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PubMed1991

Early local experience of ankle arthrography and its influence on management of patients with ankle injury.

Ankle arthrography was performed on 64 patients with a history of ankle injury from 21 January 1986 to 11 October 1988. There was a male predominance in the ratio of 15 to 1 and the mean age of our patients was 22 years. A total of 65 arthrograms were obtained as one patient had bilateral ankle arthrograms. Of these, 29 arthrograms were normal. A year after completing this study, we attempted to retrieve our patients' case-notes and reviewed their subsequent management. Our results showed that multiple factors influenced the further management of our patients and arthrogram did play a role in this respect.

Adolescent↗
PubMed1990

[Value of contrast arthrography in the diagnosis of hemophilic arthropathy].

X-ray semiotics of changes in the roentgen-negative components of the knee joint at different stages of hemophilic arthropathy has been described basing on the study of 46 contrast arthrography ++ of the joint, and their correlation with the results of macroscopic and histological investigations of the tissues removed during surgery. Identification of the character of the damage in the soft-tissue and cartilage components of the joint is particularly important at the early stages of arthropathy, as it enables determining the optimum therapeutic tactics when the data of routine roentgenography give insufficient information, and changes in the bones are limited and, as a rule, reversible.

Adolescent↗
PubMed1990

[Experimental evaluation of iotrolan as an arthrographic contrast medium--knee arthrography with iotrolan in rabbits].

Authors evaluated the efficacy and tolerability of iotrolan, a nonionic dimeric contrast medium used for myelography, as an arthrographic contrast medium in comparison with meglumine/sodium diatrizoate and iopamidol in rabbit. Iotrolan (Isovist, 300 mgI/ml) was injected in one knee joint and diatrizoate (Urografin, 292 mgI/ml) or iopamidol (Iopamiron, 300 mgI/ml) in the other at a dose of 1.5 ml/knee. Knee arthrograms were taken 2, 5, 10, 20, 30, 45 and 60 min after injection. Contrast density was determined by measuring the transmission density in the supra-patellar bursa with an image analysis system. The anterior displacement of the patellar from the femur was measured as an indicator of hydrarthrosis. Contrast duration in the supra-patellar bursa was longer with iotrolan than with diatrizoate and iopamidol. Hydrarthrosis was less pronounced with iotrolan than with diatrizoate and iopamidol. These results suggest that iotrolan has the advantage over existing contrast media for arthrography with respect to the efficacy and tolerability.

Animals↗
PubMed1990

[Results of meniscus sutures in the framework of reconstruction in combined injuries of the knee joint: clinical aspects, arthrosonography, arthrography and computerized tomography].

In spite of encouraging experimental results of suturing menisci in the not-vascularised area, even today in most of these cases subtotal resection will be done. The results of meniscal reconstruction in 15 patients with a longitudinal tear of the degeneration area as consequence of a combined injury of the knee joint are discussed. Only one patient suffered a postoperative rerupture. The others did not show any signs of continuing tears of the menisci during a study period of 18.7 months. Whereas in arthrography only in a few cases superficial notches, sign for a physiological recessus, were found, CT-scan as well as arthrosonography showed in large degree of correspondence change of density in the region of suture, which can be interpreted as a process of scar transformation. Thus it is recommendable to use suture of meniscus next to stabilizing measurements of injured knee-joint, even in the zone of degeneration.

Adult↗
PubMed1990

[Double-contrast arthrography of the knee in traumatic capsular-ligamentous lesions. A critical review].

The authors conducted a statistical study and a critical review on a series of 1,300 patients examined with double-contrast fluoroscopically guided knee arthrography using a simple examination technique. Arthrographic diagnoses were subsequently compared with arthrotomic (500 patients), arthroscopic (350 patients), and clinical (450 patients) diagnoses. The critical review pointed out the high diagnostic accuracy (90%) and the good sensitivity (87%) of arthrographic examination in patients affected with pathologic conditions of the cruciate ligaments. In collateral ligament diseases and in capsular ruptures arthrographic sensitivity was not as high but still acceptable (74%). Capsular tears and medial collateral ligament tears can be identified when contrast medium is seen leaking from the knee joint. Cruciate ligament tears may be partial or complete: if a tear is partial the synovial surface of the cruciate ligament cannot be identified the cruciate ligament is wavy, lumpy, or focally thin, while in complete tears the synovial surface of the cruciate ligament cannot be identified either entirely or partially.

