Double Contrast Arthrography Of Knee Research Articles

Air aspiration after double–contrast knee arthrography: a worthwhile exercise?

A prospective study following double-contrast knee arthrography was undertaken to compare pain and discomfort experienced at the conclusion of the procedure and for 7 days afterwards. The patients were divided into two groups. Half had the air aspirated at the end of the examination and the other half did not. Twice as many patients in the aspirated group were totally asymptomatic (48% compared with 22%); however, by 7 days after the procedure the numbers of asymptomatic patients were similar in the two groups (64% and 63%, respectively). Thus our conclusion is that air aspiration after double-contrast knee arthrography does reduce short-term morbidity.

Radiologic findings of double contrast knee arthrography

Radiologic findings of double contrast knee arthrography

A comparative study to evaluate the role of intra-articular adrenaline in double-contrast knee arthrography

The addition of adrenaline to meglumine iothalamate (Conray 280) in double-contrast knee arthrography significantly improves meniscal coating, in both immediate and delayed films, when compared with iothalamate alone. The quality of coating is comparable to that with sodium meglumine ioxaglate (Hexabrix 320) without adrenaline. The addition of adrenaline to ioxaglate produces no significant improvement in arthrographic quality in either immediate or delayed films. The use of iothalamate with adrenaline is less expensive than ioxaglate alone, but this financial advantage has to be balanced against the significantly greater pain associated with the use of intra-articular adrenaline.

Joint fluid after aspiration. A disturbing factor in knee arthrography.

The amount of fluid in the knee after aspirating any effusion was investigated and averaged 6.8 ml, being independent of the presence of a lesion. Because it causes dilution of the contrast medium, it is suggested that small amounts of a relatively high-concentrated non-ionic contrast agent should be preferred for double-contrast knee arthrography.

Comparative study of iohexol and meglumine iothalamate in double-contrast knee arthrography

A comparison has been made between meglumine iothalamate and a low-osmolar contrast medium, iohexol, in arthrography of the knee. A controlled study evaluated the immediate and delayed patient response as well as the quality of the examination, which was assessed by two radiologists without knowledge of which contrast medium had been employed. The results show that iohexol is a good contrast medium for knee arthrography but offers no advantages to offset the increased cost compared with contrast media in current use.

MENISCAL ABNORMALITIES IN KNEE ARTHROGRAPHY

When carefully performed, arthrography is a safe, simple, and accurate method for the evaluation of meniscal abnormalities. Accuracy depends on an understanding of the various tear types, their arthrographic appearances, and their expected locations. The arthrographer must also be aware of other abnormalities, such as meniscal cysts and discoid menisci, which may be accompanied by meniscal tears. With careful attention to detail in positioning, filming, and interpretation, a diagnostic accuracy of 90 per cent or better can be expected in the evaluation of meniscal abnormalities by double-contrast knee arthrography.

Epinephrine enhanced double contrast knee arthrography

Epinephrine enhanced double contrast knee arthrography

Pitfalls in double contrast knee arthrography

Two hundred and forty-two patients investigated by double-contrast knee arthrography between 1973 and 1977 have reviewed. Of these 134 have come to arthrotomy and an initial arthrographic accuracy of 85% is reported. An attempt to explain the disparities between arthrography and arthrotomy has revealed that in half the cases (ten patients) there were simple reporting errors on the arthrograms. These are shown all to be false negative reports. The other group of ten patients comprised presumed errors in arthrotomy interpretation in four and arthrographic interpretation or technical failure in six. The causes and implications of those errors are analysed and discussed.

Air or CO2 for knee arthrography?

Both air and carbon dioxide (CO2) have been advocated for use as the negative agent in double-contrast knee arthrography. In 39 patients examined, 40 knee arthrograms were obtained, using CO2 as the negative agent for 20 studies and room air in the other 20. In addition, the change in pH of the joint fluid was measured. Of the 20 patients in the CO2 group, 12 had pain, five of whom described it as severe. Of the 20 in the air group, two reported only moderate discomfort. Regardless of the gas used, the incidence of pain was directly related to the amount of decrease in pH. Air is believed superior to CO2 primarily because it produces less pain, persists in the joint longer (allowing for refilming), costs less, and is readily available.

Delayed films in double contrast knee arthrography.

Delayed films in double contrast knee arthrography.

Double Contrast Knee Arthrography in Children

The indications for knee arthrography in children consist of: suspected internal derangement; osteochondritis dissecans; Blount's disease; popliteal cysts; loose bodies; synovial tumors; and miscellaneous abnormalities including unexplained knee pain.

Double contrast knee arthrography some new points of technique including the use of dimer X

A short review of the development of techniques in knee arthrography is given, together with a full account of the author's technique, including the use of a specially designed pad and a frame to facilitate radiography and a new method to demonstrate the cruciate ligaments. Side effects in a group of patients examined using Dimer X as the positive contrast medium are compared with those in a group of patients who were examined using Urografin 60%. Comparason of the radiological advantages of Dimer X examinations with Urografin 60% examinations has been made. A possible method to distinguish normal from damaged or degenerate tissues is suggested. The author concludes that Dimer X is the positive contrast medium of choice at the present time.

