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Radio-carpal wrist MR arthrography: comparison of ultrasound with fluoroscopy and palpation-guided injections. Skeletal Radiol 2022; 51:765-775. [PMID: 34324016 DOI: 10.1007/s00256-021-03845-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 06/12/2021] [Accepted: 06/13/2021] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To compare ultrasound- (US), fluoroscopy- (FL), and palpation-guided contrast injection techniques used for dorsal radio-carpal wrist MRA. MATERIALS AND METHODS Patients with chronic wrist pain were randomized as to which injection technique they underwent into three groups of 50 participants. Dorsal radio-carpal contrast injection was performed under US, FL guidance (one radiologist for each), or palpation guidance by an orthopedic surgeon. The three techniques were compared by procedure time, success rate, number of attempts needed, frequency and grade of extravasation, joint distension, and MRA image quality. Additionally, any change from baseline wrist pain was recorded using the visual analog scale (VAS) at five time points (immediately, 8 h, 24 h, 48 h, and 1 week) after injection. RESULTS One hundred and fifty patients (83 males and 67 females; mean age 29 ± 6.5 years) were included. Success rates for US- and FL-guided injections were 100%, while palpation-guided approach was significantly less successful (72%) (P = 0.02) with significantly more frequent extravasation (56%)(P < 0.001). US guidance was the least time-consuming (6.5 ± 1.6 min) compared to FL guidance (12.5 ± 1.9 min) and palpation guidance (8 ± 1.2 min) (all P < 0.001). The mean number of joint puncture attempts was significantly lower with imaging-guided techniques (1.1 ± 0.24 and 1.2 ± 0.4 for US and FL, P = 0.23) compared to palpation-guided one (1.6 ± 0.8) (P = 0.007). The largest increases in baseline-pain were 8-h post-injection, and US guidance was the least painful at all-time points (all P < 0.05). Joint distension and image quality were significantly better with imaging-guided techniques (P < 0.001 and P = 0.003). CONCLUSIONS US-guided radio-carpal injection is a less time-consuming, more tolerable, and successful radiation-free method when compared to FL guidance. Palpation-guided injections require multiple attempts to enter the joint with high failure rates and frequent extravasation.
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Mezian K, Ricci V, Jačisko J, Sobotová K, Angerová Y, Naňka O, Özçakar L. Ultrasound Imaging and Guidance in Common Wrist/Hand Pathologies. Am J Phys Med Rehabil 2021; 100:599-609. [PMID: 33443851 DOI: 10.1097/phm.0000000000001683] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
ABSTRACT Wrist/hand pain is a prevalent musculoskeletal condition with a great spectrum of etiologies (varying from overuse injuries to soft tissue tumors). Although most of the anatomical structures are quite superficial and easily evaluated during physical examination, for several reasons, the use of ultrasound imaging and guidance has gained an intriguing and paramount concern in the prompt management of relevant patients. In this aspect, the present review aims to illustrate detailed cadaveric wrist/hand anatomy to shed light into better understanding the corresponding ultrasonographic examinations/interventions in carpal tunnel syndrome, trigger finger, de Quervain tenosynovitis, rhizarthrosis, and the radiocarpal joint arthritis. In addition, evidence from the literature supporting the rationale why ultrasound guidance is henceforth unconditional in musculoskeletal practice is also exemplified.
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Affiliation(s)
- Kamal Mezian
- From the Department of Rehabilitation Medicine, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic (KM, YA); Physical and Rehabilitation Medicine Unit, "Luigi Sacco" University Hospital, A.S.S.T. Fatebenefratelli-Sacco, Milan, Italy (VR); Department of Rehabilitation and Sports Medicine, Second Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic (JJ, KS); Institute of Anatomy, First Faculty of Medicine, Charles University, Prague, Czech Republic (ON); and Department of Physical and Rehabilitation Medicine, Hacettepe University Medical School, Ankara, Turkey (LÖ)
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To P, McClary KN, Sinclair MK, Stout BA, Foad M, Hiratzka S, Stern PJ. The Accuracy of Common Hand Injections With and Without Ultrasound: An Anatomical Study. Hand (N Y) 2017; 12:591-596. [PMID: 28719974 PMCID: PMC5669333 DOI: 10.1177/1558944717692086] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND The aim of the study is to determine the accuracy of hand injections with and without the aid of ultrasound (U/S) into the carpal tunnel, thumb carpometacarpal (CMC) joint, first dorsal compartment (DC) and the radiocarpal (RC) joint. METHODS Four participants of various level of experience injected the carpal tunnel, thumb CMC, first DC, and RC joint into 40 fresh frozen cadaver specimens with blue dye and radiographic contrast. Participants 1 and 2 were injected without U/S guidance, and participants 3 and 4 were injected with U/S guidance. A successful injection was determined by both fluoroscopy and dissection/direct observation. Additional information was recorded for each injection such as median nerve infiltration and evidence of thumb CMC arthrosis. RESULTS The overall accuracy for carpal tunnel, thumb CMC, first DC, and RC injections were 95%, 63%, 90%, and 90%, respectively. Success was compared with and without U/S guidance. Success rates were similar for each injection site, except the thumb CMC joint, where U/S participants had 25% higher accuracy. In the setting of thumb CMC arthrosis, the incidence of success was 38% for participants with no U/S aid and 72% for participants with U/S aid. There was a significant difference between participants who used U/S with the participant with more U/S experience being more successful. CONCLUSION Carpal tunnel, first DC, and RC injections had an accuracy of greater than 90%. Thumb CMC injections have a lower accuracy (63%) and one can improve accuracy with U/S. The accuracy of U/S-guided injections is dependent on the user and their experience.