Arthrography↗
PubMed1990

Evaluation of the prognostic value of positive-contrast shoulder arthrography for bilateral osteochondrosis lesions in dogs.

To investigate whether arthrographic findings had any prognostic value with respect to treatment and outcome of bilateral osteochondrosis, shoulder arthrograms (n = 80) from 40 dogs with bilateral lesions were evaluated. Arthrography was performed, using 1.5 to 4 ml of a 25% solution of meglumine-sodium diatrizoate, with admixture of 0.2 mg of epinephrine. A shoulder with signs of pain and lameness was surgically treated. The contralateral shoulder was treated conservatively, and the final outcome was compared with the arthrographic findings. In 37 dogs, signs of lameness and pain were associated with a loose cartilage flap and, in 3, with a detached cartilage flap. In 2 dogs, admitted with bilateral lameness, a loose cartilage flap was detected in both shoulders. Of 12 dogs with a detectable loose cartilage flap in the contralateral shoulder joint, 6 became lame 2 to 4 months after initial surgical intervention and needed bilateral surgery. In the contralateral joint, development of thick articular cartilage over the subchondral defect or a detached cartilage flap lodged in the caudal pouch of the shoulder joint was a favorable prognostic sign. Such dogs had no signs of lameness on the contralateral side during a follow-up period that ranged from 1 to 7 years.

Animals↗
PubMed1989

Arthrography with iotrolan: double-blind comparison between nonionic, monomeric (iohexol 300) and nonionic, dimeric (iotrolan 300) contrast media.

Arthrography of the shoulder and knee joints is optimized by the new nonionic, dimer contrast medium iotrolan 300 in comparison to the nonionic, monomer iohexol 300. Detail recognition increases and is longer lasting. The contrast density remains good for more than 40 minutes, thus making repeated examinations due to diagnostic uncertainty superfluous.

Arthrography↗
PubMed1989

Posterior subtalar joint arthrography. A useful tool in the diagnosis of hindfoot disorders.

Obscure hindfoot disorders are often classified under the heading of sinus tarsi syndrome (STS). The diagnosis of STS is based upon subjective symptoms: tenderness over the lateral aperture of the sinus tarsi and hindfoot instability. Arthrography of the posterior subtalar joint is an objective parameter, identifying peri- or intraarticular pathology as the cause of symptoms. In 27 patients with STS, the pathologic arthrographic findings include less-marked microrecesses in the sinus tarsi region, ganglions at the anterior aspect of the subtalar joint, retraction of the joint recesses, a smooth and rounded appearance of the capsule, and a frozen subtalar joint. Through analysis of these films, the appropriate therapeutic approach can be outlined; infiltrations into the sinus tarsi itself, intraarticular corticosteroid injections, or subtalar arthrodesis for resistant cases are the procedures of choice. In the authors' experience, surgical curettage of the sinus tarsi has no place in the treatment of STS.

Adolescent↗
PubMed1989

Meniscal tears--comparison of arthrography, CT, and MRI.

A total of 1750 knees were prospectively evaluated using a high-resolution noninvasive axial computed tomography (CT) scanning technique. A total of 203 knees underwent subsequent arthroscopic or arthrographic evaluation. In this group, the sensitivity of CT for the detection of a torn meniscus was 88.5%; the specificity was 95.5%; and the accuracy was 91.5%. An additional 270 knees were prospectively evaluated by both CT and magnetic resonance imaging (MRI) to determine the ability of both techniques to characterize knee menisci in patients believed to have meniscal tears. Of these knees, 94 were subsequently examined by arthroscopy. In this group, the overall accuracy of MRI for detecting a torn meniscus was 89.5% and for CT it was 92.2%. Properly performed, both CT and MRI are accurate and effective methods for noninvasively evaluating meniscal abnormalities in the acutely injured knee. The protocol for CT and MRI meniscus imaging as well as interpretation are presented in addition to their relative roles with respect to arthrography and arthroscopy.

