title: [MR-arthrography of the shoulder. Description and evaluation of the technique using a US-guided pediatric spinal needle].
abstract: OBJECTIVE
  To describe the technique of US-guided shoulder arthrography using a pediatric needle (modified Valls- Melloni technique) and to assess its efficacy.
  
  
  METHODS
  Descriptive study of articular puncture for 48 magnetic resonance imaging arthrographs of the shoulder in 48 consecutive patients. The puncture was performed by a radiologist without prior experience in the technique. We used an anterior approach to the shoulder, guiding the puncture using US according to the Valls-Melloni technique; however, we used a pediatric spinal needle (Yale spinal; 22G: 0.7 x 40 mm). The efficacy of the technique was evaluated using the following variables: time employed, number of attempts, extravasation of contrast outside the joint, pain reported by the patient (on a scale from 0 to 10), and immediate or late complications of the technique.
  
  
  RESULTS
  The time required for the procedure was 15.2+/-2.6 min (mean+/-standard deviation). A single puncture sufficed in 45 patients (94%); two attempts were necessary in two patients (4%) and three in one patient (2%). Contrast extravasation outside the joint occurred only in two patients (4%). The mean pain reported was 3.6 points (confidence interval: 3.1-4). Three patients (6%) had a vasovagal reaction. No late complications were observed.
  
  
  CONCLUSIONS
  US-guided shoulder arthrography using a pediatric spinal needle is fast, simple, and safe; it can be performed by any radiologist, even without prior experience in the technique.
authors.affiliation: Servicio de Radiología, Hospital POVISA, Vigo, Pontevedra, España. gabrife@teleline.es
authors.forename: G C
authors.initials: GC
authors.lastname: Fernández
authors.forename: M
authors.initials: M
authors.lastname: Berástegui-Imaz
authors.forename: I
authors.initials: I
authors.lastname: Pérez-Arroyuelos
authors.forename: R
authors.initials: R
authors.lastname: Prada González
authors.forename: M
authors.initials: M
authors.lastname: Velasco Casares
authors.forename: F M
authors.initials: FM
authors.lastname: Tardáguila
mesh_terms: D000293:Adolescent; D000328:Adult; D001175:Arthrography / Q000379:methods*; D005260:Female; D006801:Humans; D007592:Joint Diseases / Q000175:diagnosis* / Q000000981:diagnostic imaging; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009339:Needles; D012785:Shoulder Joint / Q000000981:diagnostic imaging; D014463:Ultrasonography