Ultrasound-guided shoulder MR arthrography: comparison of rotator interval and posterior approach

Clin Imaging. 2014 Jan-Feb;38(1):11-7. doi: 10.1016/j.clinimag.2013.07.006. Epub 2013 Oct 9.

Abstract

Purpose: The purpose of this study was to prospectively evaluate the two different ultrasound-guided injection techniques for magnetic resonance (MR) arthrography of the shoulder.

Methods and materials: This study included 100 patients [50 rotator interval group (n=50) vs. 50 posterior approach group (n=50)]. All procedures were performed by the same radiologist. The two injection techniques were compared. The discomfort during and after arthrography was evaluated. Extraarticular contrast media extravasation was graded according to the MRI findings. The number of injection attempts, effect of contrast media extravasation rate on diagnostic quality and procedure times were recorded.

Results: There were no significant difference between the posterior and rotator interval puncture groups with regard to pain (P=.915), procedure times (P=.401) or attempt scores (P=.182). There were significantly more contrast media extravasations with rotator interval approach than posterior approach (P<.05).

Conclusion: Both techniques were successful and well tolerated by patients. Posterior injection technique provided a more effective route with decreased extravasation rate and easier approach compared to the rotator interval approach.

Keywords: Posterior approach; Rotator interval; Shoulder MR arthrography; US guidance.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Arthralgia / pathology*
  • Arthrography / methods*
  • Contrast Media / administration & dosage
  • Female
  • Gadolinium / administration & dosage*
  • Humans
  • Injections, Intra-Articular / methods*
  • Magnetic Resonance Imaging / methods*
  • Male
  • Middle Aged
  • Pain Measurement
  • Prospective Studies
  • Shoulder Joint / diagnostic imaging*
  • Shoulder Joint / pathology*
  • Ultrasonography
  • Young Adult

Substances

  • Contrast Media
  • Gadolinium