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PubMed1985

Meniscal tears of the knee: evaluation by high-resolution CT combined with arthrography.

The knees of 27 patients with evidence of meniscal tears were examined with high-resolution computed tomography (HRCT) immediately following double-contrast arthrography. The arthrograms and postarthrogram HRCT scans were compared for their display of anatomic and pathologic detail. The anatomy of the semilunar cartilage and surrounding structures was more clearly outlined on the HRCT scans. The HRCT scans also enabled differentiation of the menisci from the surrounding anatomic parts (popliteal tendon sleeve and popliteal cyst) and good visualization of the relationship of torn meniscal fragments. Postarthrography HRCT should be used as a complement to arthrography. With this additional information, arthroscopists can plan the most appropriate surgical treatment.

Contrast Media↗
PubMed1985

Knee arthrography today.

Three recent studies on intraarticular knee structures are considered-one on an advance in conventional knee arthrography and two on use of computed tomography in evaluating knee menisci. A resurgence of knee arthrography is predicted.

Humans↗
PubMed1978

Arthrography of the ankle. Value in diagnosis of rupture of the lateral ligaments.

Arthrography was performed in 105 cases with freshly sprained ankles and signs of rupture of the anterior talofibular ligament. They were subsequently operated upon. The arthrographic films were examined retrospectively to assess the value of different criteria for the differential diagnosis between rupture of the anterior talofibular ligament and combined rupture of this and the calcaneofibular ligament. The diagnostic value of arthrography was found to be high in isolated rupture of the anterior talofibular ligament, and is acceptable in the combined ruptures.

Adolescent↗
PubMed1980

Arthrography of the hip in children. Technique, normal anatomy and findings in unstable hip joints.

A method by which bilateral hip arthrography was performed under general anaesthesia in 130 infants and children 1 month to 7 years of age is described. Significant contractures of the adductor muscles had been corrected before the examination. Most of the children were girls with unilateral congenital idiopathic hip instability detected before the age of one year. From films exposed in standardized projections valuable information was obtained about the configuration of the joint cavity and the size and shape of the femoral head. Criteria for normal appearance in infants of ages 2 to 12 months are presented. More reliable details on the relation between the articular surfaces, the radiographic anatomy of the acetabulum and the distribution of the contrast medium were yielded by stereoradiography. Closed reduction was usually accomplished successfully during the arthrography, which made beginning of definitive treatment under the same anaesthesia possible.

Anesthesia, General↗
PubMed1983

Arthrography of the ankle. Value in diagnosis of rupture of the calcaneofibular ligament.

As part of a clinical prospective investigations 102 patients with fresh ankle injuries underwent ankle arthrography and surgery for rupture of the lateral ligaments of the ankle. Three hypotheses concerning the improvement of the arthrographic diagnosis of rupture of the calcaneofibular ligament were tested. Two were rejected. Improvement in the diagnostic specificity was possible by combining arthrography with a stress inversion test, but the sensitivity of this combination was low. It was demonstrated that absence of peroneus sheath filling was a better diagnostic sign with good rather than with poor recess filling.

Ankle Injuries↗
PubMed1984

Omnipaque and urografin in arthrography of the knee.

The first experience with Omnipaque in arthrography of the knee in patients is reported. Forty arthrographies were performed using either Omnipaque 350 mg I/ml or Urografin 370 mg I/ml at random. The low-osmolar non-ionic Omnipaque showed a tendency for pain of shorter duration and lower incidence of hydrops. A significantly lower incidence of complaints of tension and swelling and assessed reactive synovitis was demonstrated. Both contrast media produced excellent synovial coating on standard series, but Omnipaque showed a slower decrease in attenuation.

Adolescent↗
PubMedDate not supplied

Assessment of the unstable shoulder by computed arthrography. A preliminary report.

The evaluation of 10 patients with subluxing and dislocating shoulder is presented. Routine radiography with special views detected the presence of Hill Sachs lesions in seven patients, but was not conclusive for three patients. Soft tissue and bone anomalies were documented by computed arthrography in all 10 patients. Computed arthrography represents a valuable tool in the diagnosis of obscure unstable shoulders.

Adult↗
PubMed1980

Pitfalls in double contrast knee arthrography.

Two hundred and forty-two patients investigated by double-contrast knee arthrography between 1973 and 1977 have reviewed. Of these 134 have come to arthrotomy and an initial arthrographic accuracy of 85% is reported. An attempt to explain the disparities between arthrography and arthrotomy has revealed that in half the cases (ten patients) there were simple reporting errors on the arthrograms. These are shown all to be false negative reports. The other group of ten patients comprised presumed errors in arthrotomy interpretation in four and arthrographic interpretation or technical failure in six. The causes and implications of those errors are analysed and discussed.

Adolescent↗
PubMed1980

Arthroscopy and arthrography of the knee: a critical review.

