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PubMed1997

MR arthrography of the shoulder: rethinking traditional imaging procedures to meet the technical requirements of MR imaging guidance.

OBJECTIVE: The purpose of this study was to determine the feasibility of and the appropriate technique for performance of MR imaging-guided arthrography of the shoulder. SUBJECTS AND METHODS: Thirty-eight MR imaging-guided glenohumeral joint punctures were performed using an open C-arm scanner with a vertically oriented magnetic field, adapted for interventional procedures. Two different approaches to the shoulder were used: a modification of the traditional anterior approach (seven procedures), and an anterosuperior approach (31 procedures) mimicking the anterior arthroscopy portal. The average procedure duration was determined. A retrospective review of needle mediolateral and anterioposterior position was determined for the anterosuperior approaches. RESULTS: Average procedure duration was 21 min for the anterior approach and 12 min for the anterosuperior approach. Subjectively, needle conspicuity was minimal with the anterior approach, contributing to prolonged imaging times. Needle visualization was much improved with the anterosuperior approach. Nine of the 31 anterosuperior procedures involved inadvertent injection of the subacromial or subdeltoid bursa. At the time of retrospective review, the needle was too laterally or too anteriorly positioned in six of these nine patients. CONCLUSION: With consideration of the technical demands of MR imaging guidance for interventional procedures, MR imaging-guided arthrography of the shoulder is feasible. The traditional radiologic approach to the shoulder must be modified to provide adequate visualization of the needle. The anterosuperior approach meets this needs.

Adult↗
PubMed2001

MR arthrography of the glenohumeral joint: a tailored approach.

OBJECTIVE: The purpose of this study was to anatomically confirm that anterior shoulder injection could result in penetration of the anterior stabilizing structures of the glenohumeral joint and to advocate the use of a tailored approach to MR arthrography based on presenting symptoms. CONCLUSION: A tailored approach to MR arthrography may be a useful way to isolate expected pathology in the shoulder and limit confounding findings related to the performance of the procedure.

Aged↗
PubMed2003

MR arthrography of the posterior labrocapsular complex: relationship with glenohumeral joint alignment and clinical posterior instability.

OBJECTIVE: The purpose of our study was to investigate the relationship between tears of the posterior labrocapsular complex and glenohumeral alignment on MR arthrography and the presence and extent of posterior labrocapsular tears in patients with posterior instability. MATERIALS AND METHODS: Posterior labrocapsular tears identified on 24 MR arthrograms and surgically confirmed were evaluated for length of tear and labrocapsular avulsion. These examinations and a comparison cohort of 70 normal MR arthrograms with normal findings were also evaluated for humeral head position relative to the glenoid fossa. Medical records were reviewed for clinical diagnosis of posterior instability and history of shoulder trauma. RESULTS: The position of the humeral head relative to the glenoid was significantly more posterior in patients with posterior labral tear than in patients with a normal posterior labrum (4.9 mm versus 0.7 mm; p < 0.0001). The mean length (+/- SD) of posterior labral tear was 15.9 +/- 1.7 mm, and a direct correlation was found between tear length and posterior humeral translation (r = -0.65; p = 0.002). Posterior labral tears were significantly longer (18.6 vs 13.1 mm; p = 0.04), and posterior humeral translation was greater (6.4 vs 3.4 mm; p = 0.006) in patients with labrocapsular avulsion than in those without avulsion. Twelve (50%) of the patients with posterior labrocapsular tear had posterior instability, and 10 (83%) had a history of macrotrauma. On MR arthrography, the mean posterior humeral translation was greater (6.2 mm +/- 0.08; p = 0.019), posterior labral tears were longer (19.4 mm +/- 1.7; p = 0.0008), and labrocapsular avulsion was more common (83%; p = 0.0001) in patients with posterior instability than in patients who had a posterior labral tear but a clinically stable shoulder. CONCLUSION: Clinical posterior instability is associated with excessive posterior humeral translation, long posterior labral tears, and posterior labrocapsular avulsion.

Adolescent↗
PubMed2004

Humeral avulsion of the posterior band of the inferior glenohumeral ligament: MR arthrography and clinical correlation in 17 patients.

OBJECTIVE: The purpose of this article is to describe the MR arthrography findings of humeral avulsion of the posterior band of the inferior glenohumeral ligament in 17 patients. To elucidate the clinical importance of this abnormality, we also correlate our imaging findings with the presence of coexisting structural abnormalities; clinical presentation; and, when available, arthroscopic evaluation (n = 8). CONCLUSION: Humeral avulsion or insufficiency of the posterior band of the inferior glenohumeral ligament can be easily detected using MR arthrography. This ligamentous abnormality may be seen in isolation, or it may occur in conjunction with posterior or, less often, anteroinferior capsulolabral abnormalities. The presence of this lesion in a subgroup of patients with the clinical diagnosis of multidirectional instability may offer insight into the causes and pathogenesis of this complex entity.

Adolescent↗
PubMed1980

Arthrography as an aid to diagnosis, prognosis and therapy in Legg-Calvé-Perthes' disease.

