MR ARTHROGRAPHY TECHNIQUE AND CLINICAL INDICATIONS

INJURIES IN SPORTS

MR ARTHROGRAPHY TECHNIQUE AND CLINICAL INDICATIONS

Bolog N¹, Mangrau Angelica¹, Oancea Irinel ¹, Banicescu Antonia ¹, Andreisek G^2
1 Phoenix Diagnostic Clinic, Bucharest, Romania, ² University Hospital Zurich, Switzerland

Direct magnetic resonance (MR) arthrography consists of direct injection of diluted gadolinium in the joints. The technique is used mostly for evaluating certain pathologic conditions of the shoulder and hip. During the MR arthrography of the shoulder, the joint is in a neutral position and is punctured with a 21-gauge spinal needle under fluoroscopic guidance. Approximately 1-2 mL of contrast medium is injected under fluoroscopic guidance for confirmation of the intraarticular location of the needle tip and is followed by slow injection of 15-20 mL of diluted MR contrast medium. MR arthroagraphy of the shoulder is indicated in patients with suspected labral tears, shoulder instability, loose bodies. Practically, at this moment more than 90% of the shoulder MR examinations in clinical practice are performed with this technique. For MR arthrography of the hip a direct anterior or anterolateral approach to the hip is used. A small amount of iodinated contrast material is injected to document intraarticular needle position. Once the intraarticular position is fluoroscopically confirmed, 8-15 mL of dilute solution of gadopentetate dimeglumine is injected. MR arthrography may depict intraarticular loose bodies, osteochondral abnormalities, and abnormalities of the supporting soft-tissue structures.