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A prospective randomized study comparing three different approaches to fluoroscopy-guided shoulder arthrography according to the experience of practitioners

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Abstract

Objective

To compare three approaches via the anterior and posterior glenohumeral joints, and the rotator interval in fluoroscopy-guided shoulder arthrography according to the experience of the practitioners.

Materials and methods

This prospective randomized study was originally designed to have 34 subjects for each approach, and finally evaluated 98 patients (mean age: 51.5 years; 55 men) from July to December 2014, who had shoulder arthrography via the anterior (n = 41) or posterior glenohumeral joint (n = 27) approaches, or via the rotator interval approach (n = 30) by residents (n=76) or fellows (n=22). The success rate, number of punctures, fluoroscopy time, radiation dose, and complications of the three methods were compared, and according to the practitioners.

Results

The success rate was 100% for the anterior glenohumeral joint approach (34 out of 34), 90.0% for the posterior glenohumeral joint approach (23 out of 30), and 88.2% for the rotator interval approach (30 out of 34; p = 0.013). There was no difference in the success rate according to the practitioners’ experience. Fluoroscopy time was longest for the posterior glenohumeral joint approach (mean: 95.44 s) and shortest for the rotator interval approach (mean: 31.57 s, p = 0.006). Radiation dose was larger by 1st- or 2nd-year residents (p = 0.014), with no difference among the three approaches. Only one patient who underwent arthrography using the posterior glenohumeral joint approach complained about post-procedural pain.

Conclusion

Fluoroscopy-guided shoulder arthrography via the posterior glenohumeral joint or rotator interval approach may be difficult for trainees, and the posterior glenohumeral joint approach may need a long fluoroscopy time.

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Acknowledgements

This prospective observational study was approved by the institutional review board of the Seoul National University Bundang Hospital, and written informed consent was obtained from all the participants (IRB number: B-1405-252-004).

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Authors and Affiliations

  1. Department of Radiology, Seoul National University Bundang Hospital, 300 Gumi-dong, Bundang-gu, Seongnam-si, Gyeonggi-do, Korea

    Guen Young Lee, Joon Woo Lee, Eugene Lee, Joong Mo Ahn & Heung Sik Kang

  2. Department of Radiology, Chung-Ang University Hospital, Seoul, Korea

    Guen Young Lee

Authors
  1. Guen Young Lee
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  2. Joon Woo Lee
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  3. Eugene Lee
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  4. Joong Mo Ahn
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Correspondence to Joon Woo Lee.

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Funding

This research was supported by the grant No.09-2014-005 from the SNUBH Research Fund.

Conflicts of interest

The authors declare that they have no conflicts of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

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Lee, G.Y., Lee, J.W., Lee, E. et al. A prospective randomized study comparing three different approaches to fluoroscopy-guided shoulder arthrography according to the experience of practitioners. Skeletal Radiol 46, 925–933 (2017). https://doi.org/10.1007/s00256-017-2637-2

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  • DOI: https://doi.org/10.1007/s00256-017-2637-2

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