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PubMed2005

MR arthrography of rotator interval, long head of the biceps brachii, and biceps pulley of the shoulder.

The rotator interval and the long head of the biceps brachii tendon are anatomically closely associated structures believed to confer stability to the shoulder joint. Abnormalities of the rotator interval may be acquired or congenital and are associated with instability of the long head of the biceps brachii tendon. Clinical and arthroscopic diagnoses of rotator interval abnormalities and subtle instability patterns of the long head of the biceps brachii tendon are difficult. Magnetic resonance arthrography, owing to its superior depiction of ligaments with distention of the joint capsule, may be the procedure of choice, barring open surgery, for help in diagnosis of these conditions.

Arthrography↗
PubMed1983

Arthrography of the cervical facet joints.

Arthrography was performed during steroid injection in 14 patients (22 joints) with noninflammatory conditions of the cervical facet joints. Two isolated spines were also studied. The capsular recesses were found to be quite large, especially near the intervertebral foramen. Though the appearance of the arthrogram was not clinically useful, it was helpful in positioning the needle for the steroid injection and confirming that the joint in question was abnormal. Distension of the capsule provoked pain in about 50% of cases; rupture of the distended capsule was rare but could account for leakage into the epidural space or foramen. Nine patients had significant relief of pain for three days to thirteen months.

Adult↗
PubMed1986

Oblique head position in temporomandibular joint arthrography.

Thirteen patients were prospectively studied with arthrography to determine whether oblique head positions were helpful in diagnosing internal derangement of the temporomandibular joint (TMJ). After injection of contrast material, inclined transcranial lateral spot films were obtained with the patient's head in upward oblique, downward oblique, and neutral positions. The spot films were analyzed for internal derangement by assessing the size of the mass effect on the arthrogram. Twelve of the 13 arthrograms showed evidence of internal derangement of the TMJ. However, the apparent size of the mass effect varied in different head positions. Each of the three views failed to demonstrate the mass effect in at least one instance (eight different patients). No head position was better than another in demonstrating the mass effect. Thus, oblique head positions are useful adjuncts for diagnosing internal derangement of the TMJ.

Arthrography↗
PubMed1986

Elbow joint: assessment with double-contrast CT arthrography.

The elbow joint was evaluated by means of computed tomography (CT) immediately following double-contrast arthrography. Normal baseline anatomy and representative abnormal studies are illustrated. Intraarticular abnormalities, such as osteocartilaginous bodies, hyperplastic synovium, fracture fragments, and osteophytes, were identified and precisely located on postarthrography CT scans. This technique, which enabled such abnormalities to be seen, has provided an anatomic and mechanical basis for seemingly idiopathic instances of limited elbow motion.

Adolescent↗
PubMed1986

Knee arthrography: effects of various contrast media and epinephrine on synovial fluid.

Changes in synovial fluid leukocytes, total protein, and total complement were studied in 58 patients after they underwent single contrast material-enhanced knee arthrography with ionic (sodium iothalamate, sodium meglumine diatrizoate, meglumine iothalamate) and nonionic (iopamidol, iohexol) contrast media. In 30 of 58 cases, 0.3 mg epinephrine was also injected. In patients examined without epinephrine, a significant increase in the number of leukocytes was observed when sodium iothalamate and sodium meglumine diatrizoate were used. When administered with epinephrine all ionic compounds produced significant leukocytosis; articular reactions were most evident in patients examined with sodium salts. No inflammatory changes in the synovial fluid were observed when nonionic compounds were used. These data suggest that sodium-containing compounds produce a greater reaction in the joint compared with other contrast media, nonionic compounds are better tolerated by the joint, and epinephrine increases the articular reaction to ionic contrast media.

Adolescent↗
PubMed2001

MR arthrography of the glenohumeral joint: two concentrations of gadoteridol versus Ringer solution as the intraarticular contrast material.