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Affiliation(s)
- Philip To
- OrthoArizona, Scottsdale, USA,Philip To, OrthoArizona, 5620 E. Bell Road, Scottsdale, AZ 85254, USA.
| | | | | | | | - Mohab Foad
- Beacon Orthopaedics and Sports Medicine, Cincinnati, OH, USA
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Chan WY, Chong LR. Anatomical Variants of Lister's Tubercle: A New Morphological Classification Based on Magnetic Resonance Imaging. Korean J Radiol 2017; 18:957-963. [PMID: 29089828 PMCID: PMC5639161 DOI: 10.3348/kjr.2017.18.6.957] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2016] [Accepted: 01/27/2017] [Indexed: 12/21/2022] Open
Abstract
Objective Lister's tubercle is used as a standard anatomical landmark in hand surgery and arthroscopy procedures. In this study, we aimed to evaluate and propose a classification for anatomical variants of Lister's tubercle. Materials and Methods Between September 2011 and July 2014, 360 MRI examinations for wrists performed using 1.5T scanners in a single institution were retrospectively evaluated. The prevalence of anatomical variants of Lister's tubercle based on the heights and morphology of its radial and ulnar peaks was assessed. These were classified into three distinct types: radial peak larger than ulnar peak (Type 1), similar radial and ulnar peaks (Type 2) and ulnar peak larger than radial peak (Type 3). Each type was further divided into 2 subtypes (A and B) based on the morphology of the peaks. Results The proportions of Type 1, Type 2, and Type 3 variants in the study population were 69.2, 21.4, and 9.5%, respectively. For the subtypes, the Type 1A variant was the most common (41.4%) and conformed to the classical appearance of Lister's tubercle; whereas, Type 3A and 3B variants were rare configurations (6.4% and 3.1%, respectively) wherein the extensor pollicis longus tendon coursed along the radial aspect of Lister's tubercle. Conclusion Anatomical variations of Lister's tubercle have potential clinical implications for certain pathological conditions and pre-procedural planning. The proposed classification system facilitates a better understanding of these anatomical variations and easier identification of at-risk and rare variants.
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Affiliation(s)
- Wan Ying Chan
- Department of Radiology, Changi General Hospital, Singapore 529889, Singapore
| | - Le Roy Chong
- Department of Radiology, Changi General Hospital, Singapore 529889, Singapore
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Colio SW, Smith J, Pourcho AM. Ultrasound-Guided Interventional Procedures of the Wrist and Hand: Anatomy, Indications, and Techniques. Phys Med Rehabil Clin N Am 2016; 27:589-605. [PMID: 27468668 DOI: 10.1016/j.pmr.2016.04.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Acute and chronic wrist and hand conditions are commonly seen by neuromuscular and musculoskeletal specialists. High-frequency diagnostic ultrasonography (US) has facilitated advances in the diagnosis and interventional management of wrist and hand disorders. US provides excellent soft tissue resolution, accessibility, portability, lack of ionizing radiation, and the ability to dynamically assess disorders and precisely guide interventional procedures. This article review the relevant anatomy, indications, and interventional techniques for common disorders of the wrist and hand, including radiocarpal joint arthritis, scaphotrapeziotrapezoidal joint arthritis, trapeziometacarpal joint arthritis, phalangeal joint arthritis, first dorsal compartment tenosynovitis, ganglion cysts, and stenosing tenosynovitis.