Measurements of head diameter and acetabulum-head quotient (AHQ) were made on the plain radiographs and corresponding arthrograms of 37 consecutive patients with unilateral Legg-Calvé-Perthes' Disease (L.C.P.D.). Although on plain radiographs the affected osseous femoral capital epiphysis was slightly larger (22) the same size (9) or smaller (6) than that on the normal side, on arthrography the osteochondral head was much larger in 34 and the same size in 3 instances. In 35 cases the arthrograms revealed flattening of the osteochondral head. The AHQ computed from the arthrograms was almost invariably less than that computed from the plain radiographs. Thus the AHQ computed on arthrograms more realistically assessed the almost invariably poor head coverage in L.C.P.D. This, together with signs of flattening, diagnoses the severity of the disease process and helps to differentiate the "head at risk" which requires treatment. During arthrography the degree of abduction-medial rotation of the leg necessary for containment of the flattened protruding head within the acetabulum can be determined, allowing accurate therapy to be planned, be it operative or orthotic.

Acetabulum↗
PubMed1985

Definition of endoprosthetic loosening. Comparison of arthrography, scintigraphy and roentgen stereophotogrammetry in prosthetic hips.

Contrast arthrography, radionuclide arthrography, scintigraphy and roentgen stereophotogrammetric analysis (RSA) were used to detect mechanical loosening in 14 painful total hip replacements. All prosthetic components unstable by RSA, or with abnormal arthrogram, or with increased scintigraphic activity, or loose at revision were migrating, but no non-migrating components demonstrated any of these signs of loosening. Our findings indicate that mechanical loosening should be defined as migration.

Contrast Media↗
PubMed1976

[Arthrography of the fingers and carpus in inflammatory rheumatic conditions (author's transl)].

Arthrography before isotope synoviorthesis of the fingers and wrists was carried out in 185 patients suffering from inflammatory rheumatic conditions. Signs of synovitis were found in approximately 80 per cent of cases and were accompanied by rupture of the synovial capsule (70 per cent) and capsular retraction (in advanced forms). Lymphatic passage was seen in 30 to 40 per cent of cases. Two interesting points may be emphasised: 1 degrees Arthrographic lesions may precede bone erosion. 2 degrees The contrast medium fills the eodes and erosions in active forms. Arthrography, which is essential to satisfactory synoviorthesis, is also of diagnostic and prognostic value.

Arthritis↗
PubMed1996

MR arthrography detects subtle joint pathology.

In the inevitable cost-benefit analysis to come, the appropriate role of MR arthrography will rightly be challenged. As arthroscopic and MR imaging techniques become even more widespread and refined, a well-defined niche for MR arthrography will eventually emerge.

Ankle Injuries↗
PubMed2000

MR arthrography of the rotator cuff and capsulolabral complex.

MR arthrography of the shoulder has reached maturity in recent years. As opposed to conventional MRI of the shoulder it is less prone to artefacts frequently leading to equivocal interpretation. The spectrum of pathology in which MR arthrography has significant advantages is reviewed, with emphasis on the rotator cuff and the capsulolabral complex.

Joint Capsule↗
PubMedDate not supplied

Adduction sign in pediatric hip arthrography.

Various techniques for improving the success of needle placement in hip arthrography have been described. The authors describe a simple consistent sign that occurs in both subluxated and dislocated hips and is present only when the needle is correctly placed within the hip joint. This, in conjunction with other techniques, has improved their quality of hip arthrography.

Child↗
PubMed1976

Distension arthrography of the shoulder joint.

Pain and stiffness resulting from degenerative disease of the rotator cuff of the glenohumeral joint is not always self-limiting. In a few patients, the symptoms persist despite medication and physiotherapy. Distension arthrography, a method of hydrostatic manipulation, has been used in six such patients; five recovered full range of abduction and rotation and the sixth was improved. It is concluded that distension arthrography should be part of the treatment of intractable pain stiffness of the shoulder joint.

Adolescent↗
PubMed1992

[Evaluation of digital subtraction arthrography on the diagnosis of temporomandibular joint dysfunction syndrome].

Digital subtraction arthrography of temporomandibular joint superior cavity (TMJSC-DSA) was performed for 70 cases with TMJ dysfunction syndrome. A comparative observation between the operative findings and the findings of TMJSC-DSA examination was carried out for 11 cases who underwent TMJ operation. The results showed that TMJSC-DSA could overcome the disadvantages of conventional arthrography and make exact diagnoses for the anterior displacement of the disc and the disc perforation.

Adolescent↗
PubMedDate not supplied

Magnetic resonance arthrography of the ankle.

Magnetic resonance (MR) arthrography is a useful technique in evaluating the articular structures of the ankle. With intra-articular administration of gadolinium-DTPA (Gd-DTPA), visualization and delineation of anatomic structures, that would not be depicted by other traditional imaging techniques, are achieved. It is a technique that proves to be advantageous as it does not require the use of ionizing radiation, nor iodinated contrast material as other conventional diagnostic modalities. MR arthrography also allows multiplanar imaging and provides excellent resolution.

