The clinical and radiological importance of extraarticular contrast material leakage into adjacent synovial compartments on ankle MR arthrography in patients with OCD and anterolateral impingement.
OBJECTIVE
To evaluate the tibiotalar joint capacity and the localisation, frequency and amount of extravasation in patients with extraarticular contrast material leakage into adjacent synovial compartments on ankle magnetic resonance (MR) arthrography.


METHODS
Sites of extravasation were determined in the ankle MR arthrograms of 69 patients. Thirty-four patients without extraarticular contrast material leakage into locations unrelated to the injection path were included as a control group. Volumetric measurements of extraarticular contrast material leakage and the tibiotalar joint capacity were performed on a three dimensional (3D) volume measurement workstation.


RESULTS
Extravasation of contrast material occurred through the anterior, posterior, and anterolateral recesses of the tibiotalar joint. The most common site of extravasation was along the flexor hallucis longus tendon synovium (24.6%). The amount of extravasation was significantly higher in patients with ankle osteochondritis dissecans (OCD) than in patients with a different diagnosis (p=0.039). Loose bodies were detected in all OCD's patients with insufficient tibiotalar joint distention.


CONCLUSIONS
Connections between the ankle joint and neighboring synovial compartments can decrease the diagnostic value of ankle MR arthrography examinations due to inadequate joint distention. Large injection volumes should be used for ankle MR arthrography of patients with OCD (especially OCD's patients with loose body) and impingement syndrome.
Department of Radiology, Medical Faculty, Ataturk University, Erzurum, Turkey. Electronic address: drhogul@gmail.com.
Hayri
H
Ogul
Department of Orthopaedics and Traumatology, Medical Faculty, Ordu University, Ordu, Turkey.
Yunus
Y
Guzel
Department of Radiology, Medical Faculty, Ataturk University, Erzurum, Turkey.
Berhan
B
Pirimoglu
Department of Orthopedic, Medical Faculty, Ataturk University, Erzurum, Turkey.
Kutsi
K
Tuncer
Department of Radiology, Medical Faculty, Ataturk University, Erzurum, Turkey.
Gokhan
G
Polat
Department of Radiology, Medical Faculty, Ataturk University, Erzurum, Turkey.
Fatih
F
Ergun
Department of Radiology, Medical Faculty, Ataturk University, Erzurum, Turkey.
Recep
R
Sade
Department of Radiology, Medical Faculty, Ataturk University, Erzurum, Turkey.
Ummugulsum
U
Bayraktutan
Department of Radiology, Medical Faculty, Ataturk University, Erzurum, Turkey.
Ihsan
I
Yuce
Department of Radiology, Medical Faculty, Ataturk University, Erzurum, Turkey.
Mecit
M
Kantarci
D000328:Adult; D000843:Ankle Joint / Q000000981:diagnostic imaging* / Q000473:pathology; D001175:Arthrography / Q000379:methods; D003287:Contrast Media; D005119:Extravasation of Diagnostic and Therapeutic Materials / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D007089:Image Enhancement; D021621:Imaging, Three-Dimensional; D017746:Joint Capsule / Q000000981:diagnostic imaging; D007592:Joint Diseases / Q000150:complications / Q000000981:diagnostic imaging*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010008:Osteochondritis Dissecans / Q000150:complications / Q000000981:diagnostic imaging* / Q000473:pathology; D011446:Prospective Studies; D055815:Young Adult
D003287:Contrast Media
Ankle joint; Extravasation; Loose body; MR arthrography; Osteochondritis dissecans