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PubMed1990

[Comparative arthrographic and echographic study of degenerative lesions of the rotator cuff of the shoulder].

Sonography is a simple technique which is currently employed in the study of rotator cuff lesions in the shoulder. A comparative US and arthrographic study was carried out on 52 patients with a "painful shoulder", to evaluate US yield in this pathologic condition. Arthrography was positive for a rotator cuff lesion in 31/52 cases (25 full-thickness and 6 incomplete lesions) and demonstrated associated conditions (capsulitis, chondral lesions, lesions of the long head of biceps, capsulo-ligamentous hypotonia, effusions) in 11 case. Arthrographic findings were negative in 10 cases. US demonstrated a lesion in 25/31 of positive arthrographic cases, and it was negative in 3/6 incomplete lesions. In 7/11 patients US yielded additional information as to associated conditions. US false-positives were 3/10, while in the extant 7/10 cases US was negative too. Thanks to its high sensitivity and specificity (80% and 70%, respectively, in our series), US appears as a valuable diagnostic complement to arthrography; the former may even replace the latter in those cases where conservative treatment is expected.

Adolescent↗
PubMed1989

[Lesions of the acetabular rim. Clinical manifestations, therapeutic strategies and perspectives].

Partial rupture of the acetabular rim have usually been described as accompanying traumatic or dysplasic dislocations of the hip. The five cases reported here are in favor of a specific pathology of this fibrocartilage as it is in the knee or the shoulder. Besides, the functional symptoms are not without reminding that of these two joints with sudden onset of cracks, jerks, blockings and even a real joint instability. The pain is never isolated, but may accompany other disorders. The cases were selected in order to evaluate the clinical manifestations and the therapeutic consequences of such a lesion according to the articular history. The diagnosis can only be confirmed with arthrography, which, in addition, permits to evaluate the size of the rim and the condition of the cartilage. The three patients who underwent surgery presented the lesions shown on arthrography. The problem lies in the possible arthrogenic potential of a tear, left in place because minimally disabling for the patient.

Acetabulum↗
PubMed1989

[Sciatica caused by a posterior articular cyst. Apropos of 8 cases].

The authors report 8 cases of sciatica secondary to a posterior articular cyst. They emphasize the clinical manifestations permitting to suspect this etiology of root compression, which, until now, was rather unusual. Computerized axial tomography makes the diagnosis possible along with posterior arthrography. This arthrography represents the first stage of the medical treatment by posterior joint infiltration of a steroid derivative. In 60 p. cent of the cases, a definite and persisting improvement permits to avoid a surgical procedure.

Aged↗
PubMed1989

[Arthrocele of the knee joint--a differential diagnosis to deep venous thrombosis].

The symptoms of a thrombosis in deep veins of the calf in patients with rheumatoid arthritis should have thought of the possibility of a synovial cyst or synovial cyst rupture. Because of their too small specificity clinical findings do not allow to decide for one of the two diagnosis. Phlebography and/or arthrography effect the clarification which is necessary for an effective therapy with low risk. Arthrosonography gets increasing importance instead of arthrography.

Arthritis, Rheumatoid↗
PubMed1986

The painful swollen calf. A comparative evaluation of four investigative techniques.

Complications of popliteal cysts may closely mimic the clinical features of a deep venous thrombosis. We assessed the sensitivity and specificity of the non-invasive procedures of radionuclide venography and popliteal space ultrasound examination compared with those of contrast venography and arthrography, respectively, and then prospectively studied 23 non-surgical patients with acutely painful, swollen calves to determine the utility of these techniques. The cause of this symptom was popliteal cyst complications in 10 patients, deep venous thrombosis in seven patients, and both conditions in two patients. Radionuclide venography was highly reliable and ultrasound examination was specific but only moderately sensitive in these studies. The painful, swollen calf may be investigated adequately in most cases by means of noninvasive invasive techniques; contrast venography and arthrography should be reserved for only a minority of patients.

Adult↗
PubMed1988

Sonographic evaluation of the rotator cuff. Accuracy in patients without prior surgery.

Since 1982 a sonographic technique has been devised to evaluate the integrity of the rotator cuff. In a series of 139 shoulders in 134 consecutive patients without prior surgery, sonographic results were correlated with surgical findings and/or arthrography. When sonography was compared with surgical findings (n = 90 shoulders), the overall accuracy was 95%. The sonographic diagnosis was the same as the arthrographic diagnosis in 91% of the cases (n = 50). Cuff lesions were also created in two cadavers, and images were made to confirm sonographic appearances. Because in the authors' experience sonography is accurate, safe, painless, rapid, and inexpensive, it has now been adopted as the primary study for the examination of the rotator cuff at the authors' institution. Arthrography is recommended in cases in which sonography is negative but there is significant clinical evidence of rotator cuff tear.

Arthrography↗
PubMed1988

[Proton spin tomography in the treatment of congenital hip dislocation].