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Affiliation(s)
- Sean W Colio
- Department of Physical Medicine and Rehabilitation, Swedish Spine, Sports, and Musculoskeletal Center, Swedish Medical Group, Seattle, WA, USA
| | - Jay Smith
- Departments of Physical Medicine & Rehabilitation, Mayo Clinic Sports Medicine Center, Mayo Clinic, Rochester, MN, USA; Department Radiology, Mayo Clinic Sports Medicine Center, Mayo Clinic, Rochester, MN, USA; Department Anatomy, Mayo Clinic Sports Medicine Center, Mayo Clinic, Rochester, MN, USA
| | - Adam M Pourcho
- Department of Physical Medicine and Rehabilitation, Swedish Spine, Sports, and Musculoskeletal Center, Swedish Medical Group, 600 E. Jefferson Street, Suite 300, Seattle, WA 98112, USA.
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Ağır I, Aytekin MN, Küçükdurmaz F, Gökhan S, Cavuş UY. Anatomical Localization of Lister's Tubercle and its Clinical and Surgical Importance. Open Orthop J 2014; 8:74-7. [PMID: 24843388 PMCID: PMC4023390 DOI: 10.2174/1874325001408010074] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2013] [Revised: 04/03/2014] [Accepted: 04/06/2014] [Indexed: 12/21/2022] Open
Abstract
The dorsal tubercle of the radius, once called Lister’s tubercle, is used as a landmark in wrist arthroscopy, wrist
joint injections, and similar surgical and clinical procedures. However, there is no useful information in the reference
anatomy books and literature. The aim of this study was to identify the anatomical localization of Lister’s tubercle on the
dorsum of radius in relation to the radial styloid process and the ulnar notch of radius and to demonstrate the clinical and
surgical importance of these relationships. We studied 20 dried cadaver radius specimens. The distances from Lister’s
tubercle to the radial styloid process and to the ulnar notch were measured by using a digital micrometer caliber and the
ratio of the two measures was calculated. The dorsal tubercle of the radius is variable in position and can be either closer
to the radial styloid process or to the ulnar notch. The present study showed that in 11 of the radii the dorsal tubercle of
the radius was nearer to the radial styloid process than the ulnar notch, while in 9 subjects it was nearer to the ulnar notch.
This anatomical variation may be relevant for wrist injections, wrist artroscopy or wrist surgery.
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Affiliation(s)
- Ismail Ağır
- Department of Orthopedics and Traumatology, Adıyaman University Training and Research Hospital, Adıyaman, Turkey
| | - Mahmut Nedim Aytekin
- Department of Orthopedics and Traumatology, Atatürk Training and Research Hospital, Ankara, Turkey
| | - Fatih Küçükdurmaz
- Clinic of Orthopaedics and Traumatology, Bezmi Alem Foundation University School of Medicine, 34093, Istanbul, Turkey
| | - Servan Gökhan
- Department of Emergency Medicine, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - Umut Yücel Cavuş
- Department of Emergency Medicine, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
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The Accuracy and Efficacy of Palpation versus Image-Guided Peripheral Injections in Sports Medicine. Curr Sports Med Rep 2013; 12:296-303. [DOI: 10.1097/01.csmr.0000434103.32478.36] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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Collins JMP, Smithuis R, Rutten MJCM. US-guided injection of the upper and lower extremity joints. Eur J Radiol 2011; 81:2759-70. [PMID: 22130195 DOI: 10.1016/j.ejrad.2011.10.025] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2011] [Revised: 10/12/2011] [Accepted: 10/28/2011] [Indexed: 12/13/2022]
Abstract
There is a growing interest in the application of ultrasound (US) guidance for diagnostic and therapeutic joint injections. US provides direct visualization of soft tissues and the outer borders of bony structures. With real-time needle guidance the success rate of intra-articular injections improves and iatrogenic damage to anatomic structures can be avoided. An US machine is more readily available, transferrable and more affordable than a fluoroscopy machine or CT scanner and lacks the risk of radiation. These factors make US a valuable alternative to procedures performed either blind or under fluoroscopic or CT guidance. This article focuses on the rationale for injections in the upper and lower extremity joints and describes and illustrates the different US-guided injection techniques.
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Affiliation(s)
- James M P Collins
- Department of Radiology, Medical Center Leeuwarden, H. Dunantweg 2, AD Leeuwarden, The Netherlands.
