title: Do patients with structural abnormalities of the shoulder experience pain after MR arthrography of the shoulder?
abstract: OBJECTIVE
  To assess the pain course after intraarticular injection of a gadolinium-containing contrast material admixed with anesthetic for magnetic resonance (MR) arthrography of the shoulder in relation to internal derangements of the shoulder.
  
  
  METHODS
  Institutional review board approval and informed consent were obtained for this study. The study sample consisted of 655 consecutive patients (249 female, 406 male; median age, 54 years) referred for MR arthrography of the shoulder. Pain level was measured at baseline, directly after intraarticular injection of the gadolinium-containing contrast material admixed with anesthetic, 4 hours after injection, 1 day (18-30 hours) after injection, and 1 week (6-8 days) after injection with a visual analog scale (range, 0-10). MR arthrography was used to assess the following internal derangements: lesions of the rotator cuff tendons and long biceps tendon, adhesive capsulitis (frozen shoulder), fluid in the subacromial bursa, labral tears, and osteoarthritis of the glenohumeral joint. History of shoulder surgery was recorded. Linear regression models were calculated for the dependent variable (difference between follow-up pain and baseline pain), with the independent variable grouping adjusted for age and sex.
  
  
  RESULTS
  There was no significant association between pain level over time and internal derangements of the shoulder, nor was there significant association between pain level over time in patients with a history of shoulder surgery and patients without a history of shoulder surgery.
  
  
  CONCLUSIONS
  Neither internal derangements nor prior surgery have an apparent effect on the pain course after MR arthrography of the shoulder.
authors: Department of Radiology, University Hospital Balgrist, Zurich, Switzerland. Isabelle.Steurer@ksl.ch
authors: Isabelle
authors: I
authors: Steurer-Dober
authors: Kaspar
authors: K
authors: Rufibach
authors: Juerg
authors: J
authors: Hodler
authors: Nadja
authors: N
authors: Saupe
authors: Marco
authors: M
authors: Zanetti
authors: Sandro F
authors: SF
authors: Fucentese
authors: Christian W A
authors: CW
authors: Pfirrmann
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000779:Anesthetics, Local / Q000008:administration & dosage / Q000009:adverse effects; D018771:Arthralgia / Q000209:etiology*; D003287:Contrast Media / Q000008:administration & dosage / Q000009:adverse effects; D005260:Female; D019786:Gadolinium DTPA / Q000008:administration & dosage / Q000009:adverse effects; D006801:Humans; D007270:Injections, Intra-Articular / Q000009:adverse effects*; D007479:Iopamidol / Q000008:administration & dosage / Q000009:adverse effects; D016014:Linear Models; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008619:Mepivacaine / Q000008:administration & dosage / Q000009:adverse effects; D008875:Middle Aged; D010147:Pain Measurement; D012307:Risk Factors; D000070599:Shoulder Injuries; D012785:Shoulder Joint / Q000002:abnormalities*
chemical_list: D000779:Anesthetics, Local; D003287:Contrast Media; D008619:Mepivacaine; D007479:Iopamidol; D019786:Gadolinium DTPA