PURPOSE: To compare two concentrations of gadoteridol with Ringer solution as the contrast material for magnetic resonance (MR) arthrography of the glenohumeral joint. MATERIALS AND METHODS: One hundred fifty-six consecutive MR arthrograms were randomly obtained with either 2 mmol/L gadoteridol (n = 52), 4 mmol/L gadoteridol (n = 52), or Ringer solution (n = 52). MR arthrograms were assessed quantitatively (for contrast-to-noise ratio [CNR]) and qualitatively (for overall image quality, image contrast, degree of joint distention, and motion artifacts). MR diagnoses were compared with arthroscopic or surgical reports in 88 patients. RESULTS: The mean CNR at imaging was 40.4 with 2 mmol/L gadoteridol, 45.6 with 4 mmol/L gadoteridol, and 48.7 with Ringer solution. The CNR with 2 mmol/L gadoteridol was significantly lower than that with 4 mmol/L gadoteridol (P =.025) and Ringer solution (P =.012). Qualitative differences between the two gadoteridol concentrations were not significant. Ringer solution was significantly worse with regard to overall quality, motion artifacts, image contrast, and joint distention compared with both gadoteridol concentrations. Ringer solution was slightly more sensitive and less specific than the gadoteridol solutions in the detection of supraspinatus tears and less sensitive and more specific in enabling diagnosis of superior labrum anteroposterior lesions. CONCLUSION: MR arthrograms of the shoulder obtained with gadoteridol and those obtained with Ringer solution provided equivalent diagnostic accuracy. The authors, however, preferred the image quality of the gadoteridol-enhanced arthrograms.

Adolescent↗
PubMed1991

The place of arthrography in the diagnosis and management of meniscal injuries--a 6-year review.

Four hundred and eighty-seven consecutive knee arthrograms, performed over a 6-year period, are reviewed. Their accuracy is compared with arthroscopy and, where appropriate, with arthrotomy. The increasing accuracy of arthrography has resulted in the acceptance of this method of imaging as a useful and accurate means of examining meniscal injuries in the knee. This has led to far fewer surgical procedures and an overall saving of resources.

Adult↗
PubMedDate not supplied

Joint fluid after aspiration. A disturbing factor in knee arthrography.

The amount of fluid in the knee after aspirating any effusion was investigated and averaged 6.8 ml, being independent of the presence of a lesion. Because it causes dilution of the contrast medium, it is suggested that small amounts of a relatively high-concentrated non-ionic contrast agent should be preferred for double-contrast knee arthrography.

Adolescent↗
PubMedDate not supplied

Capsular elongation in shoulders with recurrent anterior dislocation. Quantitative assessment with magnetic resonance arthrography.

BACKGROUND: Elongation of the shoulder capsule is often noticed on arthrograms or during surgery in shoulders of patients who have experienced recurrent anterior dislocations. HYPOTHESIS: We can quantify the elongation of the capsule in shoulders with recurrent anterior dislocations by using magnetic resonance arthrography. STUDY DESIGN: Retrospective review of prospectively collected data. METHODS: Twelve patients with unilateral recurrent anterior shoulder dislocations were enrolled in this study. Magnetic resonance images in the axial and coronal oblique planes were obtained from both shoulders (involved and uninvolved sides) after 10 ml of gadolinium/saline solution was injected into the glenohumeral joint. The length of the anteroinferior, inferior, and posteroinferior portions of the capsule was measured by using image analyzing software and normalized to the humeral head diameter. RESULTS: The anteroinferior capsule was significantly elongated in the involved shoulder at 4 mm (16% elongation) and 10 mm (19% elongation) superior to the inferior margin of the glenoid. The inferior capsule was also significantly elongated in the involved side both at the center (12% elongation) and at 4 mm anterior to the center of the glenoid (29% elongation). The posteroinferior capsule did not show any significant elongation. CONCLUSIONS: The anteroinferior and inferior portions of the shoulder capsule are elongated an average of 19% in shoulders with recurrent anterior dislocation.

Adolescent↗
PubMedDate not supplied

Noninvasive diagnosis of cruciate ligament damage with particular reference to computed tomography with arthrography.

Computed tomography (CT) with arthrography, a method not requiring anesthesia, has worked well in cruciate ligament damage diagnosis, particularly in the detection of PCL damage and in differentiation between ACL and PCL lesions. Evidence has been produced of its superior accuracy by comparison, in the study of 40 patients, among clinical findings, findings obtained from initial radiography, and diagnostic data produced by CT alone. Reference is also made to false interpretations in the context of clinical examination and CT.

Adolescent↗
PubMed1986

Contrast media in double-contrast arthrography of the knee: a comparison of ioxaglate and iothalamate preparations.

Hexabrix (sodium and meglumine ioxaglate) is a satisfactory medium for use in double-contrast knee arthrography. It shows no advantage over the ionic medium, meglumine iothalamate, in the quality of the immediate films, but it produces significantly better coating of the meniscus in delayed films and better results in knees which have an effusion. These advantages are to some extent counteracted by the fact that Hexabrix causes more pain or discomfort after the examination than meglumine iothalamate.

Adolescent↗
PubMed1989

Demonstration of osteochondritis dissecans of the talus by coronal computed tomographic arthrography.

