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Extra-articular contrast material leaks into locations unrelated to the injection path in shoulder MR arthrography

  • Musculoskeletal
  • Published:
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Abstract

Objectives

To evaluate the localisation, frequency and amount of extravasation in patients with extra-articular contrast material leak into locations unrelated to the injection path in shoulder magnetic resonance (MR) arthrography and associated shoulder disorders.

Methods

The sites of extravasation were determined on the shoulder MR arthrography of 40 patients. The extravasations were measured on three vertical planes of the MR arthrography. Sufficient joint distension was assessed according to the transverse diameters of the axillary recess on coronal MR images.

Results

Extravasation of the contrast material occurred through the subscapular recess, the synovium of the biceps, and the axillary recess. In four cases, extravasations were observed in more than one anatomic location. The most common site of extravasation was along the subscapularis muscle. Superior labrum anterior-posterior (SLAP) lesions were found to be most frequently associated with extravasations. The amount of extravasation was significantly higher in patients with adhesive capsulitis compared with the patients with a different diagnosis (p = 0.022).

Conclusions

The extravasations adjacent to the axillary recess do not always indicate glenohumeral ligament pathology. Massive subscapular extravasations were most frequently associated with adhesive capsulitis and SLAP lesions, and might be considered in the MR arthrography report.

Key Points

• Contrast material extravasation may reduce the diagnostic value of shoulder MR arthrography.

• The extravasations may occur into locations unrelated to the injection path.

• The extravasations adjacent to axillary recess can be misleading for HAGL lesion.

• Massive subscapular extravasations were frequently associated with adhesive capsulitis and SLAP lesions.

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Acknowledgements

The scientific guarantor of this publication is Mecit Kantarci. The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article. The authors state that this work has not received any funding. No complex statistical methods were necessary for this paper. Institutional Review Board approval was obtained. Written informed consent was obtained from all subjects (patients) in this study. Methodology: cross-sectional study.

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Authors and Affiliations

  1. Department of Radiology, Medical Faculty, Ataturk University, 200 Evler Mah. 14. Sok No 5, Dadaskent, Erzurum, 25090, Turkey

    Hayri Ogul, Mecit Kantarci, Leyla Karaca, Berhan Pirimoglu, Aylin Okur & Akin Levent

  2. Department of Orthopaedic, Medical Faculty, Ataturk University, Erzurum, Turkey

    Murat Topal, Kutsi Tuncer & Omer Selim Yildirim

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  1. Hayri Ogul
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  2. Mecit Kantarci
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  3. Murat Topal
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  4. Leyla Karaca
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  9. Akin Levent
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Correspondence to Mecit Kantarci.

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Ogul, H., Kantarci, M., Topal, M. et al. Extra-articular contrast material leaks into locations unrelated to the injection path in shoulder MR arthrography. Eur Radiol 24, 2606–2613 (2014). https://doi.org/10.1007/s00330-014-3270-2

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  • DOI: https://doi.org/10.1007/s00330-014-3270-2

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