title: Ultrasound-guided shoulder MR arthrography: comparison of rotator interval and posterior approach.
abstract: OBJECTIVE
  The purpose of this study was to prospectively evaluate the two different ultrasound-guided injection techniques for magnetic resonance (MR) arthrography of the shoulder.
  
  
  METHODS
  This study included 100 patients [50 rotator interval group (n=50) vs. 50 posterior approach group (n=50)]. All procedures were performed by the same radiologist. The two injection techniques were compared. The discomfort during and after arthrography was evaluated. Extraarticular contrast media extravasation was graded according to the MRI findings. The number of injection attempts, effect of contrast media extravasation rate on diagnostic quality and procedure times were recorded.
  
  
  RESULTS
  There were no significant difference between the posterior and rotator interval puncture groups with regard to pain (P=.915), procedure times (P=.401) or attempt scores (P=.182). There were significantly more contrast media extravasations with rotator interval approach than posterior approach (P<.05).
  
  
  CONCLUSIONS
  Both techniques were successful and well tolerated by patients. Posterior injection technique provided a more effective route with decreased extravasation rate and easier approach compared to the rotator interval approach.
authors.affiliation: Atatürk University, School of Medicine, Department of Radiology, Erzurum, Turkey.
authors.forename: Hayri
authors.initials: H
authors.lastname: Ogul
authors.forename: Ummugulsum
authors.initials: U
authors.lastname: Bayraktutan
authors.forename: Mesut
authors.initials: M
authors.lastname: Ozgokce
authors.forename: Kutsi
authors.initials: K
authors.lastname: Tuncer
authors.forename: Ihsan
authors.initials: I
authors.lastname: Yuce
authors.forename: Ahmet
authors.initials: A
authors.lastname: Yalcin
authors.forename: Berhan
authors.initials: B
authors.lastname: Pirimoglu
authors.forename: Erdem
authors.initials: E
authors.lastname: Sagsoz
authors.forename: Mecit
authors.initials: M
authors.lastname: Kantarci
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D018771:Arthralgia / Q000473:pathology*; D001175:Arthrography / Q000379:methods*; D003287:Contrast Media / Q000008:administration & dosage; D005260:Female; D005682:Gadolinium / Q000008:administration & dosage*; D006801:Humans; D007270:Injections, Intra-Articular / Q000379:methods*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D011446:Prospective Studies; D012785:Shoulder Joint / Q000000981:diagnostic imaging* / Q000473:pathology*; D014463:Ultrasonography; D055815:Young Adult
chemical_list: D003287:Contrast Media; D005682:Gadolinium
keywords: Posterior approach; Rotator interval; Shoulder MR arthrography; US guidance