Double contrast knee arthrography in the evaluation of osteochondritis dissecans.

Double contrast knee arthrography is an invaluable adjunct in the evaluation of patients with osteochondritis dissecans. The cartilage overlying the osteochondritic defect can be evaluated and unsuspected meniscal pathology accurately diagnosed. In our series, there were three unsuspected medial meniscal tears, diagnosed by arthrography and confirmed at surgery. The location of the osteochondritic defect was atypical in all four of our female patients.

Arthrography of the lateral meniscus.

ARTHROGRAPHY OF THE LATERAL MENISCUSMURRAY K. DALINKA, M.D., JAMES F. LALLY, M.D. and VIJAY K. GOHEL, M.D.Audio Available | Share

Evaluation of thermography as a screening procedure in internal derangement of the knee.

This study was performed to investigate the value of knee thermography as a screening procedure in an attempt to decrease the number of negative arthrograms. Thermagraphy was performed on 90 consecutive patients prior to double contrast knee arthrography. Most of these patients were examined for evaluation of the menisci. Surgical follow-up was available in 39 patients. Clinical follow-up was available in 46; five patients were lost to follow-up. Fifteen patients (18%) has normal thcrmograms and positive arthrograms. On the basis of this study, we feel that this high percentage of false negatives precludes the use of thermegraphy as an accurate screening procedure in the diagnosis of internal derangements of the knee.

Scientific Exhibits

Because of additional space allotted to the Scientific Exhibits area, the Scientific Exhibits Committee was able to accept 94 exhibits at the Fifty-third Scientific Assembly and Annual Meeting of the Radiological Society of North America. Even though this is the largest number of scientific exhibits ever displayed, a fairly large number were rejected because of limited available space. As in the past years, the subject material was well distributed among diagnosis, radiotherapy, nuclear medicine, and radiation physics. The exhibitors should again be congratulated for the high quality and professional caliber of the exhibits. They should also be commended for their time and effort in bringing such diversified material and information to the ever-increasing number of members, guests, and residents in attendance. The early morning and evening periods were well attended, thereby justifying the continuation of these hours for visual studies. The Secret Awards Committee again demonstrated keen judgment and distributed the following awards: Magna Cum Laude The Effect of Anti-Depressant Drugs on the Urinary Tract. Douglas W. Macewan, M.D., and Bruce D. Feaver, M.D., Winnipeg, Canada. Cum Laude The Advantages of Prone Radiography of the Abdomen in Pediatrics. Walter E. Berdon, M.D., David H. Baker, M.D., and John Leonidas, M.D., New York, N. Y. Correlative Study of Selective Bi-Plane Coronary Arteriography and Cesium 131 Myocardial Scanning. William J. Wilson, M.D., Charles A. Dobry, M.D., Charlottesville, Va., Kurt Amplatz, M.D., and Richard A. Wetzel, M.D., Minneapolis, Minn. Certificate of Merit Double Contrast Knee Arthrography. W. P. Butt, M.D., and J. L. McIntyre, M.B., Toronto, Canada. Adrenal Venography. Joseph J. Bookstein, M.D., Ann Arbor, Mich., and Stewart R. Reuter, M.D., Eloise, Mich. Percutaneous 198Au Grain Implantation and Computer Dosimetry. Yung H. Son, M.D., and Jack Wakley, B.Sc., Charlottesville, Va. Reliable in Vivo Measurement of Bone Mineral Content. John R. Cameron, Ph.D., and James A. Sorenson, M.S., Madison, Wisc. Isotope Cisternography and Ventriculography. George J. Alker, Jr., M.D., and Eugene V. Leslie, M.D., Buffalo, N. Y. Honorable Mention Laryngomalacia. J. S. Dunbar, M.D., and M. B. Nogrady, M.D., Montreal, Canada. The Controversial Infantile Sella Turcica: Anatomic Elucidation of Radiologic Misconceptions. E. Leonkier, M.D., Bronx, N. Y. Posterior Dislocation of the Shoulder. Steven J. Figiel, M.D., L. S. Figiel, M.D., M. B. Bardenstein, M.D., and W. H. Blodgett, M.D., Detroit, Mich. 99mTc Pertechnetate Scanning of Salivary Glands. Frederick C. Stebner, M.D., William R. Eyler, M.D., Lucille A. DuSault, A.B., Melvin A. Block, M.D., and Alex P. Kelly, M.D., Detroit, Mich. Epicardial Fat: The Lateral Plain Film Analysis in Normals and in Pericardial Effusions. Edward J. Lane, Jr., M.D., and Edward W. Carsky, M.D., Syracuse N. Y. Tin and Other Materials as Shields in Diagnostic Radiology.

Double-contrast arthrography of knee with horizontal roentgen ray beam.

Double-contrast arthrography of knee with horizontal roentgen ray beam.