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At least 1,171 records · Page 65Linked to original sources
PubMed1983

Tuberculous arthritis of the shoulder: delayed diagnosis aided by arthrography.

Tuberculous arthritis of the shoulder was not diagnosed in an 80-year-old man with Addison's disease until the appearance of a draining abscess in his arm. Initially signs, symptoms, x-rays and laboratory studies were consistent with calcific tendonitis and degenerative arthritis. Then an arthrogram demonstrated a connection between the shoulder joint and the abscess. A high level of suspicion for tuberculous arthritis should be maintained in an elderly patient whose past medical history is suspicious for tuberculosis and whose articular complaints are chronic.

Abscess↗
PubMed1997

Contrast media in MR arthrography of the glenohumeral joint: intra-articular gadopentetate vs saline: preliminary results.

The purpose of this investigation was to compare gadopentetate and saline as contrast media in MR arthrograms of the glenohumeral joint. In 60 consecutive patients MR arthrograms with either gadopentetate (n = 26) or saline (n = 34) were performed. After injection of gadopentate, 3D gradient-echo (GE) images were obtained (TR 32 ms, TE 10 ms, flip angle 40 degrees). With saline, double-echo steady-state images (heavily T2-weighted 3D GE images) were obtained (TR 40 ms, TE 9/45 ms, flip angle 40 degrees). In the last 14 of these patients T2-weighted turbo spin-echo (SE) images were added (TR 2900 ms, TE 96 ms). Contrast-to-noise ratios standardized for imaging times proved to be superior for the gadolinium arthrograms compared with GE and SE saline arthrograms (intra-articular fluid vs subacromial fat: p = 0.0001 and 0.0008; intra-articular fluid vs supraspinatus tendon: p = 0.0001 and 0.046). Using a qualitative scoring system gadolinium arthrograms were superior to saline arthrograms (p < 0.0001 and p < 0.0001). Saline arthrograms in combination with GE and SE sequences are inferior to gadopentetate arthrograms with GE sequences.

Adolescent↗
PubMed2006

MR arthrography of traumatic anterior shoulder lesions showed modest reproducibility and accuracy when evaluated under clinical circumstances.

INTRODUCTION: We examined the reproducibility and accuracy of high-field MRA in traumatic anterior shoulder instability under conditions resembling clinical practice and assessed the influence of observer experience. MATERIALS AND METHODS: Two radiologists with different experience levels evaluated 61 MRAs. Assessment was independent, blinded and non-sequential. For 40 MRAs, surgical reports were available to assess diagnosis accuracy and influence of observer experience. The assessed lesions were cuff lesions, Hill-Sachs lesions, bony and classic Bankart lesions, greater humeral tuberosity fractures, SLAP lesions and joint capsule lesions. Reproducibility was quantified using kappa coefficients. Accuracy was evaluated with sensitivity and specificity rates, positive and negative predictive values. Differences in the percentage of correctly diagnosed MRAs between the radiologists were tested using McNemar's test for paired proportions. RESULTS: Inter-observer k-values ranged from 0.03 for joint capsule lesions to 0.45 for humeral head lesions. The overall kappa was 0.21 (95% CI; 0.12-0.30). We also observed markedly lower sensitivity and specificity rates than those reported in the literature for most lesions. The more experienced radiologist correctly diagnosed 78.9% of all lesions compared to 65.4% for the less experienced radiologist (P < 0.001; McNemar's test). CONCLUSION: MRA-interpretations of traumatic anterior shoulder instability should be regarded with caution in clinical practice. The experience level of radiologists can affect reproducibility and accuracy.

Adolescent↗
PubMed1975

Wrist arthrography: review and comparison of normals, rheumatoid arthritis and gout patients.

Bilateral wrist arthrograms performed on a randomly selected population of 100 adult males revealed an unexpected high prevalence of communications among the three wrist compartments. These findings warrant reassessment of wrist arthrographic criteris for synovial involvement of rheumatoid arthritis. Midcarpal joint extension correlated with increasing age and occupational trauma, suggesting a degenerative or "wear and tear" mechanism in the breakdown of the delicate interosseous intercarpal ligaments. Such extension was also found to a greater than expected frequency in gout. Radioulnar joint extension correlated with acute trauma secondary to wrist sprains or fractures, presumably through tears in the tough triangular fibrocartilage. Such extension was also found to a greater than expected frequency in RA. While midcarpal extension and inferior radioulnar extension correlate with gout and RA, respectively, their occurrence in a random adult male population is so frequent (as is three compartment communication) as to obviate their diagnostic value. However, synovial corrugation and lymphatic visualization were seen only in the wrists of patients with diagnosed inflammatory arthritic conditions and may have potential diagnostic significance. Selected anthropometric variables were analyzed by age in this randomly selected adult male population and compared with the gouty and RA patient groups. Significant continuously decreasing grip strength and hand mineralization occurred with age, which was opposite to the trend for osteoarthrosis. The hematocrit, erythrocyte sedimentation rate, and serum uric acid were impressively stable until the ninth or older decades, at which time a significant increase in sedimentation rate and decrease in hematocrit were found.

Adult↗
PubMed1981

Arthrography of the metacarpo-scaphoid joint following excision of the trapezium.

Arthrograms were performed on twenty-five metacarpo-scaphoid joints following excision of the trapezium. The joint space was initially irregular and of small capacity within six months of surgery, but became larger and smoother in time. Sometimes the joint space communicated directly with the midcarpal joint or the extensor pollicis longus strength. The arthrographic appearance did not provide an indication as to the clinical outcome, but marked subluxation of the first metacarpal on the scaphoid during abduction correlated with a less successful outcome.

Aged↗
PubMed1983

Arthrography of the wrist.

Eighty-four wrist arthrograms were performed on 76 patients with posttraumatic wrist pain. Instillation of a small amount of contrast media into the radiocarpal joint under fluoroscopic control was helpful in delineating specific areas of pathology about the wrist. Comparison of the arthrographic findings with the plane films of 74 patients and the operative findings of 24 patients revealed that the arthrogram was most helpful in delineating perforations of the scapholunate ligament, the lunotriquetral ligament, the triangular fibrocartilage complex, and the wrist joint capsule.

Adolescent↗
PubMed1982

[The value of positive arthrography in the diagnosis and pathogenesis of retrofemoral Baker's cysts (author's transl)].

Retrofemoral Baker's cysts are occasionally found in athletes; they occur as a result of a rupture in the dorsal part of the bursa semimembranosa gastrocnemia. The rupture itself may occur if there is increased pressure in joints or a considerable increase in the amount of synovial fluid. Ruptures can also occur if the joint wall is inadequately adapted and the synovial fluid fails to flow into the ventral joint spaces, as is possible due to certain movements in some sports. Active movement delays healing of the rupture of the capsule: the para-articular structures become encapsulated or, respectively, adhere to one another. Depending on the duration of the effusion and the amount of fluid, the pseudocyst may become pencil-shaped, spherical, cylindrical or rhomboid. It is, therefore, a traumatic pseudocyst, which occurs as a result of insufficient adaptation, principally in athletes of individuals whose occupation involves typical stresses on the knee joint.

Adult↗
PubMed1980

[Discrepancy between arthrography and arthrotomy with posterior lesions of the medial meniscus (author's transl)].

In 102 cases with arthrographic proven lesion of the medial meniscus clinical, radiological and operative results were correlated. In 10% the lesion could not be found by arthrotomy. These were all cases with lesions in the posterior part of the meniscus, mostly at the basis. It must be assumed, that the posterior portion of the medial meniscus cannot be judged completely by arthrotomy, especially if a ventral approach is used.

Adolescent↗