iothalamate-meglumine and Joint-Diseases

The purpose of this study was to determine the utility of fat-suppressed gradient-recalled echo (GRE) compared with conventional spin echo T1-weighted (T1W) sequences in direct shoulder MR arthrography for evaluating labral tears.. Three musculoskeletal radiologists retrospectively reviewed MR arthrograms performed over a 12-month period for which surgical correlation was available. Of 180 serial arthrograms, 31 patients had surgery with a mean of 48 days following imaging. Paired coronal oblique and axial T1W or GRE sequences were analyzed by consensus for labral tear (coronal oblique two-dimensional multi-echo data image combination, 2D MEDIC; and axial three-dimensional double-echo steady-state, 3D DESS; Siemens MAGNETOM Sonata 1.5-T MR system). Interpretations were correlated with operative reports.. Of 31 shoulders, 25 had labral tears at surgery. The GRE sequences depicted labral tears in 22, while T1W images depicted tears in 16 (sensitivity 88% versus 64%; p<0.05). Subdividing the labrum, GRE was significantly more sensitive for the posterior labrum (75% versus 25%; p<0.05) with a trend toward greater sensitivity at the anterior labrum (78% versus 56%; p=0.157) but not significantly different for the superior labrum (50% versus 57%; p>0.7). Specificities were somewhat lower for GRE.. Thin section GRE sequences are more sensitive than T1W for the detection of anterior and posterior labral tears. As the specificity of GRE was lower, it should be considered as an adjunctive imaging sequence that may improve depiction of labral tears, particularly smaller tears, in routine MR arthrography protocols.

Topics: Adolescent; Adult; Arthrography; Contrast Media; Echo-Planar Imaging; Female; Humans; Imaging, Three-Dimensional; Iothalamate Meglumine; Joint Diseases; Magnetic Resonance Imaging; Male; Middle Aged; Observer Variation; Reproducibility of Results; Retrospective Studies; Sensitivity and Specificity; Shoulder Injuries; Shoulder Joint; Tendon Injuries

This report reviews a work in progress evaluating the use of postarthrography computed tomography (CT) of the wrist in assessing triangular fibrocartilage complex abnormalities. Twenty-two triangular fibrocartilage complex perforations in 119 patients were identified with both multiple compartment arthrography and postarthrography CT. To obtain a double contrast image of the triangular fibrocartilage complex, the postarthrography CT examinations were performed after multiple compartment arthrography and the injection of air into the radiocarpal compartment. The site of triangular fibrocartilage complex perforation could be identified (radial versus peripheral) as could degenerative changes and internal derangements such as chondrocalcinosis. We did not, however, find any information not provided by arthrography that would have changed the course of management. At this time there is no clinical role for postarthrography CT in the evaluation of triangular fibrocartilage complex derangements.

Topics: Arthrography; Cartilage, Articular; Humans; Iopamidol; Iothalamate Meglumine; Joint Diseases; Tomography, X-Ray Computed; Wrist Joint

An X-ray fluorescence technique was employed to study the clearance rate from the knee joint of an intraarticularly injected stable tracer. Clearance curves, determined in two normal volunteers and in three patients with various articular diseases, were found to be of the monoexponential type in agreement with results obtained by authors employing radioactive tracers. Clearance half-time values in basal conditions were higher in the normal knee joint than in the inflamed knee joint. The effect of a corticosteroid suspension injected into the knee joint was also studied. Preliminary results obtained indicate that the X-ray fluorescence technique can be employed, with some advantages compared with the radiotracer technique, for quantitative determination of spontaneous or pharmacologically induced changes in joint inflammation.

Topics: Humans; Inflammation; Iothalamate Meglumine; Joint Diseases; Kinetics; Knee Joint; Radiography; Spectrometry, X-Ray Emission; Triamcinolone Acetonide