A series of 135 knee arthroscopies has been reviewed to determine the accuracy of detection of meniscal lesions. Arthroscopy and double-contrast arthrography achieved similar accuracy (84 per cent and 86 per cent) in the diagnostically more difficult knees of the series. The combined accuracy of both examinations was 98 per cent. Arthroscopic difficulty in seeing the posterior third of the medial meniscus, and consequently tears in this region, is emphasised and discussed. Arthroscopy and arthrography are complementary in the diagnosis of difficult meniscal problems.

Adolescent↗
PubMed1987

Vibration arthrography as a diagnostic aid in diseases of the knee. A preliminary report.

The detection and recording of vibration emission from human joints, a technique which we have termed "vibration arthrography", is a sensitive, non-invasive method for the objective study of the locomotor system. Using vibration sensors attached to bony prominences around the knee, we studied the joints of both normal and symptomatic subjects. Normal subjects produced three signal types--physiological patellofemoral crepitus, patellar clicks, and the lateral band signal. In symptomatic subjects we identified and categorised many signal types and related them to pathology. Lesions of the menisci produced distinctive signals, and it was possible not only to lateralise the tear, but in many cases to determine the type of meniscal injury present. Vibration arthrography promises to be a useful tool in the non-invasive diagnosis of knee disorders.

Auscultation↗
PubMed1999

Development of the ball-and-socket ankle as assessed by radiography and arthrography. A long-term follow-up report.

We studied the development of ball-and-socket deformity of the ankle by arthrography and radiography in 14 ankles of ten patients with congenital longitudinal deficiency of the fibula accompanied by various anomalies. The mean follow-up was for 18 years 10 months. In three ankles in infants less than one year old the lateral and medial sides of the ankle were already slightly round. In another seven ankles the ball-and-socket appearance developed before the age of five years. This was thought to be due to osseous coalition which limits eversion and inversion. In another four ankles in children who were over the age of one year at the initial examination, the deformity was demonstrated by arthrography and radiography at their first examination. Ball-and-socket deformity accompanied by tarsal coalition is an acquired deformity secondary to limitation of movement of the subtalar and midtarsal joints. It has completely developed by about five years of age.

Adolescent↗
PubMed2006

Diagnostic performance of MR arthrography after rotator cuff repair.

OBJECTIVE: The objective of this study was to investigate the diagnostic performance of MR arthrography after rotator cuff repair. MATERIALS AND METHODS: MR arthrographic examinations of the shoulder performed after rotator cuff repair and before revision surgery were retrospectively analyzed in 48 patients (31 males, 17 females; mean age, 50.3 years; age range, 17-69 years). Full-thickness and partial-thickness defects of the supraspinatus, infraspinatus, and subscapularis tendons were diagnosed independently by two radiologists. Revision surgery served as the standard of reference. RESULTS: Observer 1 correctly recognized five of eight intact supraspinatus tendons, 10 of 19 partial-thickness defects, and 19 of 21 full-thickness defects. For observer 2, the numbers were three of eight, eight of 19, and 18 of 21. The corresponding numbers for the infraspinatus tendon for observer 1 were 28 of 31, 0 of three, and 14 of 14 tendons. For observer 2, they were 28 of 31, two of three, and 11 of 14. For the subscapularis tendon, observer 1 made the correct diagnosis in 18 of 31, five of six, and nine of 11 tendons. The results for observer 2 were 26 of 31, one of six, and 10 of 11 tendons. Interobserver agreement (weighted kappa) was 0.47 for the supraspinatus, 0.64 for the infraspinatus, and 0.20 for the subscapularis tendons, respectively. CONCLUSION: Postoperative full-thickness defects of the rotator cuff are reliably diagnosed with MR arthrography. The diagnostic performance for partial-thickness defects is only moderate.

Adolescent↗
PubMed1976

Arthrography in total hip prosthesis complications.

Previous reports have stressed the value of hip arthrography primarily in determining the presence of loosening of the total hip prosthesis. Although loosening is a common complication and frequently associated with infection, other complications producing a painful hip prosthesis exist and are demonstrable by arthrography. Since the etiologies of these are as diversely different as the treatment, the hip arthrogram is advocated as an integral part of the diagnostic approach to the patient with a painful hip prosthesis in order to assess the specific complication and determine the therapeutic approach.

Aged↗
PubMed1981

Pain in knee arthrography: comparison of air vs. CO2 and reaspiration vs. no reaspiration.

A prospective study of 255 patients undergoing double-contrast arthrography of the knee was performed to evaluate postexamination knee pain after two procedural modifications: (1) intraarticular carbon dioxide versus room air and (2) postprocedural joint reaspiration versus no reaspiration. A moderate or severe increase in pain during the 24 hr after the examination was experienced by 20% of patients. Carbon dioxide resulted in slightly greater patient pain immediately after the procedure than did room air. However, there was no difference in morbidity in these two groups at 24 hr. Aspiration of the knee joint had no immediate or delayed effect on patient pain. Older patients, women, and patients with abnormal arthrograms, reported more baseline discomfort but, allowing for this, they tolerated the procedure as well as younger patients, men, and patients with normal arthrograms. It is recommended that double contrast arthrography of the knee be performed using intraarticular air without reaspiration of the joint.

