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At least 19 recordsLinked to original sources

PubMed1992

[Contribution of gradient-echo MRI in the study of subacromial pathology: correlation between surgery and arthrography].

30 asymptomatic volunteer subjects and more than 400 patients with suspected rotator cuff lesions were examined by MRI at 0.5 T using T2*-PD weighted gradient echo (T2-GEI) sequences. Its superiority over T2 spin echo imaging was established in previous studies. The results were compared to those of surgery in 87 cases and arthrography in 233 cases (associated with CT arthrography in 70 cases). In the operated patients, T2-GEI and arthrography correctly diagnosed 49 complete ruptures (CR). T2-GEI was found to be superior to arthrography for defining the real extent of the rupture, the degree of tendon retraction and the local muscular trophicity, essential information to define the therapeutic indications. In contrast, among 22 lesions of the long biceps tendon, correctly demonstrated by arthrography or CT arthrography, 5 intracapsular lesions were not detected by MRI. MRI was able to detect 8 lesions of the anterior labrum associated with a CR not demonstrated by arthrography. Lastly, among the 18 cases of partial inferior rupture (PIR), 6 partial superficial ruptures and 14 cases of inflammatory changes, correctly diagnosed by MRI, only 8 PIR were also demonstrated by arthrography. For the non-operated patients investigated by the two modalities (146 cases), T2-GEI and arthrography were concordant in 43 cases. In contrast, 103 intact cuffs on arthrography showed features on T2-GEI compatible with tendinopathy without rupture, bursitis and degenerative changes. In the absence of very fine surgical or histological correlations for these small lesions, it is impossible, at the present time, to determine the real sensitivity and specificity of MRI.

Arthrography↗

PubMed1992

Combined nuclear and digital subtraction contrast arthrography in painful knee prosthesis.

The evaluation of a painful knee prosthesis remains a difficult problem for both orthopaedic surgeons and radiologists. We have compared digital subtraction arthrography with nuclear arthrography in 7 patients with a painful knee prosthesis. Three patients showed a loose tibial component, demonstrated by both digital subtraction and nuclear arthrography. All 3 underwent revision of their prosthesis. One patient had an equivocal digital subtraction arthrogram and negative nuclear arthrogram, while both studies were negative in the 3 remaining patients. Nuclear arthrography is a simple procedure and can provide useful additional information when combined with digital subtraction arthrography.

Aged↗

PubMed1991

Contrast and nuclear arthrography in loosening of the uncemented hip prosthesis.

The recent popularity of ingrowth or uncemented hip arthroplasties has presented problems in the radiographic diagnosis of loosening because there is no longer a cement interface in which lucencies may be seen. We evaluated a combination of positive contrast and nuclear arthrography to see whether these studies could accurately detect loosening of uncemented femoral components of hip prostheses. We performed routine contrast and nuclear arthrography in 21 patients with ingrowth total hip arthroplasties or bipolar endoprostheses. The results were surgically confirmed in 12 patients. The contrast arthrogram was true positive in 5 and false negative in 5. There were no false positives and 2 true negatives. The nuclear arthrogram was true positive in 7 patients, false negative in 3, and true negative in 2. Taken together, there was only 1 patient in whom both contrast and nuclear arthrography were false negative, and there were no false positives. Thus, when either contrast or nuclear arthrography is positive, the sensitivity of the combined procedures is 90%; when both studies are negative, the specificity is 100%. The combination of contrast and nuclear arthrography is an accurate method of determining loosening of the femoral component of an uncemented hip arthroplasty or bipolar endoprosthesis in the patient with postoperative hip pain.

Adult↗

PubMed1979

Grey scale ultrasonography and arthrography in evaluation of popliteal cysts.

Ultrasonography will reliably detect popliteal cysts of clinically significant size and improvements in ultrasound imaging have enhanced the value of ultrasound in relation to arthrography in the assessment of cyst rupture. Forty-eight knees in 25 patients suspected of having a popliteal cyst were examined by ultrasonography followed immediately by arthrography. Popliteal cysts were demonstrated in 40% (19/48) by ultrasound and in 46% (22/48) by arthrogram. Arthrography detected small cysts not seen with ultrasound, but altrasonic scanning showed cysts which did not fill on arthrography. A ruptured cyst or deep venous thrombosis was suspected in 10 patients. Rupture was confirmed in two patients by arthrography, in both of whom soft tissue changes and attenuation of the distal margin of the cysts were shown by ultrasound.

Cysts↗

PubMed1978

Findings at arthroscopy and arthrography in knee injuries.

