title: Prospective evaluation of two different injection techniques for MR arthrography of the hip.
abstract: The aim of the study was to evaluate prospectively the technical feasibility and discomfort of two different injection techniques for MR arthrography of the hip. Sixty-one consecutive patients undergoing MR arthrography of the hip (68 hips) were randomly injected either at the femoral head (36 hips) or the femoral neck (32 hips). The patients rated discomfort during and 0-72 h after arthrography using a visual analogue scale (VAS, 0="did not feel anything", 100="unbearable"). The volume injected, the distance between the needle tract and the neurovascular bundle, the duration of the procedure and the extra-articular contrast leakage were measured. No significant differences were found for the volume injected, the distance between the needle tract and the neurovascular bundle, or the procedure duration. Volume of extra-articular contrast leakage was statistically significantly different (head 1+/-2 cm(3), neck 3+/-5 cm(3), P=0.024). The VAS score for needle advancement was significantly different (head 25+/-20, neck 19+/-23, P=0.031). No significant differences were found for the VAS score regarding delayed discomfort. Before the examination the arthrography-related discomfort was overestimated by 74% (50/68), correctly anticipated by 22% (15/68) and underestimated by 4% (3/68) of the patients. MR-related discomfort was overestimated by 32% (22/68), correctly anticipated by 57% (39/68) and underestimated by 10% (7/68) of the patients. Both hip puncture techniques were well tolerated. The neck injection technique produced less discomfort and was associated with greater extra-articular contrast leakage.
authors.affiliation: Department of Radiology, University Hospital, Balgrist, Forchstrasse 340, 8008, Zurich, Switzerland. Sylvain.duc@balgrist.ch
authors.forename: Sylvain R
authors.initials: SR
authors.lastname: Duc
authors.forename: Juerg
authors.initials: J
authors.lastname: Hodler
authors.forename: Marius R
authors.initials: MR
authors.lastname: Schmid
authors.forename: Marco
authors.initials: M
authors.lastname: Zanetti
authors.forename: Bernard
authors.initials: B
authors.lastname: Mengiardi
authors.forename: Claudio
authors.initials: C
authors.lastname: Dora
authors.forename: Christian W A
authors.initials: CW
authors.lastname: Pfirrmann
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001175:Arthrography / Q000379:methods*; D002358:Cartilage, Articular / Q000000981:diagnostic imaging; D005240:Feasibility Studies; D005260:Female; D005270:Femur Head / Q000000981:diagnostic imaging; D005272:Femur Neck / Q000000981:diagnostic imaging; D006621:Hip Joint / Q000000981:diagnostic imaging*; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D007091:Image Processing, Computer-Assisted; D007270:Injections, Intra-Articular / Q000379:methods; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009339:Needles; D010147:Pain Measurement; D010342:Patient Acceptance of Health Care; D012680:Sensitivity and Specificity