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Smith J, Rizzo M, Sayeed YA, Finnoff JT. Sonographically guided distal radioulnar joint injection: technique and validation in a cadaveric model. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2011; 30:1587-1592. [PMID: 22039032 DOI: 10.7863/jum.2011.30.11.1587] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Distal radioulnar joint (DRUJ) disorders are uncommon but important causes of ulnar-sided wrist pain and disability. Fluoroscopically guided injections may be performed to diagnose or treat DRUJ-related pain or as part of a diagnostic arthrogram. Sonographic guidance may provide a favorable alternative to fluoroscopic guidance for distal DRUJ injections. This report describes and validates a sonographically guided technique for DRUJ injections in an unembalmed cadaveric model. An experienced clinician used sonographic guidance to inject diluted colored latex into the DRUJs of 10 unembalmed cadaveric specimens. Subsequent dissection by a fellowship-trained hand surgeon confirmed accurate injections in all 10 specimens. Two cases of ulnocarpal flow, indicative of triangular fibrocartilage injury, were noted during injection and subsequently confirmed during dissection. Clinicians should consider using sonographic guidance to perform DRUJ injections when clinically indicated. Further research should explore the efficacy of sonographically guided DRUJ injections to treat patients with painful DRUJ syndromes or to evaluate the triangular fibrocartilage complex in patients with ulnar wrist pain syndromes.
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Affiliation(s)
- Jay Smith
- Departments of Physical Medicine and Rehabilitation and Radiology, W14, Mayo Clinic College of Medicine, Rochester, MN 55905 USA.
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The Accuracy of Ultrasound-Guided and Palpation-Guided Peroneal Tendon Sheath Injections. Am J Phys Med Rehabil 2011; 90:564-71. [DOI: 10.1097/phm.0b013e31821f6e63] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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Omoumi P, Teixeira P, Lecouvet F, Chung CB. Glenohumeral joint instability. J Magn Reson Imaging 2011; 33:2-16. [PMID: 21182115 DOI: 10.1002/jmri.22343] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Due to the configuration of its bony elements, the glenohumeral joint is the most mobile joint of the body, but also an inherently unstable articulation. Stabilization of the joint is linked to a complex balance between static and dynamic soft tissue stabilizers. Because of complex biomechanics, and the existence of numerous classifications and acronyms to describe shoulder instability lesions, this remains a daunting topic for most radiologists. In this article we provide a brief review of the anatomy of the glenohumeral joint, as well as the classifications and the pathogenesis of shoulder instability. Technical aspects related to the available imaging techniques (including computed tomography [CT] arthrography, magnetic resonance imaging [MRI], and MR arthrography) are reviewed. We then describe the imaging findings related to shoulder instability, focusing on those elements that are important to the clinician.
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Affiliation(s)
- Patrick Omoumi
- Department of Radiology, Cliniques Universitaires Saint Luc, Académie Universitaire de Louvain, Brussels, Belgium
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Peterson C, Hodler J. Adverse events from diagnostic and therapeutic joint injections: a literature review. Skeletal Radiol 2011; 40:5-12. [PMID: 19949787 DOI: 10.1007/s00256-009-0839-y] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2009] [Revised: 11/02/2009] [Accepted: 11/05/2009] [Indexed: 02/02/2023]
Abstract
This review article classifies the various adverse reactions arising from intra-articular injections by severity, diagnostic category, and whether they are due to corticosteroid, local anesthetic or viscosupplementation injections. Life-threatening and serious adverse events from intra-articular injections are rare and range from local complications to systemic afflictions. Measures to reduce the likelihood of an adverse event occurring are outlined and patients with significant features in their clinical histories, predisposing them to adverse events, are highlighted.
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Affiliation(s)
- Cynthia Peterson
- Radiology, Orthopaedic University Hospital of Balgrist, Forchstrasse 340, 8008, Zürich, Switzerland.
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Choudur HN, Ellins ML. Ultrasound-guided gadolinium joint injections for magnetic resonance arthrography. JOURNAL OF CLINICAL ULTRASOUND : JCU 2011; 39:6-11. [PMID: 21136580 DOI: 10.1002/jcu.20753] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
PURPOSE To determine the feasibility and accuracy of ultrasound (US) -guided gadolinium injection for MR arthrography of shoulders, wrists, hips, and knee joints as an alternate technique to fluoroscopy. METHODS One hundred patients referred to our center for an MR arthrogram of shoulders, wrists, hips, and knees were included in the study. There were 53 males and 47 females and ages ranged from 17 to 63 years (mean age, 37). US was used to guide the needle tip into the joint. The intra-articular location of the needle tip was confirmed by fluoroscopic visualization of injected iodinated contrast medium, prior to gadolinium injection. The patients then proceeded for the MRI examination. RESULTS Ninety-nine of the 100 patients were successfully injected with gadolinium under US guidance. One patient had a vasovagal reaction after local anesthetic injection and the procedure was aborted. CONCLUSION US is an effective alternate guidance technique for the injection of gadolinium into shoulder, hip, knee, and wrist joints for MR arthrography. Its advantages are cost effectiveness, ease of performance, and lack of radiation.