The diagnostic accuracy of arthroscopy and arthrography was investigated. A total of 135 patients were examined by the two methods. All were operated on and 90 of them were analyzed in detail, the X-ray examinations being done at this hospital. In 82 patients arthroscopy gave correct information. In eight (9 per cent) the diagnosis was incorrect, in most cases a rupture of the posterior horn of the medial meniscus being overlooked. Arthrography gave accurate preoperative information in 52 patients, but in 38 (42 per cent) the diagnosis was inaccurate. This difference in correlation with the operation findings between arthroscopy and arthrography was highly significant (P less than 0.001), and it is concluded that endoscopy gives more complete and more useful preoperative information than arthrography. Arthrography, however, remains a valuable diagnostic tool, as arthroscopy cannot be performed in every patient with knee symptoms.

Adolescent↗

PubMed1991

Internal derangement of the temporomandibular joint: an audit of clinical findings, arthrography and surgical treatment.

Forty seven patients who underwent double contrast video-arthrography followed by surgery for internal derangement of the temporomandibular joint were reviewed retrospectively. Of the 50 joints assessed, arthrography demonstrated 39 (78%) with irreducible meniscal displacement and 11 (22%) with reducible displacement. Clinical findings were found to be unreliable in demonstrating the degree of internal derangement: 49% of irreducible meniscal displacements presented with clicking and only 20% with loss of click. The importance of video-arthrography is emphasised. Surgery for internal derangement proved successful. It is proposed that patients who have clinical evidence suggestive of irreducible meniscal displacement and have disabling symptoms should undergo early video-arthrography and be offered surgical correction.

Adolescent↗

PubMed1992

Chronic wrist pain: spin-echo and short tau inversion recovery MR imaging and conventional and MR arthrography.

The accuracy of T1-, proton-density-, and T2-weighted magnetic resonance (MR) imaging sequences and gadolinium-enhanced MR arthrography in evaluation of the triangular fibro-cartilage complex (TFCC) and the scapholunate (SL) and lunotriquetral (LT) ligaments was studied in 15 patients with chronic wrist pain. Arthrography and arthroscopy were used as standards of reference. Twelve patients also underwent imaging with short tau inversion recovery (STIR) sequences. MR imaging was more reliable in evaluation of the morphology of the TFCC and SL ligament than in that of the LT ligament. With arthrography as the standard, sensitivity was 0.721, specificity was 0.947, and accuracy was 0.887 for the TFCC; these values were 0.500, 0.864, and 0.765 for the SL ligament and 0.519, 0.455, and 0.490 for the LT ligament. No visualization of the SL ligament indicated a tear, but this sign was not helpful in evaluation of the LT ligament. Fluid in the distal radioulnar joint had a high association with TFCC tears. Accuracy with MR arthrography was higher than with the other sequences. STIR images were effective in evaluation of the TFCC. The combination of proton-density-and T2-weighted images appears to be useful because morphologic characteristics and the presence of fluid can be evaluated.

Arthrography↗

PubMed1992

CT arthrography and arthroscopy in chronic glenohumeral joint instability.

The authors evaluate the value of CT arthrography in glenohumeral joint instability. A study was conducted on a group of 16 patients with recurrent dislocation of the shoulder. All patients underwent CT arthrography and arthroscopy. The diagnostic accuracy of CT arthrography was rated for different types of lesions on the basis of arthroscopic confirmation of its findings. Our results, which include a statistical analysis, showed a diagnostic accuracy of 97.3% in Bankart lesions and 100% in Hill-Sachs lesions and loose bodies. Dilation of the subscapular bursa and injury of the glenoid labrum-IGHL complex were often identified, while chondritis and synovitis were less frequently diagnosed. The authors therefore conclude that CT arthrography may be considered an extremely reliable diagnostic test for obtaining an overall picture of injuries due to instability. Arthroscopy, on the other hand, should be reserved for cases in which surgery may be performed in the same stage as diagnosis.

Adult↗

PubMed1991

Arthrography of the hand and wrist.

Arthrography of the wrist and hand is easy to perform, but accurate diagnosis requires meticulous technique and thorough knowledge of anatomy, pathology, and imaging principles. Wrist arthrography is usually performed to assess pain or instability after trauma; a complete examination usually requires injection of the RC, midcarpal, and distal radioulnar joints. Abnormalities that can be detected include interosseous ligament tears, capsular tears, triangular fibrocartilage perforations and separations, cartilaginous defects, loose bodies, and synovial abnormalities including adhesive capsulitis. Arthrography can also be useful in the evaluation of masses and scaphoid nonunion. Finger arthrography can demonstrate capsular injury, ligament tears, tendon derangement, volar plate disruption, cartilage abnormalities, fibrous ankylosis, synovial abnormalities, and ganglia. Tenography is seldom performed; this technique can delineate synovial abnormalities and can be used to evaluate tendon subluxation.