Adult↗
PubMed1985

A comparison of Hexabrix and Renografin-60 in knee arthrography.

Forty patients were randomized in a double-blind study to compare the safety and diagnostic quality of Hexabrix vs. Renografin-60 without epinephrine in knee arthrography. Hexabrix is a monoacidic dimer of meglumine and sodium salts of ioxaglic acid with a lower osmolality than conventional contrast agents of similar concentration (32% iodine). Initial films were of equally high diagnostic quality for both groups, but delayed films at 20 and 30 min significantly favored Hexabrix for diagnostic quality. Hexabrix proved to be a safe and effective contrast agent for knee arthrography.

Adolescent↗
PubMed1995

Localization of specific joint causing hindfoot pain: value of injecting local anesthetics into individual joints during arthrography.

OBJECTIVE: The purpose of this study was to evaluate the utility of selective injection of local anesthetic into hindfoot articulations for localizing the source of posttraumatic pain and to compare clinical response with the severity of degenerative change in the various articulations evident on plain radiographs or CT scans. SUBJECTS AND METHODS: Anesthetic arthrography was performed in 18 patients with posttraumatic hindfoot pain. In all, 32 joints were assessed: 15 talocalcaneonavicular, 11 subtalar, five ankle, and one calcaneocuboid. Following intraarticular injection of a mixture of equal amounts of meglumine diatrizoate 60%, lidocaine 1%, and bupivacaine 0.25%, patients were asked to grade the degree of pain relief they experienced on a scale from 0% to 100%. The degree of degenerative changes seen on preliminary radiographs and CT scans was graded blindly and retrospectively by an experienced musculoskeletal radiologist using a 3-point scale (grade 0 indicated a normal joint, grade 1 indicated mild to moderate degenerative change, and grade 2 indicated severe degenerative change). The value of findings on both routine radiographs and CT scans as predictors of the degree of symptomatic relief obtained from specific joint injections was determined. Arthrodesis was performed in nine patients on the basis of the results of anesthetic injections. RESULTS: The degree of pain relief experienced after intraarticular injection of anesthetic correlated with the severity of degenerative change as assessed by routine radiography in 15 of 32 joints and as assessed by CT in eight of 18 joints. In 14 of 32 joints assessed by routine radiography and in seven of 18 joints assessed by CT, the amount of pain relief achieved by anesthetic arthrography was less than that predicted by imaging evidence of degenerative disease. In five of 32 joints judged normal on plain film radiographs, significant pain relief was experienced following anesthetic injection, resulting in a change in the proposed surgical procedure. Long-term follow-up indicated satisfactory results in eight of the nine patients in whom arthrodesis was performed. CONCLUSION: Selective intraarticular anesthetic injections afford a direct method of confirming the site of hindfoot pain and may aid in surgical planning, because plain film radiography or CT may underestimate or poorly indicate the most symptomatic articulations.

Adult↗
PubMed1995

MR arthrography of the hip: improved imaging of the acetabular labrum with histologic correlation in cadavers.

OBJECTIVE: The objective of this study was to correlate findings on conventional MR imaging and MR arthrography of the hip with pathologic findings in cadavers with abnormal labra to determine (1) the efficacy of MR imaging in assessing labral degeneration, (2) whether delineation of the labrum from the joint capsule is possible, and (3) if the conspicuity of surface abnormalities of the labrum is improved by administering intraarticular contrast material. MATERIALS AND METHODS: Twelve cadaveric hip joints were obtained from elderly cadavers. Each hip was examined using fat-suppressed three-dimensional spoiled GRASS (gradient-recalled acquisition in the steady state) (SPGR) imaging and T1-weighted spin-echo imaging before and after intraarticular injection of contrast material. Thirty-six labral sections (three from each hip joint) were evaluated histologically to determine the labral-capsular relationship, the presence of degeneration, and the configuration of the labral base. These findings were correlated with the results of a blinded MR evaluation of these sections. RESULTS: Delineation of the labrum from the adjacent joint capsule was possible on SPGR and T1-weighted MR arthrographic images (34 of 36 and 33 of 36 specimens, respectively), but was not consistently possible on standard SPGR and T1-weighted MR images (7 of 36 and 4 of 36 specimens, respectively). The sensitivities and specificities of the various MR sequences in evaluating labral degeneration varied from 50% to 67%, and from 25% to 94%. Increased signal at the base was common in both the normal (n = 12) and the abnormal (n = 24) labrum. CONCLUSION: Conspicuity of the acetabular labral complex is enhanced with the intraarticular administration of contrast material. Although MR arthrography did not improve our specificity for diagnosing labral degeneration, the detection of surface abnormalities, particularly those near the base, was significantly improved.

Acetabulum↗