肩関節臼唇前方部分の撮影法 : 半軸位 double-contrast arthrotomography

Abstract

In recurrent dislocation of the shoulder joint, the semi-axial view of double-contrast arthrotomography that we had tried provided superior visualization of anterior glenoid labrum, articular cartilage and of the capsule on the radiographs. In our method ; 1-1.5 ml of 76% Urografin and 10-12 ml room air are injected anteriorly into the glenohumeral joint space of the patient under fluoroscopic control. After that procedure, put the patient in about a 45°angle sitting position. And maintaining it, turn the patient oblique to a 60° angle to the table, with the injured shoulder closest to it. In this position, the glenoid cavity is positioned semi-axial and the joint is perpendicular to the film anatomically. At that time, the humerus of the damaged side need to be slightly abducted and rotated internally. Following to the aforementioned positioning, arthrotomography is carried out using the spiral locus program. In sectioning, we go down from the coracoid process at 3 millimeter intervals. In this tomography, we use high-contrast single-screen system. To maintain the positioning for tomographic sectioning, we made a special devide. This method is now routine X-ray studies for recurrent dislocation of the shoulder and for the loose shoulder in our hospital.