In twelve patients with a congenital dislocation of the hip a comparative study was carried out with Magnetic Resonance Imaging and arthrography. MRI can provide accurate information about pathologic anatomic changes in and around a luxated hip in several planes. Until recently arthrography was considered as the imaging technique of choice when further precise information was required. However it is an invasive method which involves ionising radiation. Furthermore, tridimensional structures are transformed in two-dimensional structures and the contrast medium only outlines the bony and soft tissues, which contour the hip joint.

Arthrography↗
PubMed1987

[Ultrasonics of the shoulder. Diagnostic possibilities in lesions of the rotator cuff].

Twenty five healthy people and 25 patients with shoulder pain underwent US control over a 12-month period: 24 patients with shoulder pain had rotator cuff and/or biceps tendon lesions. The US findings on rotator cuff and biceps tendon lesions are compared with those of arthrography and/or surgery (96% sensitivity). US is rapid, safe, non invasive, inexpensive and often more accurate, and its use is recommended for the routine examination of the shoulder joint instead of arthrography.

Adolescent↗
PubMed1986

Stress examination of traumatized lateral ligaments of the ankle.

In the diagnostic analysis of acute injury to the lateral ankle ligaments, ankle arthrography and plain film stress examination play an important role. Inasmuch as the treatment of choice, whether conservative or surgery, and insofar as the therapeutic results may be determined by the extent of injury, it is important to have access to quantitative information on the functional properties of the involved ligaments at the time of the initial diagnostic studies. This can be obtained by measuring the strain on the anterior talofibular (tf) and calcaneofibular (cf) ligaments as a function of pressure applied to the distal tibia. Any device that ensures that the externally applied pressure is proportionally carried through to the ligaments can be used for this purpose. The results of 25 quantitative stress examinations using a Telos stress device are compared with arthrography findings and findings at surgery. Stress examination correlates well with both arthrographic and operative findings. The method is also useful for the evaluation of chronic ankle instability, follow-up examinations, and for the detection of vestiges of previous trauma of the contralateral ankle. The procedure is straightforward and noninvasive and can be performed within 15 minutes.

Adult↗
PubMedDate not supplied

Dynamic imaging of the wrist.

Dynamic imaging of the wrist can be performed through the use of fluoroscopy, arthrography, and arthrotomography. These methods of imaging have proved valuable in the diagnosis of many pathologic conditions of the wrist. Fluoroscopy has proved valuable as it captures the kinematics of the wrist. Arthrography utilizes contrast media to demonstrate anatomic structures not normally visualized on plain radiographs. Last, the technique of arthrotomography improves evaluation by helping to eliminate the problem of superimposition of structures within the wrist. Dynamic imaging of the wrist has proved to be a valuable tool in the diagnosis of chronic conditions of the wrist.

Adult↗
PubMed1995

Considerations about a unique clinical pattern: flexion block of the shoulder.

Frozen shoulder is a well-defined nosologic entity characterized by retraction of the anterior portion of the glenohumeral joint capsule. When clinical findings are inconclusive, arthrography can differentiate a frozen shoulder from a stiff and painful shoulder. We report three cases of stiffness of the shoulder that we believe was due to a unique pathological process. Flexion was restricted to 120 degrees and a sensation suggestive of mechanical blockage was felt upon passive flexion. Medical rotation was restricted and painful, whereas lateral rotation with the elbow held against the torso was normal. Findings upon arthrography or magnetic resonance imaging were normal, with no evidence of capsulitis or chronic rotator cuff lesions. Our pathogenic hypotheses include a lesion of the proximal portion of the long head of the biceps brachii or a focal ligamentous lesion. Treatment should consist of specific physical therapy and, in refractory forms, gentle mobilization under general anesthesia.

Adult↗
PubMed1994

[Isolated lesions of the subscapularis muscle. Apropos of 21 cases].

PURPOSE OF THE STUDY: The goal of this retrospective study is to describe the different anatomic lesions of the subscapularis and to precise the diagnostic value of the clinical and imaging tests. MATERIAL: Twenty-one cases of isolated tear of the subscapularis were operated on between 1989 and 1992. Affecting both sex, this lesion happens in younger patients than the rotator cuff tear concerning supra or infra-spinatus. The onset was most often traumatic but not specific. Four patients had no traumatic history. RESULTS: In 16 cases, the complaint was an unspecific chronic painful shoulder. The Jobe test was positive in 12 cases. The lift-off test was positive in 9 cases. Arthrography showed extravasation of dye into the subacromial bursa in 11 cases. Subscapularis lesion was suspected with the presence of dye spot on the lesser tuberosity on the A.P. view in external rotation (18 cases). Arthro-CT-scan was diagnostic in 12 cases, revealing dye spot touching the lesser tuberosity. At surgery, 3 types of lesions were found: complete ruptures or ruptures concerning the superior two-thirds of the tendon and letting intact the inferior muscular third (15 cases): partial superior lesions (5 cases) and a muscular tear of the inferior two-thirds. The long head of the biceps was dislocated in 5 cases, subluxated in 5 cases, ruptured in 3 cases and normal in 8 cases. DISCUSSION: The mechanisms of these lesions are probably different. The most common mechanism is traumatic but 4 patients had no traumatic injury. Degenerative changes of the tendon or subcoracoid impingement are also evocated. Arthrography permits a good screening but arthro-CT-scan is the most accurate to detect the lesion. Presence of dye touching the lesser tuberosity is a specific sign of the subscapularis lesion.

