Keywords:
Arthrography, MR, Musculoskeletal soft tissue, Pathology
Authors:
E. Spanò, E. Genovese, L. Callegari, C. Fugazzola; Varese/IT
DOI:
10.1594/ecr2012/C-1006
Methods and Materials
From January 2003 to January 2009,
we retrospectively reviewed 42 patients (30 males and 12 females) with a mean age of 36 years (ranging from 19 to 62 years) who underwent MR-arthrography of the shoulder followed by arthroscopic surgery.
All patients had clinical signs of shoulder supraequatorial chronic instability with diffuse shoulder pain that was difficult to pinpoint,
radiated to the arm,
was exacerbated by external rotation and arm extension and was associated with weakness.
Symptoms were present for a period of 3-6 months,
and all patients were treated with conservative treatment with NSAIDs (Non Steroid Anti Inflammatory Drugs) and PKT (physiokinesitherapy) before they underwent MR-arthrography.
The majority of patients described "snapping and popping" feelings during movements,
“dead arm” sensation,
painful subluxation,
or transient locking.
On physical examinations,
range of motion testing commonly revealed increased external rotation in abduction combined with reduced internal rotation.
The exclusion criteria were a history of recent traumatic events (within the last year) or shoulder surgical procedures and clinical signs of primary rotator cuff disease.
The mean interval between MR-arthrography and arthroscopy was 3 months (1-5 months).
All MR studies were performed with a dedicated shoulder coil using a 1.5-T scanner (Eclipse,
Picker-Marconi [Unit 1] or Avanto,
Siemens [Unit 2]).
All patients gave written informed consent before the procedure.
MR-arthrography was performed after an intra-articular injection of approximately 20 ml of paramagnetic contrast agent (Magnevist 2 mmol / l,
Bayer-Schering; Dotarem 2.5 mmol / l,
Guebet).
The examination was performed immediately after the intra-articular injection of the contrast agent.
The MR-arthrography images were retrospectively reviewed by two different radiologists at the consultant level in a blinded analysis and compared with the surgical outcomes.