ULTRASOUND GUIDANCE WITH POSTERIOR APPROACH FOR MR ARTHROGRAPHY OF THE SHOULDER JOINT
Vladka Salapura, Goran Mitrovič, Mislav Čavka
Instability of glenohumeral joint is mostly a consequence of injury of intra-articular structures. Magnetic resonance arthrography is a method of choice for diagnostic imaging. It permits an evaluation of labral-ligamentous complex, injuries of the inner part of rotator cuff and rotator cuff interval structures, imaging of articular cartilage, and postoperative evaluation of glenohumeral joint. In Clinical Institute of Radiology, University Medical Centre Ljubljana, we conducted a study to evaluate the feasibility, diagnostic value, and safety of magnetic resonance arthrography under ultrasound guidance. We included 67 patients with glenohumeral joint instability or rotator cuff injury. We evaluated technical success rate, procedural time, extravasation and pain grades, and rate of complications. Technical success rate was 100%, average procedural time was 8.8 min, severe extravasation grade and complication rate were 7.5%, in both parameters. Average pain grade was 3.6. The results of our study confirm that ultrasound guided magnetic resonance arthrography with posterior approach to glenohumeral joint is a very good alternative technique to standard fluoroscopic guidance with significant advantages for patients.