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PubMed1985

Computer-processed subtraction arthrography.

We describe a film subtraction method using computer processing. The computer processed subtraction arthrograms in 16 cases were compared with conventional photographic subtraction. Although the computer reduced image resolution, it presented significant advantages over photographic film subtraction, including faster access to subtraction, optimal superimposition of mask and postinjection films by the radiologists, reduction of artifacts, and time saved.

Arthrography↗
PubMed1987

Knee arthrography: a comparison of iohexol, ioxaglate sodium meglumine, and metrizoate.

The arthrographic image quality and relative morbidity resulting from use of Omnipaque 300 (iohexol), Hexabrix 320 (ioxaglate sodium meglumine), and Isopaque Coronar 370 (metrizoate) were compared in a prospective double-blind study performed with 120 patients. Radiographs obtained 2, 5, 10, 15, 20, and 25 minutes after injection were judged for diagnostic quality. Relative morbidity was evaluated by the physician during the examination and later by the patient via a questionnaire. Hexabrix demonstrated the best and most persistent diagnostic quality over serial radiographs (P less than .05). Omnipaque caused significantly less postprocedural pain (P less than .05). The other types of discomfort measured did not indicate statistically significant differences in morbidity resulting from the three contrast agents.

Adolescent↗
PubMed1988

Knee arthrography.

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Arthrography↗
PubMed1989

Facet joint arthrography in lumbar spondylolysis: anatomic basis for spread of contrast medium.

Facet arthrograms in patients with lumbar spondylolyses show spread of contrast medium through pars interarticularis defects into the adjacent ipsilateral facet joint space and across the midline into the contralateral joint space. Transverse and sagittal sections of facet joints from 141 postmortem lumbar spines were studied. Five examples of spondylolysis were found. Anatomic studies of the relationship of the joint recesses to the pars interarticularis demonstrated the basis for the patterns of spread of contrast medium observed radiographically in this and previous series. The pars interarticularis forms the only boundary between the inferior recess of one facet joint and the superior recess of the adjacent joint. Fracture through the pars interarticularis establishes communication between adjacent ipsilateral joints and opens a communication to the retrodural space, through which contrast medium can track to the contralateral joint.

Arthrography↗
PubMedDate not supplied

Preoperative evaluation of the ulnar collateral ligament by magnetic resonance imaging and computed tomography arthrography. Evaluation in 25 baseball players with surgical confirmation.

A prospective study was completed on 25 baseball players with medial side elbow pain. They were evaluated preoperatively with both computed tomography arthrogram and magnetic resonance imaging examinations of the elbow to assess the ulnar collateral ligament. At surgery, 16 of 25 patients had an abnormal ulnar collateral ligament and 9 patients had a normal ulnar collateral ligament. The computed tomography arthrogram detected abnormalities in 12 of the 14 patients with ulnar collateral ligament tearing (sensitivity, 86%). The magnetic resonance imaging scan indicated abnormalities in 8 of 14 patients (sensitivity, 57%). The specificity of the computed tomography arthrogram was 91% and the magnetic resonance imaging was 100%. A newly described "T-sign" was seen on the computed tomography arthrogram in the patients with an undersurface tear of the ulnar collateral ligament. This represented the dye leaking around the detachment of the ulnar collateral ligament from its bony insertion but remaining contained within the intact superficial layer of the ulnar collateral ligament and capsule. Both the computed tomography arthrogram and the magnetic resonance imaging scan were accurate in diagnosing a complete tear of the ulnar collateral ligament preoperatively in all cases. The main advantage of the computed tomography arthrogram was in evaluating the partial undersurface tear.

Adolescent↗
PubMed1995

Temporomandibular joint disc position in arthrography. A descriptive analysis of the observer performance.

OBJECTIVES: To explore the relationship between the use of diagnostic cues and observer performance in the diagnosis of the temporomandibular joint (TMJ) disc position. METHODS: Thirty arthrographic examinations using fluoroscopy alone and combined with either transcranial radiography or tomography were selected. Seven observers assessed the examinations with the aid of reference images and written diagnostic cues for three disc diagnoses. After one month three of the observers repeated the assessments and noted how they applied the diagnostic cues. Later, they made a consensus report on how the cues were applied to each joint. RESULTS: The seven observers agreed unanimously with the reference diagnosis by fluoroscopy alone in 11 joints and in 14 when supplemented with transcranial radiography or tomography. Seven joints were given three different diagnoses by the seven observers when fluoroscopy was used alone and five when supplemented with transcranial radiography or tomography. The cues were applied with confidence in those joints where the observers were unanimous but in those with three different diagnoses, the anatomical features described in the cues were difficult to identify or the findings were ambiguous as they did not match the cues. CONCLUSIONS: It appears difficult to define radiographic cues applicable to all TMJ disc positions.

Arthrography↗
PubMed1986

Negative bone scans of joints after aspiration or arthrography: experimental studies.

It has long been suspected anecdotally that needle aspiration or contrast arthrogram before bone scan may cause a false-positive bone scan. This dictum often directs the sequence of events in the clinical workup of joint disease, yet data to support or refute this are lacking. This study was undertaken to generate such data. Fifty-six joints in mature dogs were examined, including hips, knees, elbows, and shoulders. The joints were examined in pairs; one joint was injected with Conray 60 for an arthrogram, and the contralateral joint was injected with an equal volume of normal saline to simulate a joint aspiration. Confirmation of needle placement and injection into the joints was made with fluoroscopic and digital subtraction imaging. Numbers of attempts required for aspiration and quantity of contrast material extravasated were noted for each joint. Baseline 99mTc-HDP or 99mTc-MDP bone scans were done before the experimental joint aspirations, with follow-up scans at 24 and 96 hr. The scans showed no significant change from baseline after either needle aspiration or arthrogram. When the diagnostic workup suggests the need for such a procedure, it should be performed. In contradiction to popular belief, joint aspiration and/or arthrogram did not affect a subsequent bone scan.

Animals↗