of 161 patients who were diagnosed with locking of the TMJ were retrospectively analysed. Mouth opening had improved in 57 out of 161 patients (35%). Twenty-three patients (14%) had improved by 5 mm or less. Nineteen patients (11%) had improved by more than 5 mm but less than 10 mm, whereas 15 patients (9%) had improved by more than 10 mm. Of the patients who experienced an improved mouth opening, only nine (15%) had improved from their pre-arthrography restricted maximum opening to beyond the lower limit of normal. This suggests that the injection of contrast medium had an effect on the range of vertical opening in patients with displacement of the disc without reduction.

Adolescent↗