Frequency of technical success of ultrasound-guided arthrogram injections in children.
Elbow
Hip
Magnetic resonance arthrography
Pediatric
Shoulder
Ultrasound guidance
Journal
Pediatric radiology
ISSN: 1432-1998
Titre abrégé: Pediatr Radiol
Pays: Germany
ID NLM: 0365332
Informations de publication
Date de publication:
11 2023
11 2023
Historique:
received:
19
06
2023
accepted:
18
09
2023
revised:
13
09
2023
medline:
13
11
2023
pubmed:
29
9
2023
entrez:
29
9
2023
Statut:
ppublish
Résumé
MR arthrography is an essential diagnostic tool to assess and guide management of labral, ligamentous, fibrocartilaginous, and capsular abnormalities in children. While fluoroscopy is traditionally used for intra-articular contrast administration, ultrasound offers advantages of portability and lack of ionizing radiation exposure for both the patient and proceduralist. The purpose of this retrospective study is to quantify technical success and frequency of complications of ultrasound-guided arthrogram injections at our institution. This retrospective analysis investigates the results of 217 ultrasound-guided arthrograms of the shoulder, elbow, and hip in patients aged 5-18 years. Successful injection of contrast into the target joint, clinical indication for MR arthrography, and complications were reviewed. Accurate ultrasound-guided intra-articular administration of contrast into the target joint was successful for 100% of shoulder cases (90/90), 97% of elbow cases (77/79), and 98% of hip cases (47/48). Leak of contrast outside the target joint occurred in 1.4% (3/217) of cases. No major side effects including excessive bleeding, paresthesia, allergic reactions, or infection occurred during or after the procedure. Additionally, no major vessel, nerve, or tendon complications were observed on MR images. Ultrasound guidance is a reliable, effective, and safe approach to arthrography in children.
Sections du résumé
BACKGROUND
MR arthrography is an essential diagnostic tool to assess and guide management of labral, ligamentous, fibrocartilaginous, and capsular abnormalities in children. While fluoroscopy is traditionally used for intra-articular contrast administration, ultrasound offers advantages of portability and lack of ionizing radiation exposure for both the patient and proceduralist.
OBJECTIVE
The purpose of this retrospective study is to quantify technical success and frequency of complications of ultrasound-guided arthrogram injections at our institution.
MATERIALS AND METHODS
This retrospective analysis investigates the results of 217 ultrasound-guided arthrograms of the shoulder, elbow, and hip in patients aged 5-18 years. Successful injection of contrast into the target joint, clinical indication for MR arthrography, and complications were reviewed.
RESULTS
Accurate ultrasound-guided intra-articular administration of contrast into the target joint was successful for 100% of shoulder cases (90/90), 97% of elbow cases (77/79), and 98% of hip cases (47/48). Leak of contrast outside the target joint occurred in 1.4% (3/217) of cases. No major side effects including excessive bleeding, paresthesia, allergic reactions, or infection occurred during or after the procedure. Additionally, no major vessel, nerve, or tendon complications were observed on MR images.
CONCLUSION
Ultrasound guidance is a reliable, effective, and safe approach to arthrography in children.
Identifiants
pubmed: 37773443
doi: 10.1007/s00247-023-05777-5
pii: 10.1007/s00247-023-05777-5
doi:
Substances chimiques
Contrast Media
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
2380-2385Informations de copyright
© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.
Références
Magee T (2009) 3-T MRI of the shoulder: is MR arthrography necessary? Am J Roentgenol 192:86–92
doi: 10.2214/AJR.08.1097
Peterson JJ, Bancroft LW (2009) History of arthrography. Radiol Clin North Am 47:373–386
doi: 10.1016/j.rcl.2008.12.001
pubmed: 19361665
Choudur HN, Lou EM (2011) Ultrasound-guided gadolinium joint injections for magnetic resonance arthrography. J Clin Ultrasound 39:6–11
doi: 10.1002/jcu.20753
pubmed: 21136580
Jernick M, Walker Gallego E, Nuzzo M (2017) Retrospective analysis of the accuracy of ultrasound-guided magnetic resonance arthrogram injections of the hip in the office setting. Orthop J Sports Med 5(12). https://doi.org/10.1177/2325967117743915
Otjen J, Parnell SE, Menashe S, Thapa MM (2015) Ultrasound-guided joint injections for MR arthrography in pediatric patients: how we do it. Pediatr Radiol 45:308–316
doi: 10.1007/s00247-014-3212-9
pubmed: 25726013
