[Ultrasound-guided intraarticular injection for MR arthrography of the shoulder].
OBJECTIVE
To evaluate ultrasound guidance for intraarticular contrast injection via an anterolateral approach in comparison with fluoroscopic guidance.


METHODS
Contrast agent injection was performed in 40 consecutive patients, 20 under sonographic guidance and 20 under fluoroscopic guidance. None of the patients had previous shoulder surgery. The procedure time was measured and the efficiency of joint distension, incidence of extravasation and intraarticular air on the consecutive MR arthrograms were assessed by three blinded radiologists with musculoskeletal radiology experience. Statistical analysis was performed using the Kruskal-Wallis test.


RESULTS
Intraarticular contrast injection was successfully accomplished in all 40 patients. Subsequent MR arthrograms did not show any significant difference between sonographic and fluoroscopic guidance with respect to diagnostic quality, joint distension (p=0.6665), intraarticular air bubbles (p=0.1567) and occurrence of contrast extravasation (p=0.8565). The mean duration of ultrasound-guided injection was 7:30 min compared to a shorter procedure time of 4:15 min for fluoroscopic guidance. In both groups, no procedural complications were observed.


CONCLUSIONS
Ultrasound-guided injection for MR arthrography of the shoulder via an anterolateral approach represents a simple, safe, and effective technique which yields comparable results to those of injection under fluoroscopic guidance, but is slightly more time-consuming.
Schaeffeler
C
C
Institut für Röntgendiagnostik, Klinikum rechts der Isar der Technischen Universität München. schaeffeler@roe.med.tum.de
Brügel
M
M
Waldt
S
S
Rummeny
E J
EJ
Wörtler
K
K
D000293:Adolescent; D000328:Adult; D000368:Aged; D001175:Arthrography / Q000379:methods*; D003287:Contrast Media / Q000008:administration & dosage*; D005260:Female; D005471:Fluoroscopy; D019786:Gadolinium DTPA / Q000008:administration & dosage*; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D007270:Injections, Intra-Articular; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D017006:Rotator Cuff / Q000473:pathology; D000070636:Rotator Cuff Injuries; D012680:Sensitivity and Specificity; D012785:Shoulder Joint / Q000473:pathology; D013708:Tendon Injuries / Q000175:diagnosis*; D018084:Ultrasonography, Interventional / Q000379:methods*; D055815:Young Adult
D003287:Contrast Media; D019786:Gadolinium DTPA