Patient perception of magnetic resonance arthrography.
OBJECTIVE
Magnetic resonance (MR) arthrography has been demonstrated to be more accurate than MR imaging alone in the identification of a variety of musculoskeletal pathology. While the complication rate of intra-articular gadolinium: saline injection has been shown to be relatively low, MR arthrography is more invasive, painful, and costly, and less convenient, than MR imaging alone. The purpose of this study was to evaluate patients' perception of the fear and discomfort, and to assess their overall acceptance of the intra-articular gadolinium injection.


METHODS
Between October 1997 and January 1998, 113 outpatients who were referred to Yale-New Haven Hospital for MR arthrography of the ankle, elbow, hip, knee, shoulder, or wrist were asked to complete a questionnaire rating their fear of factors most commonly associated with the procedure including "pain", "needles", "complications", and "discovery of results that would lead to surgery". In addition, after having undergone the intra-articular gadolinium:saline injection, patients were asked to rate their perception of pain.


RESULTS
While many patients expressed fear of "pain" and "needles", after having undergone the injection their overall pain rating score was low. Only 6% actually found gadolinium arthrography more painful than expected.


CONCLUSIONS
Despite the fact that patients expressed apprehension about certain aspects of MR arthrography, subjects who underwent the intra-articular gadolinium injection considered the discomfort less than expected. Clinicians should not hesitate to order MR arthrography because the accuracy of the procedure is high enough that patients accept the discomfort.
Robbins
M I
MI
Department of Diagnostic Radiology, Yale University School of Medicine, New Haven, CT 06520-8042, USA.
Anzilotti
K F
KF
Katz
L D
LD
Lange
R C
RC
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care; D001294:Attitude to Health; D002648:Child; D003287:Contrast Media / Q000008:administration & dosage; D003973:Diatrizoate; D005239:Fear / Q000523:psychology; D005260:Female; D005682:Gadolinium / Q000008:administration & dosage; D006801:Humans; D007270:Injections, Intra-Articular; D007592:Joint Diseases / Q000175:diagnosis*; D008279:Magnetic Resonance Imaging / Q000009:adverse effects / Q000379:methods* / Q000523:psychology; D008297:Male; D008875:Middle Aged; D009339:Needles; D010146:Pain / Q000503:physiopathology / Q000523:psychology; D010147:Pain Measurement; D017060:Patient Satisfaction; D012965:Sodium Chloride; D011795:Surveys and Questionnaires
D003287:Contrast Media; D003973:Diatrizoate; D012965:Sodium Chloride; D005682:Gadolinium