Review of imaging modalities for evaluation of chondral lesions

This poster is published under an open license. Please read the disclaimer for further details.

Congress:

ECR 2016

Poster Number:

C-1447

Type:

Educational Exhibit

Keywords:

Education and training, Athletic injuries, Arthrography, MR, CT, Musculoskeletal joint, Geriatrics

Authors:

A. Zaidi¹, C. Barhoumi², M. Guerfel², Y. Ben Salah³; ¹Ariana/TN, ²Tunis/TN, ³Brussels/BE

DOI:

10.1594/ecr2016/C-1447

DOI-Link:

https://dx.doi.org/10.1594/ecr2016/C-1447

Fig. 1: Anterior approach to shoulder arthrogram : the soulder is sligntly externally...

Fig. 2: Lateral approach to elbow arthrography : the needle’s tip is placed within...

Fig. 3: Radiocarpal injection. For radial sided injection, the needle’s target is the...

Fig. 4: Radioulnar joint injection. Needle target is radial border of ulnar head

Learning objectives

- Describe using photos the different techniques to perform knee, shoulder, wrist, elbow and ankle arthrography (including choice of puncture site and contrast medium). - To cover the use of arthrography, computed tomography arthrography (CTA), magnetic resonance imaging (MRI), and magnetic resonance arthrography (MRA) for the detection of chondral lesions

Background

Arthrography techniques: Wereview the anatomical bases and technical principles for arthrography in different articulations of upper and lower limbs. General technique of arthrography: Projection of the tip of needle should be surimposed on joint space or ideally on articular recess projection(fig2), when it buts up against bone, it is progressively withdrawn with a simoultanous injection test of an anaesthetic agent. Intra-articular location is presumed when a decrease in resistance is felt. Then, a contrast subtance is used to confirm intra-articular location. An iodinated contrast medium...

Findings and procedure details

We used imaging exams performed in our department of patients who mainly had post traumatic (articular fracture) or degenerative arthrosis to depict the different cartilage anomalies. We also provide used iconography from litterature to illustrate newer MR techniques.

Conclusion

Despite the advance in imaging techniques for the assessment of chondral lesions; for many orthopedics, imaging still have an insufficient sensitivity in some cases to determine the therapeutic options and arthroscopic investigation is thus the gold-standard.

Personal information

References

Lungu E, Moser TP. A practical guide for performing arthrography under fluoroscopic or ultrasound guidance.Insights into Imaging. 2015;6(6):601-610. Masala S, Fiori R, Bartolucci DA, et al. Diagnostic and Therapeutic Joint Injections.Seminars in Interventional Radiology. 2010;27(2):160-171. Rutten MJCM, Collins JMP, Maresch BJ, et al. Glenohumeral joint injection: a comparative study of ultrasound and fluoroscopically guided techniques before MR arthrography.European Radiology. 2009;19(3):722-730. Felson DT. Osteoarthritis of the knee. N Engl J Med 2006;354(8):841–848. Gold GE, Chen CA, Koo S, Hargreaves BA, Bangerter NK. Recent advances in MRI...