Dépelteau H, Bureau NJ, Cardinal E, Aubin B, Brassard P (2004) Arthrography of the shoulder: a simple fluoroscopically guided approach for targeting the rotator cuff interval. AJR Am J Roentgenol 182(2):329–332. https://doi.org/10.2214/ajr.182.2.1820329
doi: 10.2214/ajr.182.2.1820329
pubmed: 14736656
Schulte-Altedorneburg G, Gebhard M, Wohlgemuth WA et al (2003) MR arthrography: pharmacology, efficacy and safety in clinical trials. Skeletal Radiol 32:1–12
doi: 10.1007/s00256-002-0595-8
pubmed: 12525938
Shortt CP, Morrison WB, Roberts CC et al (2009) Shoulder, hip, and knee arthrography needle placement using fluoroscopic guidance: practice patterns of musculoskeletal radiologists in North America. Skeletal Radiol 38:377–385
doi: 10.1007/s00256-009-0648-3
pubmed: 19183985
Kuratani K, Tanaka M, Hanai H, Hayashida K (2022) Accuracy of shoulder joint injections with ultrasound guidance: confirmed by magnetic resonance arthrography. World J Orthop 13:259–266
doi: 10.5312/wjo.v13.i3.259
pubmed: 35317253
pmcid: 8935327
Ali AH, Said HG, Abo elhamd E et al (2021) Shoulder MR arthrography: comparative evaluation of three different contrast injection techniques using an anterior approach. J Magn Reson Imaging 53:481–490
doi: 10.1002/jmri.27348
pubmed: 32914911
Martínez-Martínez A, García-Espinosa J, Ruiz-Santiago F et al (2016) Comparison of ultrasound and fluoroscopic guidance for injection in CT arthrography and MR arthrography of the hip. Radiología (English Edition) 58:454–459
doi: 10.1016/j.rxeng.2016.07.006
Rutten MJCM, Collins JMP, Maresch BJ et al (2009) Glenohumeral joint injection: a comparative study of ultrasound and fluoroscopically guided techniques before MR arthrography. Eur Radiol 19:722–730
doi: 10.1007/s00330-008-1200-x
pubmed: 18958474
Ng AWH, Hung EHY, Griffith JF et al (2013) Comparison of ultrasound versus fluorcoscopic guided rotator cuff interval approach for MR arthrography. Clin Imaging 37:548–553
doi: 10.1016/j.clinimag.2012.08.002
pubmed: 23601770
Perdikakis E, Drakonaki E, Maris T, Karantanas A (2013) MR arthrography of the shoulder: tolerance evaluation of four different injection techniques. Skeletal Radiol 42:99–105
doi: 10.1007/s00256-012-1526-y
pubmed: 23064511
Byrd JWT, Potts EA, Allison RK, Jones KS (2014) Ultrasound-guided hip injections: a comparative study with fluoroscopy-guided injections. Arthroscopy - J Arthrosc Related Surg 30:42–46
doi: 10.1016/j.arthro.2013.09.083
Chopra A, Grainger AJ, Dube B et al (2018) Comparative reliability and diagnostic performance of conventional 3T magnetic resonance imaging and 1.5T magnetic resonance arthrography for the evaluation of internal derangement of the hip. Eur Radiol 28:963–971
doi: 10.1007/s00330-017-5069-4
pubmed: 28986631
Crespo-Rodríguez AM, De Lucas-Villarrubia JC, Pastrana-Ledesma M et al (2017) The diagnostic performance of non-contrast 3-Tesla magnetic resonance imaging (3-T MRI) versus 1.5-Tesla magnetic resonance arthrography (1.5-T MRA) in femoro-acetabular impingement. Eur J Radiol 88:109–116
doi: 10.1016/j.ejrad.2016.12.031
pubmed: 28189195
Zhang P, Li C, Wang W, Zhang B, Miao W, Liu Y (2022) 3.0 T MRI is more recommended to detect acetabular labral tears than MR Arthrography: an updated meta-analysis of diagnostic accuracy. J Orthop Surg Res 17(1):126
Magee T (2015) Accuracy of 3-T MR arthrography versus conventional 3-T MRI of elbow tendons and ligaments compared with surgery. AJR Am J Roentgenol 204:W70–W75
doi: 10.2214/AJR.14.12553
pubmed: 25539278
Major NM, Browne J, Domzalski T et al (2011) Evaluation of the glenoid labrum with 3-T MRI: Is intraarticular contrast necessary? Am J Roentgenol 196:1139–1144
doi: 10.2214/AJR.08.1734
Oh CH, Schweitzer ME, Spettell CM (1999) Internal derangements of the shoulder: decision tree and cost-effectiveness analysis of conventional arthrography, conventional MRI, and MR arthrography. Skeletal Radiol. 28(12):670–678. https://doi.org/10.1007/s002560050572
doi: 10.1007/s002560050572
pubmed: 10653361
Souza PM, Aguiar RO, Marchiori E, Bardoe SA (2010) Arthrography of the shoulder: a modified ultrasound guided technique of joint injection at the rotator interval. Eur J Radiol 74(3):e29–e32. https://doi.org/10.1016/j.ejrad.2009.03.020
doi: 10.1016/j.ejrad.2009.03.020
pubmed: 19394776
Patel DN, Nayyar S, Hasan S et al (2012) Comparison of ultrasound-guided versus blind glenohumeral injections: a cadaveric study. J Shoulder Elbow Surg 21:1664–1668
doi: 10.1016/j.jse.2011.11.026
pubmed: 22445159
Furtado RNV, Pereira DF, da Luz KR et al (2013) Effectiveness of imaging-guided intra-articular injection: a comparison study between fluoroscopy and ultrasound. Revista Brasileira de Reumatologia (English Edition) 53:476–482
doi: 10.1016/j.rbre.2013.07.001