scholarly journals Role of MRI Arthrography Compared to Conventional MRI in Assessment of Shoulder Joint Disorders

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
M A Nassef ◽  
S A A Abdulrahim ◽  
D A A M Eldesouki
Keyword(s):  
Joint Instability ◽  
Glenohumeral Joint ◽  
Imaging Technique ◽  
Mr Arthrography ◽  
Contrast Injection ◽  
Ct Guided ◽  
Ct Arthrography ◽  
Glenoid Labrum ◽  
Conventional Mri

Abstract Glenohumeral joint instability is extremely common. With regard to primary anterior shoulder dislocations, the incidence is between 8.2 and 23.9 per 100 000 person-years, with an estimated prevalence of 1.7%. Many imaging methods, including arthrography, CT arthrography, MR arthrography, have been used to image the glenoid labrum and the associated structures of the capsular mechanism. The aim of the study is to prove MR arthrography is the preferred imaging technique for the investigation of patients with shoulder instability. MR arthrography reliably shows subtle lesions of the labroligamentous complex, providing information essential to the surgeon concerning the surgery or arthroscopic repair .Thirty Patients with clinically evident or suspected shoulder impingemint or glenohumeral instability.of both sexes were included , conventional MRI was performed for all patients followed by CT guided intraarticular contrast injection then MRI Arthrography images taken within thirty minutes. Data were collected, revised, coded and entered to the Statistical Package for Social Science (IBM SPSS) version 20.

scholarly journals Interdisciplinary consensus statements on imaging of scapholunate joint instability

2021 ◽  
Author(s):  
Tobias Johannes Dietrich ◽  
Andoni Paul Toms ◽  
Luis Cerezal ◽  
Patrick Omoumi ◽  
Robert Downey Boutin ◽  
...  
Keyword(s):  
Joint Instability ◽  
Mr Arthrography ◽  
Accurate Diagnosis ◽  
Cartilage Defects ◽  
Group Consensus ◽  
Interosseous Ligament ◽  
Ct Arthrography ◽  
Delphi Round ◽  
Consensus Statements ◽  
Work Up

Abstract Objectives The purpose of this agreement was to establish evidence-based consensus statements on imaging of scapholunate joint (SLJ) instability by an expert group using the Delphi technique. Methods Nineteen hand surgeons developed a preliminary list of questions on SLJ instability. Radiologists created statements based on the literature and the authors’ clinical experience. Questions and statements were revised during three iterative Delphi rounds. Delphi panellists consisted of twenty-seven musculoskeletal radiologists. The panellists scored their degree of agreement to each statement on an eleven-item numeric scale. Scores of ‘0’, ‘5’ and ‘10’ reflected complete disagreement, indeterminate agreement and complete agreement, respectively. Group consensus was defined as a score of ‘8’ or higher for 80% or more of the panellists. Results Ten of fifteen statements achieved group consensus in the second Delphi round. The remaining five statements achieved group consensus in the third Delphi round. It was agreed that dorsopalmar and lateral radiographs should be acquired as routine imaging work-up in patients with suspected SLJ instability. Radiographic stress views and dynamic fluoroscopy allow accurate diagnosis of dynamic SLJ instability. MR arthrography and CT arthrography are accurate for detecting scapholunate interosseous ligament tears and articular cartilage defects. Ultrasonography and MRI can delineate most extrinsic carpal ligaments, although validated scientific evidence on accurate differentiation between partially or completely torn or incompetent ligaments is not available. Conclusions Delphi-based agreements suggest that standardized radiographs, radiographic stress views, dynamic fluoroscopy, MR arthrography and CT arthrography are the most useful and accurate imaging techniques for the work-up of SLJ instability. Key Points • Dorsopalmar and lateral wrist radiographs remain the basic imaging modality for routine imaging work-up in patients with suspected scapholunate joint instability. • Radiographic stress views and dynamic fluoroscopy of the wrist allow accurate diagnosis of dynamic scapholunate joint instability. • Wrist MR arthrography and CT arthrography are accurate for determination of scapholunate interosseous ligament tears and cartilage defects.

Shoulder Arthrography

2019 ◽  
pp. 149-150
Author(s):  
Matthew DelGiudice
Keyword(s):  
Rotator Cuff ◽  
Glenohumeral Joint ◽  
Adhesive Capsulitis ◽  
Total Shoulder Arthroplasty ◽  
Mr Arthrography ◽  
Routine Clinical Practice ◽  
Ct Arthrography ◽  
Cuff Tear ◽  
Shoulder Arthrography ◽  
Cuff Repair

Chapter 98 describes indications, technique, and imaging findings of shoulder arthrography. Shoulder arthrography is commonly performed in routine clinical practice for MR arthrography (MRA), typically in younger patients. The main indications include evaluation of shoulder instability and postoperative rotator cuff. Other indications include fluoroscopic guidance for therapeutic injections or therapy for adhesive capsulitis. CT arthrography (CTA) may also be performed for evaluation of total shoulder arthroplasty (TSA) loosening and conversion from anatomic to reverse TSA. Contrast should be easy to inject and disperse throughout the joint. Abnormal communication between the glenohumeral joint and subacromial-subdeltoid and subcoracoid bursae is diagnostic of a full-thickness rotator cuff tear unless the contrast is accidentally injected into the bursa. However, in the setting of prior rotator cuff repair, contrast may extend into the bursa even in the absence of re-tear because the cuff is not watertight. Contrast extension into the glenoid labral substance is diagnostic of labral tear.

