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PubMed1983

Medicine or meddling? use of arthrography in rheumatology.

In the wardrobe of diagnostic procedures for the arthritic patient, the arthrogram is like a tuxedo. It produces striking images in black-and-white, it can be slightly uncomfortable, and there are times when it can be just the right thing. However, like the tuxedo, the arthrogram should be reserved for infrequent special occasions. Although arthrography can show changes which are characteristic of arthritis, it can seldom differentiate one type of synovitis from another. It may be useful to determine whether or not a synovial disorder is present, but this will not be necessary for the great majority of patients. Its most important uses are in the evaluation of masses in and around joints, and of the pseudothrombophlebitis syndrome. In selected cases, it may help to elucidate the stage and mechanism of disease.

Arthritis↗
PubMed1984

Evaluation of analytical grade of metrizamide for canine stifle arthrography.

The use of analytical grade of metrizamide as contrast material in canine stifle arthrography was evaluated in 27 stifle joints. A concentration of 280 mg of I/100 ml was prepared, and the material was injected at a rate of 0.3 ml/cm thickness of the lateral to medial measurement. Acceptable arthrograms were produced in 22 (81.5%) cases. The mediolateral radiographic view was useful in demonstrating the cranial and caudal cruciate ligaments, the infrapatellar fat pad, and the tendon of the long digital extensor muscle. The caudocranial radiographic view was useful in demonstrating the medial and lateral menisci, the articular surfaces of the femoral condyles, and the outline of the joint capsule. Radiographs made within 15 minutes after injection of the contrast medium were acceptable, thus setting this period as the limit for obtaining useful arthrograms. The double contrast technique was found to be of little value.

Animals↗
PubMedDate not supplied

[Lesions of the rotator cuff and acromioclavicular joint. Data of arthrography. Apropos of 2 cases].

Arthrography using an opaque medium to explore the shoulder in two cases demonstrated rupture of the rotator muscles sheath associated with a communication into the acromioclavicular joint. Rupture of the sheath allows direct contact between the humeral head and the capsule of the acromioclavicular joint which becomes eroded progressively. Recent studies have produced data indicating participation of the acromioclavicular joint in the natural history of deteriation of the sheath of the rotator muscles.

Acromioclavicular Joint↗
PubMed1984

[Arthrography in pathology of the hip in older children].

Arthrography of the hip was performed in outpatients on 25 children aged 5 to 14 years, using a supra-trochanteric latero-external puncture approach. Data obtained supplied anatomical details indispensable for the decision to operate or not, particularly in certain congenital dislocations or in Legg-Perthes-Calvé disease. The examination findings were useful not only for analyzing articular cartilages, limbus and chondro-articular surfaces in abduction and adduction but also for evaluating anteversion of bony and cartilaginous acetabula using an axial projection. The scanner provides comparable data with respect to the latter feature, but access is still more difficult.

Adolescent↗
PubMed1983

The clicking painful temporomandibular joint. Use of arthrography in diagnosis.

Why does the clicking temporomandibular joint not lock, and the locked joint not click. Why is either of these conditions painful? Improved temporomandibular joint arthrography is able to delineate the problem and to direct surgical intervention appropriately, rather than toward the empirical remedies of the recent past.

Humans↗
PubMed1984

Arthrography (plica views). A noninvasive method for diagnosis and prognosis of plica syndrome.

In 45 patients with chronic knee problems arthrograms of the knee were obtained with emphasis on plica views. Thirty arthrograms showed radiographic evidence of plica syndrome. Three patients had thin bands in the proximal part of the suprapatellar pouch. Four patients had infrapatellar plicae. Eighteen patients had suprapatellar plicae, and five had mediopatellar plicae. The cross-table lateral view of the knee in different degrees of flexion is a valuable prognostic method. Five patients with suprapatellar plicae demonstrated excursion of the thick fibrotic band over the anteromedial femoral condyle during arthrography with the knee in different degrees of flexion. These patients did not respond to conservative treatment and required surgical excision of the plicae. Cross-table anteroposterior and tangential views with the medial side of the knee facing upward demonstrate impingement of the medial femoral condyle or the medial facet joint of the patella by the fibrotic mediopatellar plica. All patients (5 of 5) with mediopatellar plicae required surgical excision of the plicae.

Adolescent↗
PubMedDate not supplied

Wrist arthrography.

Wrist arthrography can be helpful in the evaluation of the chronically painful wrist and, more specifically, in visualization of the integrity of the triangular fibrocartilage and interosseous ligaments. To be meaningful, arthrographic findings, i.e., compartment communication, synovial irregularity, tendon sheath and lymphatic visualization, loose bodies, and cartilage abnormalities, must be correlated with clinical history and physical examination.

Arthritis, Rheumatoid↗
PubMed1978

Further pitfalls in knee arthrography.