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Affiliation(s)
- Hema Nalini Choudur
- Department of Diagnostic Imaging, Hamilton Health Sciences, Hamilton General Hospital, McMaster University, Hamilton, Ontario, Canada
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Finnoff JT, Nutz DJ, Henning PT, Hollman JH, Smith J. Accuracy of Ultrasound-Guided versus Unguided Pes Anserinus Bursa Injections. PM R 2010; 2:732-9. [DOI: 10.1016/j.pmrj.2010.03.014] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2009] [Revised: 03/01/2010] [Accepted: 03/08/2010] [Indexed: 11/25/2022]
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Gonçalves B, Ambrosio C, Serra S, Alves F, Gil-Agostinho A, Caseiro-Alves F. US-guided interventional joint procedures in patients with rheumatic diseases--when and how we do it? Eur J Radiol 2010; 79:407-14. [PMID: 20554144 DOI: 10.1016/j.ejrad.2010.04.001] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2010] [Accepted: 04/07/2010] [Indexed: 10/19/2022]
Abstract
OBJECTIVE To describe the main indications and the technical steps to perform ultrasound guided procedures in patients with rheumatic diseases. To access procedures accuracy, safety and effectiveness. MATERIALS AND METHODS 27 patients with pain related to articular complications of rheumatic diseases and according to previous radiographic or US exam were submitted to several US-guided procedures. 42% of patients (n=11) had rheumatoid arthritis, 11% (n=3) spondyloarthropathies, 18% (n=5) psoriatic arthritis, 15% (n=4) undifferentiated arthritis, 3% (n=1) Sjögren syndrome and 11% (n=3) had gout. Described procedures are synovial biopsies, intra-articular injections of corticosteroids, radiation synovectomy and synovial cysts drainage procedures. When a therapeutical procedure was made, patients were evaluated by 2 rheumatologists. Corticosteroids used were Prednisolone and Triamcinolone. Yttrium-90 was used for synovectomy. RESULTS In all cases success was achieved with correct needle placement inside the joint. After injection/aspiration symptoms successfully solved with all patients improving their health status. No complications were recorded during follow-up period. CONCLUSIONS US-guidance is very reliable to afford a safety procedure always checking the injection, biopsy or aspiration. Guided-biopsy has high success rates obtaining several samples. Thus is also possible to use more powerful/long acting therapeutic drugs aggressive to extra-articular structures avoiding complications.
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Affiliation(s)
- B Gonçalves
- Department of Radiology, Hospitais da Universidade de Coimbra - HUC, Coimbra, Portugal.
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Abstract
CT arthrography and MR arthrography are accurate methods for the study of surface cartilage lesions and cartilage loss. They also provide information on subchondral bone and marrow changes, and ligaments and meniscal lesions that can be associated with osteoarthritis. Nuclear medicine also offers new insights in the assessment of the disease. This article discusses the strengths and limitations of CT arthrography and MR arthrography. It also highlights nuclear medicine methods that may be relevant to the study of osteoarthritis in research and clinical practice.
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De Zordo T, Mur E, Bellmann-Weiler R, Sailer-Höck M, Chhem R, Feuchtner GM, Jaschke W, Klauser AS. US guided injections in arthritis. Eur J Radiol 2009; 71:197-203. [PMID: 19450942 DOI: 10.1016/j.ejrad.2009.04.047] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2009] [Accepted: 04/16/2009] [Indexed: 10/20/2022]
Abstract
US guided procedures for diagnosis or treatment of different forms of arthritis are becoming more and more important. This review describes general considerations for fluid aspiration, articular or periarticular injections and biopsies by US guidance according to the recent literature. Guidelines regarding instrumentation, different techniques, pre- and postprocedural care as well as complications are outlined and in the second part a more detailed overview of different interventions in joints, tendons and other periarticular regions (nerves, bursae, etc.) is included. Furthermore, some newer, more sophisticated techniques are briefly discussed.
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Affiliation(s)
- Tobias De Zordo
- Department of Diagnostic Radiology, Medical University Innsbruck, Anichstrasse 35, 6020 Innsbruck, Austria
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