Functional cortical changes associated with shoulder instability – a systematic review

2021 ◽  
pp. 175857322110190
Author(s):  
Morissa F Livett ◽  
Deborah Williams ◽  
Hayley Potter ◽  
Melinda Cairns
Keyword(s):  
Systematic Review ◽  
Joint Instability ◽  
Glenohumeral Joint ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Cortical Function ◽  
High Quality Research ◽  
Central Register ◽  
Rehabilitative Measures ◽  
Randomised Controlled

Background Glenohumeral joint instability is associated with structural deficits and/or alterations in sensory and motor processing; however, a proportion of patients with glenohumeral joint instability fail to respond to surgical and rehabilitative measures. This systematic review aimed to establish if functional cortical changes occur in patients with glenohumeral joint instability. Methods AMED, CINAHL, Cochrane Central Register of Controlled Trials, Embase, Medline, PEDro, Pubmed, PsychINFO and Scopus were searched from inception to 17 March 2021. Randomised controlled trials and non-randomised trials were included and quality was appraised using the Downs and Black tool. Results One thousand two hundred seventy-nine records were identified of which five were included in the review. All studies showed altered cortical function when comparing instability patients with healthy controls and included areas associated with higher cortical functions. Discussion The findings of this systematic review offer some insight as to why interventions addressing peripheral pathoanatomical factors in patients with glenohumeral joint instability may fail in some cases due to functional cortical changes. However, data are of moderate to high risk of bias. Further high-quality research is required to ascertain the degree of functional cortical changes associated with the type and duration of glenohumeral joint instability.

Sublabral clefts and recesses in the anterior, inferior, and posterior glenoid labrum at MR arthrography

2012 ◽  
Vol 42 (3) ◽  
pp. 353-362 ◽  
Author(s):  
Michael J. Tuite ◽  
Jonathan W. Currie ◽  
John F. Orwin ◽  
Geoffrey S. Baer ◽  
Alejandro Munoz del Rio
Keyword(s):  
Mr Arthrography ◽  
Glenoid Labrum

Role of Diffusion Weighted Imaging in Differentiating Benign from Pathological Vertebral Compression

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Faten Mohammed Mahmoud Kamel ◽  
Hazem Ibrahim Abdel Rahman ◽  
Amany Sayed Khaleel Ahmed Elkhayat
Keyword(s):  
Vertebral Fractures ◽  
Diffusion Weighted Imaging ◽  
Laboratory Evaluation ◽  
Vertebral Collapse ◽  
Adc Value ◽  
Conventional Mri ◽  
Diffusion Weighted ◽  
Significant Difference

Abstract Background Vertebral collapse is a common problem due to benign conditions (trauma, infection, osteoporosis) or malignant process. And although the spine is the most common site of bone metastases (39% of bony metastases in patients with primary neoplasms) benign vertebral fractures due to osteopenia occur in one third of cancer patients, making it essential to determine whether the cause of vertebral collapse is benign or malignant. Aim of the Work To establish the role of DWI in differentiating benign from pathologic vertebral fractures using ADC values in comparison with histopathology report /laboratory evaluation and clinical follow-up. Patients and Methods A cross sectional study is approved by the ethics review board of Ain Shams University Hospital (Al Demerdash). All patients provided informed consent for the MR imaging examinations and for inclusion of their data in this analysis. From April 2020 to october 2020, 25 cases with previous imaging with vertebral compression underwent conventional MRI study on the affected region. Diffusion weighted imaging and ADC was added. Results We performed DWI using maximum b-values 600, and quantitative analysis, named apparent diffusion coefficient (ADC). We correlated the ADC number to histopathology, laboratory finding and clinical follow up. In our study there was significant difference (p < 0.04) between DWI of the benign and malignant groups. Also the ADC value showed significant difference <0.001. The mean ADCs of benign VCFs were higher significantly than those of pathological fractures. Conclusion DWI with ADC value was helpful when added to conventional MRI to differentiate benign from pathological (malignant) vertebral compression. It should be a routine sequence in patients with vertebral compression fractures for accurate diagnosis and successful management also can decrease no of biopsies.

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