J Korean Soc Radiol.  2011 Oct;65(4):403-409. 10.3348/jksr.2011.65.4.403.

Fluoroscopically-Guided Posterior Approach for Shoulder Magnetic Resonance Arthrography: Comparison with Conventional Anterior Approach

• Yoo KJ
• Ha DH
• Lee SM

• KMID: 2002943
• DOI: http://doi.org/10.3348/jksr.2011.65.4.403

Abstract

PURPOSE
To prospectively evaluate the usefulness of the fluoroscopically-guided posterior approach compared with the anterior approach for shoulder magnetic resonance (MR) arthrography.
MATERIALS AND METHODS
Institutional review board approval and informed consent were obtained. Among 60 shoulder MR arthrographies performed on 59 patients with symptomatic shoulders, an intra-articular injection was performed (30 cases using the anterior approach and 30 using the posterior approach). Procedure-related pain was assessed by using a 5 score visual analogue scale (VAS). Depth of the puncture and standardized depth of puncture by body mass index (BMI) were recorded. The contrast leakage along the course of the puncture was evaluated by reviewing the MR. The statistical analyses included the Mann-Whitney U and Kruskal-Wallis test.
RESULTS
There was no significant difference in VAS scores between the anterior and posterior groups (1.77 +/- 1.10 vs. 1.80 +/- 0.96). Depth of puncture and standardized depth of puncture by BMI were significantly shorter in the posterior group than those in the anterior group (4.4 +/- 0.8 cm and 1.8 +/- 0.3 cm vs. 6.6 +/- 0.9 cm and 2.8 +/- 0.4 cm, p < 0.001), respectively. The incidence of contrast leakage was more frequent in the posterior group (p = 0.003).
CONCLUSION
The posterior approach will be useful in shoulder MR arthrography with a suspected anterior pathology, a postoperative follow-up study or obese patient.

MeSH Terms

Arthrography
Body Mass Index
Ethics Committees, Research
Follow-Up Studies
Humans
Incidence
Informed Consent
Injections, Intra-Articular
Magnetic Resonance Spectroscopy
Magnetics
Magnets
Prospective Studies
Punctures
Shoulder