Ten cases of osteochondritis dissecans of the talus are reviewed. Coronal computed tomographic arthrography identified the precise location in each case and consistently revealed the extent of the lesion to be greater than that apparent on the plain radiographs. The talar cartilage over the lesion was shown to be thinned in four cases, deficient in two, and fissuring of the cartilage was demonstrated in four. Subarticular cysts were identified in all but two cases and contrast medium was shown to enter the cysts in two cases indicating a communication with the ankle joint. The aetiology and relevance of these findings to treatment are discussed.

Adult↗
PubMed1994

Prone oblique positioning for computed tomographic arthrography of the shoulder.

Computed tomographic arthrography (CTA) of the shoulder is currently the best investigation of the unstable shoulder. 47 patients had CTA in the prone oblique position to assess its ability to demonstrate both anterior and posterior capsular mechanisms simultaneously. The first five patients were also scanned supine oblique to allow direct comparison with the prone oblique position. All studies were reviewed retrospectively by three musculoskeletal radiologists with regard to how well the relevant structures were demonstrated. In the prone oblique position, the anterior capsule was well shown in 98%, anterior labrum 98%, posterior capsule 91%, posterior labrum 89%, subscapularis tendon 98%, biceps tendon 100% and biceps tendon proximal insertion 78%. In 86% of cases both anterior and posterior structures were well seen simultaneously. In the five cases that also had supine imaging the prone oblique images were superior. The cause of poor demonstration of structures was invariably insufficient intraarticular air. It is concluded that the prone oblique is an excellent technique for CTA of the shoulder and should become the standard position for assessing shoulder instability.

Adolescent↗
PubMed1994

A comparison of a conventional non-ionic contrast medium (iohexol) alone and with adrenaline and an iso-osmolar non-ionic contrast medium (iotrolan) in computed tomographic arthrography of the shoulder.

The physico-chemical properties of the iso-osmolar dimeric contrast medium iotrolan offers potential advantages in computed tomographic arthrography (CTA). A trial was undertaken comparing iotrolan with iohexol to assess if these theoretical benefits produced an increase in the measured densities in a series of shoulder CTAs. The results showed that iotrolan did produce clinically useful increases in density when compared to a monomeric non-ionic contrast medium. The addition of adrenaline to the monomeric contrast medium produced a significant improvement in the computed tomography density which surpassed that offered by the dimeric contrast medium alone.

Arthrography↗
PubMed1986

Arthrography of the shoulder after operative repair of the torn rotator cuff.

Double-contrast shoulder arthrograms were performed in 20 patients at an average of 30 months after operative repair of a torn rotator cuff. In 18 out of 20 shoulders the contrast medium leaked into the subacromial bursa indicating a defect in the rotator cuff. Despite this, 17 patients had complete relief of pain and 15 had a full range of shoulder elevation. The results suggest that a completely watertight closure is not essential for a good functional result, and that arthrography may not be helpful in the investigation of failure of repair.

Adult↗
PubMed1989

Arthrography of early Perthes' disease. Swelling of the ligamentum teres as a cause of subluxation.

Hip arthrography was performed in 19 patients in the initial stage of Perthes' disease. Sphericity and subluxation were measured and it was found that subluxation was independent of the femoral head deformity. We therefore tried to identify the cause of early subluxation: in seven patients a swollen ligamentum teres was thought to be responsible, and was associated with medial pooling of the contrast medium. A swollen ligamentum teres was seen in another seven cases; the other five arthrograms were normal. These findings were further clarified by enhanced CT scans, which confirmed that ligament swelling may be an important cause of early subluxation.

Arthrography↗
PubMed1999

Subperiosteal ganglion cyst of the tibia. A communication with the knee demonstrated by delayed arthrography.

We report a patient with a subperiosteal ganglion cyst of the tibia which was imaged by radiography, arthrography, CT and MRI. The images were correlated with the arthroscopic surgical and histological findings. Spiculated formation of periosteal new bone on plain radiographs led to the initial suspicion of a malignant tumour. Demonstration of the cystic nature of the tumour using cross-sectional imaging was important for the precise diagnosis. Communication between the ganglion cyst and the knee was shown by a delayed arthrographic technique, and the presence of this communication was confirmed at arthroscopy and surgically.

Arthrography↗
PubMed2000

Magnetic resonance arthrography of the acetabular labrum. Macroscopic and histological correlation in 20 cadavers.

We studied the sensitivity and specificity of magnetic resonance arthrography (MRa) for the diagnosis of lesions of the acetabular labrum in 20 cadaver hips. The MRa results were compared with macroscopic and histological findings. We found that the labrum could be satisfactorily delineated by MRa and that large detachments could be identified satisfactorily. The diagnosis of small detachments and degeneration of the labrum was less reliable.

Acetabulum↗