Peripheral separations of the posterior medial meniscus, diagnosed at arthrography, may not be recognized at arthroscopy, arthrotomy or even upon examination of the resected specimen. Arthrographic recognition of an oblique buckethandle meniscal tear may be difficult when the visualized outer fragment maintains a triangular appearance. Articular cartilage defects, out of profile to the x-ray beam, may be suspected at fluoroscopy and confirmed by additional views. There is an icreased incidence of chondromalacia in symptomatic postmeniscectomy knees. Degenerative meniscal changes without arthrographically recognized discrete tears are common, particularly in older individuals. Localized lack of definition of meniscal surfaces may be the only arthrographic finding. Resected specimens invariably show surface irregularities to be more extensive than suggested radiologivally, and frequently there are unsuspected associated horizontal cleavage tears. The clinical implications of degenerated menisci are controversial. A variety of normal synovial folds can simulate the anterior cruciate ligament.

Fluoroscopy↗
PubMed1983

When is arthrography indicated in Legg-Calvé-Perthes disease?

We evaluated plain radiographs and arthrograms of twenty-one children with active Legg-Calvé-Perthes disease in order to determine the value of the arthrography. We found that when epiphyseal protrusion was shown by the arthrograms it could be seen on the plain radiographs as well in all patients. Also, an acetabulum-head index of less than 90 or an acetabulum-head quotient of less than 92 as determined on plain radiographs correlated well with a diagnosis of protrusion. Thus, an arthrogram is not necessary to make the diagnosis of protrusion in most patients. The arthrogram is more useful in delineating changes in the articular surface for prognoses concerning arthritis and in tailoring the treatment to the individual patient.

Child↗
PubMed1981

Internal derangements of the temporomandibular joint: correlation of arthrography with surgical findings.

The diagnosis of dysfunctional temporomandibular joint (TMJ) disorders unresponsive to nonsurgical treatments heretofore has often been empirical. With the development of TMJ arthrography, diagnosis has been greatly improved; an accurate picture of the condition of the joint now provides a substantial base on which to build a rational and reasonable treatment plan. Clinical symptoms can be accurately correlated with the radiographic picture, a valid surgical procedure can be performed because the joint condition is known, and a meaningful prognosis can be determined. Successful management, however, very often requires multifaceted treatment consisting not only of surgery but also of bite-plate, occlusal, restorative, and physical therapy, both preoperatively and postoperatively.

Cartilage, Articular↗
PubMed1982

[Arthrography in lesions of triangular fibrocartilage of the wrist (author's transl)].

Arthrography of the wrist is a safe method to demonstrate lesions of the triangular fibrocartilage. Indications are posttraumatic pain and restriction of movement of the wrist. Lesions of the triangular fibrocartilage are caused by a distal fracture of the radius with shortening, sudden drop on the overextended hand and work with rock drills. The extent of injury is quite different: small fissures and splits, detachment of the discus from the lower end of the ulna, fragmentation and destruction of the fibrocartilage. Problems of therapy, however, are greater than problems of diagnosis: actually there is no generally adopted surgical method for the treatment of discus lesions.

Carpal Bones↗
PubMed1982

[Arthrography as a diagnostic measure in injuries of ligament and capsule of the ankle joint (author's transl)].

The application of monocontrast arthrography in examining the ankle joint is demonstrated by means of an extensive series of examinations. It is evident that this method of examination is more reliable than x-ray films of the forced extreme joint position, especially in combined injuries of the ligamentous apparatus, so that it enables better planning of the necessary therapeutic procedure.

Adolescent↗
PubMed1982

Diagnosis of chondromalacia patellae using CT arthrography.

Using anatomical specimens for experimental investigations, the physical-technical prerequisites for proper demonstration of the femoro-patellar articulation were determined and the following results obtained: hyaline cartilage possesses an attenuation value of 25-35 HU; artificial lesions from 1 mm. deep and 2 mm. wide minimum can be visualized; the use of positive contrast medium is best suited for demonstration of chondral lesions. In clinical practice we found that the various stages of cartilaginous degeneration peculiar to chondromalacia (Fründ I to III) are clearly demonstrated by CT arthrography. In CT the predisposing changes in the morphology of the patella and the femoro-patellar articulation are more precisely defined than in conventional tangential roentgenograms. In 69 cases the CT arthrographic findings could be verified at operation. However, the extent and severity of the lesions was, at times, underestimated.

Adolescent↗
PubMed1980

Is double contrast arthrography of any value in lesions of the anterior cruciate ligament?

The clinical diagnosis of lesions of the anterior cruciate ligament may be difficult. It would be useful to have available an arthrographic method by means of which the clinical diagnosis could be confirmed. The results obtained with three different techniques using double contrast arthrography were studied in 150 cases, of which eighty-one were submitted to surgery. The anterior cruciate ligament was abnormal at operation in twenty-three of these eight-one cases. The level of accuracy using the technique described by Pavlov and Torg was approximately 85 per cent. Provided careful attention is paid to technical details, and the operator has some experience in the interpretation of arthrographic results, we would recommend this modification as being rapid, simple and free from risk.

Adolescent↗