Morbidity of Direct MR Arthrography

Department of Radiology, University of California, San Francisco, San Francisco, CA, USA.
American Journal of Roentgenology (Impact Factor: 2.74). 04/2011; 196(4):868-74. DOI: 10.2214/AJR.10.5145
Source: PubMed

ABSTRACT The purpose of this study was to determine the incidence and severity of arthrographic pain after intraarticular injection of a gadolinium mixture diluted in normal saline for direct MR arthrography.
From March 2009 until January 2010, 155 consecutive patients underwent direct MR arthrography; 20 patients were lost to follow-up. Patients were contacted by telephone between 3 and 7 days after joint injection. Using an 11-point numeric pain rating scale, patients were asked to report if they had experienced joint pain that was different or more intense than their preinjection baseline, the severity of pain, the duration of pain, time to onset of pain, and eventual resolution of pain.
The incidence of postarthrographic pain was 66% (89/135), with an average intensity of pain of 4.8 ± 2.4 (range, 1-10). Postarthrographic pain lasted an average of 44.4 ± 30.5 hours (range, 6-168 hours). The time to onset of pain after joint injection was on average 16.6 ± 13.1 hours (range, 4-72 hours). There was no significant difference regarding the severity or incidence of postarthrographic pain between groups on the basis of patient age (p = 0.20 and 0.26), patient sex (p = 0.20 and 0.86), contrast mixture contents (p = 0.83 and 0.49), or joint injected (p = 0.51 and 0.47). No patients experienced any other serious side effects.
Sixty-six percent of patients who undergo direct MR arthrography will experience a fairly severe delayed onset of pain that completely resolves over the course of several days.

  • [Show abstract] [Hide abstract]
    ABSTRACT: Direct MR arthrography of the shoulder is a safe, relatively easy procedure that can increase diagnostic confidence in the evaluation of rotator cuff and labroligamentous disorders compared with conventional MR imaging of the shoulder. Surgeons more often request MR arthrography in younger patients who may have internal impingement or subtle shoulder subluxation rather than obvious cuff rupture, repeated dislocation, or arthropathy. This article describes the advances in glenohumeral injection and MR protocol techniques, imaging pitfalls, anatomical variants, common lesions associated with internal derangement of the shoulder, and MR arthrography of the postoperative shoulder.
    Seminars in musculoskeletal radiology 09/2014; 18(4):352-64. DOI:10.1055/s-0034-1384825 · 0.95 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: The concept of femoroacetabular impingement (FAI) has, in a relatively short time, come to the forefront of orthopedic imaging. In just a few short years MRI findings that were in the past ascribed to degenerative change, normal variation, or other pathologies must now be described and included in radiology reports, as they have been shown, or are suspected to be related to, FAI. Crucial questions have come up in this time, including: what is the relationship of bony morphology to subsequent cartilage and labral damage, and most importantly, how is this morphology related to the development of osteoarthritis? In this review, we attempt to place a historical perspective on the controversy, provide guidelines for interpretation of MRI examinations of patients with suspected FAI, and offer a glimpse into the future of MRI of this complex condition. J. Magn. Reson. Imaging 2015;41:558-572. © 2014 Wiley Periodicals, Inc. © 2014 Wiley Periodicals, Inc.
    Journal of Magnetic Resonance Imaging 08/2014; 41(3). DOI:10.1002/jmri.24725 · 2.79 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: An increasing number of children are taking up sporting activities and at more competitive levels. For this reason (pediatric) radiologists should expect to receive greater numbers of requests from their orthopedic colleagues to image the athletic child who presents with hip or groin pain: "athletic pubalgia."Lower limb sports-related pathology is particularly common in sports such as ballet, football, hockey, rugby, and running. Injuries to the hip and groin may account for up to a quarter of injuries seen in athletic children and may be acute or chronic, osseous, cartilaginous, ligamentous, or muscular. The radiologist should also bear in mind the possibility of non-sports-related pathology such as inflammation or tumor and of complications related to previous trauma such as avascular necrosis or femoroacetabular impingement complicating previous slipped capital femoral epiphysis. Radiologists should avoid use of the term sports hernia and provide a more specific description of the true abnormality.The major imaging modalities are radiographs and MRI. In this article we provide an overview of the common sports-related pathologies of the hip and groin that may be encountered in the athletic child.
    Seminars in musculoskeletal radiology 11/2014; 18(5):478-88. DOI:10.1055/s-0034-1389265 · 0.95 Impact Factor