Indirect arthrography
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At the time the article was created Frank Gaillard had no recorded disclosures.
View Frank Gaillard's current disclosuresAt the time the article was last revised Andrew Murphy had no financial relationships to ineligible companies to disclose.
View Andrew Murphy's current disclosures- Indirect MR arthrography
- Indirect magnetic resonance arthrography
Indirect arthrography is an MRI technique to produce arthrographic images without the need to perform a direct joint injection.
A standard dose of a gadolinium-containing contrast agent is injected intravenously and imaging of the shoulder performed after a delay of typically between 5 and 15 minutes 2,3, during which time exercise of the joint is performed to facilitate the diffusion of contrast into the joint.
Although the advantages of indirect arthrography are obvious (not requiring direct injection into the joint), it is not without substantial drawbacks that have limited widespread adoption. The main concerns are 1-3:
- lack of predictability of the degree of intra-articular enhancement, dependent on synovial surface area, inflammation, and amount of joint fluid
- lack of joint distention (unless a joint effusion is already present)
- inability to detect non-anatomical communications between fluid-containing spaces, as they will all enhance simultaneously
References
- 1. Morrison WB. Indirect MR arthrography: concepts and controversies. (2005) Seminars in musculoskeletal radiology. 9 (2): 125-34. doi:10.1055/s-2005-872338 - Pubmed
- 2. Fallahi F, Green N, Gadde S, Jeavons L, Armstrong P, Jonker L. Indirect magnetic resonance arthrography of the shoulder; a reliable diagnostic tool for investigation of suspected labral pathology. (2013) Skeletal radiology. 42 (9): 1225-33. doi:10.1007/s00256-013-1644-1 - Pubmed
- 3. Vahlensieck M, Sommer T, Textor J, Pauleit D, Lang P, Genant HK, Schild HH. Indirect MR arthrography: techniques and applications. (1998) European radiology. 8 (2): 232-5. doi:10.1007/s003300050369 - Pubmed
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