MR Arthrography Shoulder
Teaching points
Usually done under fluoroscopy /ultrasonography/CT guidance to avoid labral cartilage injury. By Dr MGK Murthy and Dr Sudheer Kunkunuru
· Indications
1. Primarily for Rotator cuff tear suspicion or evaluation
2. Cartilage evaluation
3. All the internal structures including glenohumeral ligaments
· Technique
PreArthrography Xray shoulder AP with external and internal rotation views to look for presence of hydroxyl apatite crystals/calcification (which could be confused with rotator cuff tear producing contrast leak)
-Supine and external rotation
-Mark the joint lateral to humeral head cortex
-20 to 22gauge LP needle perpendicular to fluoroscopy beam. Testing the safe INJOINT position with local anaesthetic after aspiration to test for blood vessels
-Confirm position with iodinated contrast
- Dilute gadolinium injected to the comfort level usually
10 to 16 ml (Cocktail made of 0.1 ml Gadolinium+10ml Iohexol+10ml 0.9%saline+0.3ml of epinephrine of 1:1000 in 20 ml syringe )
MR Arthrography Shoulder
Reviewed by Sumer Sethi
on
Wednesday, June 15, 2011
Rating:
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