Arthrography↗

PubMed1992

Rotator cuff disease: assessment with MR arthrography versus standard MR imaging in 36 patients with arthroscopic confirmation.

Standard proton-density- and T2-weighted magnetic resonance (MR) imaging and MR arthrography were used to depict rotator cuff disease in 36 shoulders in 36 patients; the findings were compared with arthroscopic findings in every patient. In 19 rotator cuffs normal at arthroscopy, MR arthrography revealed no tear in 16 patients, a partial tear in one patient, and a full-thickness tear in two patients. Standard proton-density- and T2-weighted images were normal in 15 of these patients and revealed a partial tear in two patients and a full-thickness tear in two patients. In 13 partial tears found at arthroscopy, MR arthrography showed a partial tear in six patients, no tear in five patients, and a full-thickness tear in two patients; standard MR imaging revealed a partial tear in one patient, no tear in 10 patients, and a full-thickness tear in two patients. All four full-thickness tears proved with arthroscopy were correctly diagnosed with both MR imaging methods. The main advantage of MR arthrography was better depiction of partial tears in the articular surface.

Adolescent↗

PubMed1991

[MRI and arthrography in the evaluation of TMJ disorders].

Arthrosis of the temporomandibular joint (TMJ) is a noninfectious, noninflammatory condition characterized by joint pain, noise (clicking) and abnormal motion. It contains various disease processes, such as abnormalities in the menisci or masticating muscles, subluxation of the condyle and degenerative joint disease. Analysis of the morphology and dynamics of TMJ by means of imaging modalities has become highly advanced since the development of arthrography in the late 1970s. Magnetic resonance imaging (MRI) has become the modality of choice in the evaluation of TMJ owing to the development of surface coils. We retrospectively studied MRI and inferior joint compartment arthrography in the evaluation of TMJ disorders. Nineteen joints of 14 patients included 15 with internal derangement, two with osteoarthrosis and two normal joints. Sagittal MR images were routinely obtained in a resting position and in positions with the mouth half open, and also with the mouth fully open on balanced images. Although perforation of the menisci was difficult to evaluate, MRI and arthrography were equally useful in identifying the shape and position of the meniscus. However, MRI was more reliable in depicting TMJ abnormalities than arthrography. MR is considered to be the modality of choice in screening arthrosis of TMJ, making the definitive diagnosis of internal derangement and monitoring conservative therapy for arthrosis.

Adult↗

PubMed1979

[Arthrography of the wrist: procedures and normal results (author's transl)].

The results of 31 opaque arthrographies of the wrist carried out under two different circumstances are reported. --In a first group the investigation was made immediately after or within a longer period following injury to the wrist or forearm. The results supply information to the surgeon on the condition of the triangular ligament in dislocation and partial dislocations of the inferior radioulnar joint, caused by an architectural fault in the radius after trauma (fracture of the head, diaphysis, or lower extremity). Simple reduction of the radius, without intervention on the inferior radio-ulnar joint, provides an excellent functional result when the triangular ligament is simply stretched. When it is torn (sprains, dislocation locally or at a distance) results are not very convincing in spite of the many possible procedures available. Arthrography easily reveals the presence of a reflex dystrophy complicating the injury. Both the radiological and clinical signs give characteristic pictures of the condition. --This examination is still only used infrequently for the diagnosis of chronic inflammatory rheumatic diseases. The arthrographic images appear very early, however, and are characteristic of an inflammatory synovial lesion. Examinations were carried out mainly for evaluation before therapy, surgical in the case of a synovectomy, medical for a chemical or isotopic synovial treatment. Arthrography in a acutely inflammed joint is followed by an injection of corticoid, sometimes associated with a local antibiotic. This rapidly relieves the patient and prevents worsening of the acute inflammatory process. Arthrography of the wrist is a simple, painless, rapidly performed examination. There has never been a failure, any incident, or accident. It appears to be the only direct exploratory procedure for this joint. A precise anatomical evaluation can be made from the image which gives a true picture of the different anatomical structures.

Adrenal Cortex Hormones↗

PubMed1979

Correlations of arthrography with arthroscopy.

Arthrography and arthroscopy were compared on a prospective basis in 100 consecutive and unselected knees, all in patients who underwent arthrography, arthroscopy, and surgery. Arthroscopy was found to be more accurate than arthrography in the diagnosis of medial and lateral meniscus and anterior cruciate ligament lesions. Because of its easy availability and relatively low cost, arthrography continues to be a useful extension of the physical examination of the knee, serving as a further diagnostic screening technique. However, arthroscopy is recommended in all patients prior to surgery because it provides more complete and more accurate delineation of intra-articular lesions.

