Skip to main content

Advertisement

Log in

Technical errors in MR arthrography

  • Review Article
  • Published:
Skeletal Radiology Aims and scope Submit manuscript

Abstract

This article discusses potential technical problems of MR arthrography. It starts with contraindications, followed by problems relating to injection technique, contrast material and MR imaging technique. For some of the aspects discussed, there is only little published evidence. Therefore, the article is based on the personal experience of the author and on local standards of procedures. Such standards, as well as medico-legal considerations, may vary from country to country. Contraindications for MR arthrography include pre-existing infection, reflex sympathetic dystrophy and possibly bleeding disorders, avascular necrosis and known allergy to contrast media. Errors in injection technique may lead to extra-articular collection of contrast agent or to contrast agent leaking from the joint space, which may cause diagnostic difficulties. Incorrect concentrations of contrast material influence image quality and may also lead to non-diagnostic examinations. Errors relating to MR imaging include delays between injection and imaging and inadequate choice of sequences. Potential solutions to the various possible errors are presented.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7
Fig. 8
Fig. 9
Fig. 10
Fig. 11
Fig. 12
Fig. 13

Similar content being viewed by others

References

  1. Steinbach LS, Palmer WE, Schweitzer ME. Special focus session. MR arthrography. Radiographics 2002; 22: 1223–1246.

    PubMed  Google Scholar 

  2. Grainger AJ, Elliott JM, Campbell RS, Tirman PF, Steinbach LS, Genant HK. Direct MR arthrography: a review of current use. Clin Radiol 2000; 55: 163–176.

    Article  PubMed  CAS  Google Scholar 

  3. Elentuck D, Palmer WE. Direct magnetic resonance arthrography. Eur Radiol 2004; 14: 1956–1967.

    Article  PubMed  Google Scholar 

  4. Dunn AS, Turpie AG. Perioperative management of patients receiving oral anticoagulants: a systematic review. Arch Intern Med 2003; 163: 901–908.

    Article  PubMed  Google Scholar 

  5. Thumboo J, O’Duffy JD. A prospective study of the safety of joint and soft tissue aspirations and injections in patients taking warfarin sodium. Arthritis Rheum 1998; 41: 736–739.

    Article  PubMed  CAS  Google Scholar 

  6. Sparling M, Malleson P, Wood B, Petty R. Radiographic followup of joints injected with triamcinolone hexacetonide for the management of childhood arthritis. Arthritis Rheum 1990; 33: 821–826.

    Article  PubMed  CAS  Google Scholar 

  7. McCarthy JC, Lee JA. Arthroscopic intervention in early hip disease. Clin Orthop Relat Res 2004; 429: 157–162.

    Article  PubMed  Google Scholar 

  8. Hasselbacher P, Schumacher HR. Synovial fluid eosinophilia following arthrography. J Rheumatol 1978; 5: 173–176.

    PubMed  CAS  Google Scholar 

  9. Binkert CA, Zanetti M, Gerber C, Hodler J. MR arthrography of the glenohumeral joint: two concentrations of gadoteridol versus Ringer solution as the intraarticular contrast material. Radiology 2001; 220: 219–224.

    PubMed  CAS  Google Scholar 

  10. Zanetti M, Hodler J. Contrast media in MR arthrography of the glenohumeral joint: intra-articular gadopentetate vs saline: preliminary results. Eur Radiol 1997; 7: 498–502.

    Article  PubMed  CAS  Google Scholar 

  11. Kuo PH, Kanal E, Abu-Alfa AK, Cowper SE. Gadolinium-based MR contrast agents and nephrogenic systemic fibrosis. Radiology 2007; 242: 647–649.

    PubMed  Google Scholar 

  12. Duc SR, Hodler J, Schmid MR, et al. Prospective evaluation of two different injection techniques for MR arthrography of the hip. Eur Radiol 2006; 16: 473–478.

    Article  PubMed  Google Scholar 

  13. Farmer KD, Hughes PM. MR arthrography of the shoulder: fluoroscopically guided technique using a posterior approach. AJR Am J Roentgenol 2002; 178: 433–434.

    PubMed  CAS  Google Scholar 

  14. Schulte-Altedorneburg G, Gebhard M, Wohlgemuth WA, et al. MR arthrography: pharmacology, efficacy and safety in clinical trials. Skeletal Radiol 2003; 32: 1–12.

    Article  PubMed  CAS  Google Scholar 

  15. Guckel C, Nidecker A. The rope ladder: an uncommon artifact and potential pitfall in MR arthrography of the shoulder. AJR Am J Roentgenol 1997; 168: 947–950.

    PubMed  CAS  Google Scholar 

  16. Newberg AH, Munn CS, Robbins AH. Complications of arthrography. Radiology 1985; 155: 605–606.

    PubMed  CAS  Google Scholar 

  17. Hugo PC 3rd, Newberg AH, Newman JS, Wetzner SM. Complications of arthrography. Semin Musculoskelet Radiol 1998; 2: 345–348.

    Article  PubMed  Google Scholar 

  18. Kaandorp CJ, Van Schaardenburg D, Krijnen P, Habbema JD, van de Laar MA. Risk factors for septic arthritis in patients with joint disease. A prospective study. Arthritis Rheum 1995; 38: 1819–1825.

    Article  PubMed  CAS  Google Scholar 

  19. Hajek PC, Sartoris DJ, Neumann CH, Resnick D. Potential contrast agents for MR arthrography: in vitro evaluation and practical observations. AJR Am J Roentgenol 1987; 149: 97–104.

    PubMed  CAS  Google Scholar 

  20. Schweitzer ME, Magbalon MJ, Fenlin JM, Frieman BG, Ehrlich S, Epstein RE. Effusion criteria and clinical importance of glenohumeral joint fluid: MR imaging evaluation. Radiology 1995; 194: 821–824.

    PubMed  CAS  Google Scholar 

  21. Schweitzer ME, van Leersum M, Ehrlich SS, Wapner K. Fluid in normal and abnormal ankle joints: amount and distribution as seen on MR images. AJR Am J Roentgenol 1994; 162: 111–114.

    PubMed  CAS  Google Scholar 

  22. Brenner ML, Morrison WB, Carrino JA, et al. Direct MR arthrography of the shoulder: is exercise prior to imaging beneficial or detrimental? Radiology 2000; 215: 491–496.

    PubMed  CAS  Google Scholar 

  23. Smith DK, Chopp TM, Aufdemorte TB, Witkowski EG, Jones RC. Sublabral recess of the superior glenoid labrum: study of cadavers with conventional nonenhanced MR imaging, MR arthrography, anatomic dissection, and limited histologic examination. Radiology 1996; 201: 251–256.

    PubMed  CAS  Google Scholar 

  24. Kopka L, Funke M, Fischer U, Keating D, Oestmann J, Grabbe E. MR arthrography of the shoulder with gadopentetate dimeglumine: influence of concentration, iodinated contrast material, and time on signal intensity. AJR Am J Roentgenol 1994; 163: 621–623.

    PubMed  CAS  Google Scholar 

  25. Wagner SC, Schweitzer ME, Weishaupt D. Temporal behavior of intraarticular gadolinium. J Comput Assist Tomogr 2001; 25: 661–670.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Juerg Hodler.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Hodler, J. Technical errors in MR arthrography. Skeletal Radiol 37, 9–18 (2008). https://doi.org/10.1007/s00256-007-0329-z

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00256-007-0329-z

Keywords

Navigation