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Arthrography for rheumatic disease. When, why, and for whom.

The primary rheumatologic indication for an aspiration/arthrogram is the diagnosis of a septic joint. A second indication is the evaluation of a patient who has monoarticular complaints and normal plain radiographs. A third indication in patients who have known arthritis is that the contrast study can be used to evaluate the extent of cartilage destruction, identify complications that exacerbate pain, and determine if a soft tissue mass near the joint is related to the arthritis.

Arthritis, Infectious↗

[Temporomandibular arthrography in 1990].

After a description of the normal anatomy of the temporomandibular joint, the technique of examination is reported, including: a) opacification of both lower and upper joint spaces, b) standard films with mouth open and closed, in the sagittal and coronal planes, and c) systematic video-fluoroscopy. The indications are diagnostic and sometimes therapeutic (loosening of adhesions, reduction of meniscal displacement). The authors describe the arthrographic appearance of the various abnormalities observed in a series of more than 600 arthrograms.

Adolescent↗

[Arthrography of recurrent dislocation of the TMJ--with special reference to the movement of the articular disk].

To investigate the movement of the articular disk in recurrent luxations, 4 temporomandibular joints in three patients were studied with the arthrotomographs. All the superior articular cavities were extended anteriorly. On the mouth open in two patients with recurrent subluxation, the mandibular head accompanied with the articular disk located very anterior position from the articular tubercle. At this time, the retro-discal pad were stretched, but the relation between mandibular head and articular disk were normal findings: the mandibular head located on the central thin part of the articular disk. One of them showed anterior disk displacement with reduction. The other patient showed the bone cavity at the anterior slope of the articular tubercle. On the mouth open, the mandibular head and posterior band fitted that cavity. The other hand, remaining one patient was recurrent luxation on the left side. On the mouth open, the relation between mandibular head and articular disk were abnormal findings: The mandibular head located very anterior position, over the articular tubercle and anterior band of the disk. Therefore, the inferior articular cavity was extended, but the retro-discal pad was not stretched. The anterior slope of the articular tubercle was steep. The other side TMJ of this patient was recurrent subluxation and anterior disk displacement with reduction. On the mouth open, it was showed the hypermobility of mandibular head. But the relation between mandibular head and articular disk were normal findings. As mentioned above, in luxation and subluxation, it was made obvious that there were tow types about the relation between mandibular head and articular disk on the mouth open: one type was that mandibular head located anteriorly to the anterior band of the disk, the other was under the disk.

Arthrography↗

[An evaluation of various methods for arthrography of the temporomandibular joint].

In 130 patients with temporomandibular joint dysfunctions several arthrographic techniques were applied, and their advantages and drawbacks pointed to. Indications to different joint contrasting techniques were established. Contrast arthrotomography combined with computerized tomography showed major diagnostic value in detection of internal joint disorders.

Adult↗

[Distention arthrography in the treatment of adhesive capsulitis of the shoulder].

Adhesive capsulitis of the shoulder is an idiopathic condition characterized clinically by pain and limitation of movement. The characteristic arthrographic features are those of limited capacity of the joint, pain during injection, and retracted recesses. Progressive distension of the capsule with 1% lidocaine and 40 mg of triamcinolone acetonide (Kenalog) is a recommended form of treatment for this condition. Twenty-five patients treated by this method were reviewed retrospectively. Eleven (44%) were completely relieved of their symptoms, 6 (24%) had a 50% improvement, and 8 (32%) had no relief. Patients with idiopathic adhesive capsulitis responded more favorably to the treatment than those with a traumatic etiology. The duration of symptoms had no correlation with the results of therapy. There were no complications from the treatment.

Adult↗