Adult↗
PubMedDate not supplied

[Normal and pathological aspects of the glenoid labrum in opaque arthro-scanner].

The morphology of the glenoid labrum was studied by CT arthrography in 88 patients. These were divided in 2 groups. In the first group, the patients underwent CT arthrography for a clinical instability of the shoulder. The second group was the reference group to study the morphology of the glenoid labrum, it included patients with rotator cuff tears or other pathology of the shoulder, without clinical instability. We described the normal labrum which presents important morphologic variations. Its study may be difficult because of the proximity of capsular structures of the shoulder, mainly the gleno-humeral ligaments. The normal variants and the pathologic aspects of the labrum were studied: the clefts, tears and degenerative phenomenous. The cleft aspect was studied comparatively in the instable population and in the reference population.

Arthrography↗
PubMed1994

Radiographic assessment of asymmetry of the mandible.

PURPOSE: To assess the relationship between mandibular asymmetry and disorders of the temporomandibular joint. METHODS: We used advanced imaging of the temporomandibular joint to distinguish different causes of mandibular asymmetry. MR imaging and arthrography were applied to the temporomandibular joints of 11 patients presenting with mandibular asymmetry. RESULTS: Condyle hyperplasia was identified as the cause of the asymmetry in 5 patients. In the other 6 patients the mandibular condyle was normal on the long side, but the short side of the face demonstrated a small condyle head, short condyle neck associated with disk displacement, internal derangement, and degenerative joint disease of the temporomandibular joint. CONCLUSIONS: These observations suggest that both condyle hyperplasia on the long side of the mandible and disk displacement and degenerative joint disease of the temporomandibular joint on the short side can cause mandibular asymmetry. It was concluded that MR imaging or arthrography can be valuable for understanding the cause of mandibular asymmetry and be effective in treatment planning.

Adult↗
PubMed1993

Communicating intraosseous ganglion of the lunate.

The authors describe a symptomatic intraosseous ganglion of the lunate communicating directly with the scapholunate joint. The communication was demonstrated by arthrography and computed tomography. This case is believed to be the first reported in which the communication was shown by arthrography. Demonstration of such a communication can obviate the need for further imaging to diagnose the lesion. A review of intraosseous ganglia of the hand and their treatment is presented.

Adult↗
PubMed1993

[The ulnar recess in the arthrogram of the proximal wrist joint].

Arthrography of the proximal wrist joint does not provide details regarding the shape and the extension of the recessus ulnaris. The recessus located between the ulnocarpal disc and the meniscus homologue as a diverticulum of the articular lining was examined in 61 wrists by arthrography and dissection. Using the Pleximon-injection technique, specimens of the proximal wrist cavity allowed a systematic description of morphology and topography of the ulnar recessus. The shape and location of the ulnar recessus show variations, but a sacciform recessus, which usually bears a close relationship to the ulnar styloid process, is the most common. The comparison of arthrographic and morphologic findings allows an assessment of the credibility of arthrographic depictions of the wrist as regards the clinically relevant close relationship to the recessus ulnaris.

Adult↗
PubMed1995

[The labrum acetabulare].

There are two types of labrum acetabulare lesions. The first, posterior in the labrum, must be evocated when hip pain occurs secondary after slight traumatisms. The second, much more frequent, superior in the labrum, is responsible for important hip pain contrasting with slight X-ray abnormalities of the pelvis, except for frequent acetabular dysplasia. Not only arthrography, but also coronal arthro-tomography and CT-arthrography are necessary for the diagnosis of labrum acetabulare lesions.

Acetabulum↗
PubMed1996

Update on imaging techniques of the wrist and hand.

Several imaging techniques are available and necessary for evaluation and treatment of hand and wrist pathology. Conventional radiography is still the imaging technique of first choice for evaluation of abnormalities of the wrist and hand. Bone scintigraphy is an important diagnostic tool with a high sensitivity but low specificity. Arthrography should be performed if abnormality of ligamentous or triangular fibrocartilaginous pathology is suspected; however, using arthrography, all three major compartments and both wrists should be examined arthrographically. In selected cases, such as occult fractures, fracture healing, and early detection of avascular necrosis, advanced imaging techniques, such as magnetic resonance imaging and computed tomography, may be necessary and are helpful to achieve correct diagnosis.

Arthrography↗