Cartilage, Articular↗

PubMed1979

Arthrography of the hip in the diagnosis of postoperative painful conditions after total hip replacement.

Arthrography of the artificial hip joint was performed postoperatively in 29 patients with pain after total hip replacement. In 23 cases the arthrographic findings were checked by operation and corresponded in 91%. In two arthrographies which did not give reliable results sinuses outside the thigh or a large pseudocapsule prevented a satisfactory performance of the arthrography. The unoperated patients had only mild discomfort or were considered a high risk for reoperation; they were treated with physiotherapy and medication. As a result of this investigation arthrography can be regarded as a highly reliable method of diagnosing the various causes of pains in the hip after total hip replacement.

Hip Joint↗

PubMed1992

Shoulder impingement syndrome: impingement view and arthrography study based on 100 cases.

A prospective evaluation combining the shoulder impingement view and arthrography was made in patients presenting with chronic shoulder pain. Five hundred and twenty-three patients with chronic shoulder pain were X-rayed using conventional views and impingement views. One hundred of these patients (mean age 62 years) had subacromial bony spurs on the impingement view; these underwent arthrography. They were divided into two groups according to the degree of spur formation--whether or not the size of the spur exceeded one half of the acromial width as measured from the outer margin to the acromioclavicular joint. Of the 100 subacromial spurs demonstrated on the impingement view, only 18 were visible on the conventional view as assessed by an independent radiologist. Arthrography showed 35 cases of rotator cuff tear. The size of the bony spur was strongly associated with the incidence of rotator cuff tear (P < 0.02).

Acromion↗

PubMed1992

Temporomandibular joint: diagnosis of medial and lateral disk displacement with anteroposterior arthrography. Correlation with cryosections.

The purpose of this investigation was to determine whether it is possible to diagnose medial and lateral disk displacements by single-contrast lower-compartment arthrography with an anteroposterior projection. Contrast medium was injected into the lower joint space of 29 fresh temporomandibular joint autopsy specimens. Anteroposterior arthrograms and anteroposterior arthrotomograms were obtained. Enlargement of the medial or lateral recess of the lower joint space was considered an arthrographic indication of medial or lateral displacement of the disk. After arthrography the joints were deep frozen and cryosectioned in the coronal plane. Imaging findings were correlated to observations in the cryosections in a blind fashion. The anteroposterior arthrograms were 48% accurate in determining the position of the disk in the coronal plane. The anteroposterior arthrotomograms were 59% accurate. It was concluded that anteroposterior lower joint space arthrography as well as arthrotomography is not reliable for diagnosis of medial or lateral disk displacement.

Aged↗

PubMed1991

[CT arthrography of the shoulder after surgical repair for ventral instability].

25 patients who had undergone a modified Lange repair were examined postoperatively after about four years, both clinically and by CT arthrography. Ventral redislocation was no longer seen postoperatively. As regards residual ventral instability, there was agreement between CT arthrography and the clinical findings in 20/25 patients (90%). Newly developed or residual dorsal instability could be accurately demonstrated by the presence of pathological changes of the dorsal labrum and by the observation of a wide dorsal joint recess. CT arthrography did not provide reliable evidence concerning loss of function and mobility of the treated shoulder. However, the presence of marked capsular folding suggests a poor clinical result.

Adult↗

PubMed1991

Condylar movements in clicking joints before and after arthrography.

The aim of this study was to investigate whether anaesthesia and contrast medium injection alter the biomechanics of the TMJ, thus influencing the arthrographic diagnosis in patients with anterior disc displacement with reduction. Opening and closing movements were recorded in nine patients by means of an opto-electronic motion recorder (Jaws 3D) before anaesthesia, after anaesthesia and after arthrography. The system computed the trajectories of a condylar point in the sagittal, frontal and horizontal plane. Data were analysed for changes in the position of the clicks, for the amount of condylar translation and for changes of the trajectories between recording conditions. The results indicated that arthrography had a significant effect on the position of the opening clicks in all nine patients. After injection, the clicks occurred on average 1.6 mm later than before injection. This was probably due to the excursive movements required for defusion of the contrast medium in the joint. The other parameters examined were not affected by the joint anaesthesia and the arthrographic procedure. The interventions influenced the shape and the incline of the sagittal condylar movement in three of the nine patients. In conclusion, arthrography altered the joint biomechanics, but not sufficiently to invalidate the arthrographic diagnosis.

Adult↗