Keywords:
Athletic injuries, Arthrography, Ultrasound, MR, Musculoskeletal joint
Authors:
M. Cavka, M. Josipovic, D. Štivić, T. Balasko Josipovic, I. Karlak; Zagreb/HR
DOI:
10.1594/essr2017/P-0283
Imaging findings OR Procedure Details
Patient is positioned on the opposite flank (figure 2) with the hand holding the opposite shoulder.
Under ultrasound guidance 5 mL of Lidocain is injected mostly in the subcutaneous tissue (figure 3 and 4).
After a minute (when patient loses the feeling on the puncture place) posterior recess of the glenohumeral (GH) joint is visualized.
Usually the probe is placed 15 mm medially and 15 mm caudally to the acromion.
Probe is placed in the tranverse plane (figure 5),
which worsens the visualization of the needle,
but facilitates the view of GH joint which usually is located on 3-5 cm below the surface (figure 7).
12 mL of mixture of 5 mL Lidocain,
0.5 mL Dotarem,
5 mL saline solution and 10 mL of iodinated contrast is injected intraarticulary when the tip of the needle is visualized near the humeral periosteum.
Needle and syrnge are connected through small extension tube (figure 8) to minimize the movement of the needle tip during the injection.
T1 fat saturated sequences in all three planes are then acquired.
We have used the manufacturer shoulder coil on 1.5 MR units (Avanto, Siemens AG Medical Solutions,
Erlangen,
Germany and Ingenia,
Koninklijke Philips N.V.,
Amsterdam,
The Netherlands).