Arthrography↗
PubMed1988

Examination of the sprained ankle: anterior drawer test or arthrography?

The accuracy of the anterior drawer test for the diagnosis of recent lateral ligament tears in the ankle was evaluated in a series of 192 patients using surgical or arthrographic findings for reference. Considerable overlapping of results was obtained in ankles with and without ligament tear. Twenty-eight per cent of the anterior talofibular ligament tears, and 38% of the combined anterior talofibular and calcaneofibular tears were not detected, and single and combined tears could not be differentiated. It is concluded that the anterior drawer test is too unreliable as a basis for any decision regarding surgical treatment of a recent sprain. Therefore, arthrography is recommended as the method of choice in such cases of recent ankle sprain, where the need of surgery has to be supported by X-ray analysis.

Adolescent↗
PubMed1988

[Contrast arthrography of the temporomandibular joint].

Seventy-four temporomandibular arthrographic examinations, mostly involving paracentesis of the menisco-condylar compartment, provided the means for visualizing normal and pathologic aspects of both reducible and non-reducible meniscal dislocations, and of perforations. Findings included distension of the bilaminar zone and adhesions. Post modeling condyloplasty status was noted. At present, arthrography seems to be the most reliable test, as well as being the easiest to perform and the least expensive one for visualizing menisco-condylar abnormalities.

Adolescent↗
PubMed1988

Arthrography of the biceps tendon.

The purpose of this study was to analyse the factors having an influence on the arthrographic imaging of the biceps tendon. The study comprised 174 patients suffering from chronic shoulder pain. They underwent conventional shoulder arthrography with sodium meglumine metrizoate or metrizamide as a contrast medium. In the patients with a full-thickness tear of the rotator cuff, the biceps tendon sheath failed to fill with contrast medium more often than in those with an intact tendinous cuff. Metrizamide filled the biceps tendon sheath more readily than sodium meglumine metrizoate in patients with a full-thickness tear of the rotator cuff. The volume of the contrast medium injected had no influence on the imaging of the biceps tendon.

Arthrography↗
PubMed1988

[Significance of a transthoracic imaging technic in shoulder arthrography].

Even in this era of sonography, arthrography of the shoulder is an important diagnostic investigation, making it possible to exclude unrecognized connective tissue lesions in patients with chronic shoulder pain resistant to therapy. Sometimes standard X-ray techniques do not yield all the information the surgeon needs about ventral or dorsal localization of a rotator-cuff rupture. An additional approach to the joint is needed: a transthoracic lateral-view X-ray provides the surgeon with adequate information to help in selection of the most appropriate operative approach to the shoulder.

Arthrography↗
PubMed1986

Computerized tomography with routine arthrography in early evaluation of congenital hip dysplasia.

The earliest accurate assessment of the pathologic anatomy in congenital hip dysplasia allows for the most effective treatment and ultimate joint development. Computerized tomography has been suggested to better delineate bony orientation, size, and congruity; however, the inability of the routine CT scan to clearly depict cartilaginous structures has further confirmed the adequacy of the arthrogram alone in most patients. We present a technique employing computerized tomography following routine arthrography to more thoroughly assess the cartilaginous and soft tissue structures in the younger patient. Although certainly not indicated in all patients, this technique provides an effective diagnostic adjunct in select patients with complicated hip dysplasia early in the hip development.

Arthrography↗
PubMed1987

[Value of adrenaline in opaque arthrography of the knee. Comparative study of 100 cases].

A prospective study evaluated efficacy of adrenaline in image improvement of opaque arthrography of knee. Of the 100 cases assessed, adrenaline was combined with contrast medium in 50%. Quality of images was compared by double reading of couples of images taken at end of examination. Marked improvement was observed in 2 of 3 cases and it is proposed to use adrenaline routinely to prolong quality of initial arthrogram.

Arthrography↗
PubMedDate not supplied

[Posterior lumbar vertebral arthrography. Normal anatomic study].

Historical aspects and anatomophysiologic features of posterior lumbar vertebral joints are summarized and results of arthrography of 55 joints presented, together with a simple, original method for performing this examination. Normal anatomic appearances condition understanding of principal lesions encountered, particularly with respect to compression of adjacent nerve structures.

Arthrography↗