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Frequency of technical success of ultrasound-guided arthrogram injections in children

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Abstract

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.

Graphical Abstract

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Data availability

The datasets generated and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Authors and Affiliations

  1. Department of Radiology, Seattle Children’s Hospital, University of Washington School of Medicine, 4800 Sand Point Way NE, Seattle, WA, 98105, USA

    Joseph O’Sullivan, Helen H. R. Kim, Jeffrey P. Otjen, Anh-Vu Ngo, Ezekiel Maloney, Sarah J. Menashe, Ramesh S. Iyer & Mahesh Thapa

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  1. Joseph O’Sullivan
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  2. Helen H. R. Kim
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  3. Jeffrey P. Otjen
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  4. Anh-Vu Ngo
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  5. Ezekiel Maloney
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  6. Sarah J. Menashe
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  7. Ramesh S. Iyer
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  8. Mahesh Thapa
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Contributions

M.T. and J.P.O. conceptualized, supervised, and supported the study. R.I., S.M., and E.M. collected the data. J.O. performed the statistical analysis and drafted the initial manuscript. H.K. edited the manuscript and mentored J.O. H.K. and A.N. provided the figures. All authors reviewed and approved the final manuscript.

Corresponding author

Correspondence to Helen H. R. Kim.

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O’Sullivan, J., Kim, H.H.R., Otjen, J.P. et al. Frequency of technical success of ultrasound-guided arthrogram injections in children. Pediatr Radiol 53, 2380–2385 (2023). https://doi.org/10.1007/s00247-023-05777-5

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  • DOI: https://doi.org/10.1007/s00247-023-05777-5

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