Aged↗
PubMed2004

Spiral CT arthrography of multiplanar reconstruction and virtual arthroscopy technique in diagnosis of knee with internal derangements.

OBJECTIVE: To evaluate the values of spiral CT arthrography with multiplanar reconstruction and virtual arthroscopy technique in diagnosis of internal derangements of the knee. METHODS: Ten bovine knees were used for experiment. The menisci, anterior and posterior cruciate ligaments and cartilage of these 10 bovine knees were injured with a hook. Each of the joints was injected with 100 ml air, then soon scanned with a PQ6000 spiral computed tomography scanner. The data obtained was input into the work station, and multiplanar reconstruction technique was used to illustrate lesions in the knees. The results of CT diagnosis were compared to those found by gross inspection of the specimens. Clinically, 10 knees of 9 patients diagnosed as internal derangement were evaluated with the same method after 50-70 ml air was injected into each of the joints. Nine months later, the data of 2 patients were used for CT endoscopy reconstruction. The results were compared with intraoperative findings. RESULTS: Experimentally, the sensitivity and specificity were 88.9% and 93.9% by detection of meniscal abnormalities, 85.7% and 100% by detection of cruciate ligament lesions, and 72.7% and 100% by detection of cartilage damage, respectively. Clinically, the sensitivity and specificity were 90.0% and 95.0% by detection of meniscal lesion. As to ligament, the figures were 85.7% and 100% respectively. Images of virtual arthroscopy simulated the images of real arthroscopy. CONCLUSIONS: Spiral CT arthrography of multiplanar reconstruction technique offers fine images of internal structures of the knee, with clear border and internal structure. It is an accurate method for detecting meniscal, cruciate and collateral ligament and cartilaginous lesions that cause internal derangement of the knee. Virtual arthroscopy technique is a hopeful method for detecting reasons of derangement of the knee.

Animals↗
PubMed1989

[Diagnostic importance of arthrography of the shoulder in rotator cuff rupture].

Arthrography of the shoulder serves to elucidate pathological changes of rotator cuff of the shoulder. To test the reliability of this method in the diagnosis of rupture of the rotator cuff the author compared 72 preoperative arhtrographies with surgical findings. The double contrast method was applied, using a needle in an oblique direction inserted close under the surface. In ruptures of the whole thickness of the arthrography proved to be a highly sensitive method, in particular in medium-sized and small ruptures, and made it thus possible to select the optimal surgical approach.

Adult↗
PubMed1985

Internal derangement of the knee: diagnosis by arthrography, arthroscopy, and arthrotomy.

Three hundred eighty-four cases involving all patients with meniscal or anterior cruciate ligament tears were examined surgically by 16 orthopedic surgeons over two distinct 12-month periods. The incidence of both menisci (ipsilateral knee) torn was 3.9%, and the ratio of medial to lateral meniscal tears was 2.7:1. Twelve percent of cases had tears of the anterior cruciate ligament, 70% of which were found with a concomitant medial meniscus tear. Arthrography was completely accurate in 73.2% of cases, and arthroscopy was accurate in 94.9%. When clinical impression, arthrography, and arthroscopy were combined, the overall diagnostic accuracy was 96.8%.

Arthroscopy↗
PubMed1979

Arthrography--a diagnostic aid to knee injury.

Injuries of the knee often present diagnostic problem. Using double contrast arthrography, each segment of the two menisci can be studied in detail. In addition, ligamentous tears can be detected. This method is particularly useful when the clinical signs are non-specific and the symptoms atypical. In the present series, double contrast arthrography was performed in 100 cases of suspected internal derangement of the knee. Abnormal radiological findings were recorded in 31 cases. Confirmation of the diagnosis was available in 17 out of 21 patients, subjected to surgery, giving a pre-operative diagnostic accuracy of 81%. This figure could be improved with experience and can be further enhanced, if used in conjunction with arthroscopy.

Humans↗
PubMed1979

[Double-contrast arthrography in chondropathia patellae--clinical and experimental study on pathogenesis and diagnosis (author's transl)].

This study is based on the evaluation of 250 arthrographies of the patellofemoral joint ("défilé" arthrographs in Ficat's terminology) which were performed because of clinical suspicion of chondropathia patellae and which could be controlled intraoperatively in 30 cases, as well as on examinations employing an etching paste as used in metallurgy and performed on 20 knee-joints of corpses. 46% of the arthrographies showed a ridge-shaped cartilaginous thickening which was not pre-modelled in the osseous structure and which separated the medial facette into a paramedian and a marginal segment and correlated with chondromalacia to a greater degree than patellar dysplasias or secondary osseous changes. This variant, which could not be detected by plain roentgenography, must be considered as a pre-arthrotic deformity on account of the high point-shaped pressure load on the ridge. The findings were fully confirmed by macroscopic examination of the postmortem material.

Adolescent↗