MRI Arthrogram

MRI Arthrography

Magnetic resonance arthrography is an important technique, especially in the hip, shoulder and ankle. A small amount of positive contrast agent a gadolinium maybe, is injected directly to the joints.

MR arthrography is an intra-articular use of gadolinium to diagnose rotator cuff tears, glenoid labral disruption and chondral defects. The procedure is usually involves injecting a very dilute solution of contrast in saline at a ratio of 1:100 or a very thin concentration of gadolinium into the joint capsule under fluoroscopic control followed by conventional magnetic resonance imaging. Alternatively, saline injection followed by fat suppressed T2 weighted FSE sequence, or examining the joint after prolonged exercise to exacerbate a joint effusion may be effective in shoulder MR arthrography.

Direct MR Arthrography

Direct MR arthrography is sometimes used in the ankle to identify ligament tears and for increasing the sensitivity for ankle impingement syndromes. It also has a role in assessing the stability of osteochondral lesions and delineating loose bodies.

Indirect MR Arthrography

arthrography involves the administration of intravenous diluted gadolinium and is sometimes used when direct arthrography is not feasible. Although indirect MR arthrography has some disadvantages when compared with direct MR arthrography, it does not require fluoroscopic guidance or invasive joint injection. It is also superior to non contrast MR imaging in delineating structures when there is minimal joint fluid. In addition, vascularized or inflamed tissue enhances with this method.

Temporomandibular Joints (TMJ) MRI

Contrast is not commonly used in this area. However, arthrography of the joints may prove useful in the future. The joint is injected with a small amount of gadolinium followed by sagittal/oblique T1 weighted imaging.

Elbow MR Arthrography

In elbow Arthrogram Contrast may be useful for visualizing some soft tissue abnormalities.

In addition, elbow MR arthrography is useful for visualizing partial- and fullthickness tears of the collateral ligament and delineating bands in the elbow.

Coronal Elbow MR Arthrogram

Wrist MRI

Contrast is not routinely used in the wrist; however MR arthrography is sometimes useful in increasing the certainty of seeing perforations of the ligaments and triangular fibrocartilage.

Wrist MR arthrogram

Hips MR Arthrogram

IV contrast is virtually never indicated in hip joint imaging unless as an indirect MR arthrography technique (see Shoulder in Upper Limb). Direct MR arthrography of the hip is an important technique in the diagnosis of some hip disorders, especially labral tears.

Hips Axial MR Arthrogram.

Knee MRI Arthrogram

IV contrast is virtually never indicated in knee joint imaging although it may assist in the classification of some pathologies. Knee MR arthrography is used for the diagnosis of meniscal tears and chondral defects and for identifying residual or recurrent tears in the knee following meniscectomy. It also has a role in identifying loose bodies within the joint. A very dilute solution of gadolinium in saline (1 : 100) is introduced into the joint capsule and the single joint is imaged at high resolution with fatsuppressed

T1 weighted images in three planes aligned relative to the joint as described.

Knee Arthrography

Ankle MRI Arthrography

IV contrast is not used to assess joint disease although it may be useful for the classification of tumours. Direct MR arthrography is sometimes used in the ankle to identify ligament tears and for increasing the sensitivity for ankle impingement syndromes. It also has a role in assessing the stability of osteochondral lesions and delineating loose bodies.