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Fluoroscopically-Guided Posterior Approach for Shoulder Magnetic Resonance Arthrography: Comparison with Conventional Anterior Approach  

Yoo, Ko-Un J. (Department of Radiology, CHA Bundang Medical Center, CHA University College of Medicine)
Ha, Doo-Hoe (Department of Radiology, CHA Bundang Medical Center, CHA University College of Medicine)
Lee, Sang-Min (Department of Radiology, CHA Bundang Medical Center, CHA University College of Medicine)
Publication Information
Journal of the Korean Society of Radiology / v.65, no.4, 2011 , pp. 403-409 More about this Journal
Abstract
Purpose: To prospectively evaluate the usefulness of the fluoroscopically-guided posterior approach compared with the anterior approach for shoulder magnetic resonance (MR) arthrography. Materials and Methods: Institutional review board approval and informed consent were obtained. Among 60 shoulder MR arthrographies performed on 59 patients with symptomatic shoulders, an intra-articular injection was performed (30 cases using the anterior approach and 30 using the posterior approach). Procedure-related pain was assessed by using a 5 score visual analogue scale (VAS). Depth of the puncture and standardized depth of puncture by body mass index (BMI) were recorded. The contrast leakage along the course of the puncture was evaluated by reviewing the MR. The statistical analyses included the Mann-Whitney U and Kruskal-Wallis test. Results: There was no significant difference in VAS scores between the anterior and posterior groups (1.77 ${\pm}$ 1.10 vs. 1.80 ${\pm}$ 0.96). Depth of puncture and standardized depth of puncture by BMI were significantly shorter in the posterior group than those in the anterior group (4.4 ${\pm}$ 0.8 cm and 1.8 ${\pm}$ 0.3 cm vs. 6.6 ${\pm}$ 0.9 cm and 2.8 ${\pm}$ 0.4 cm, p < 0.001), respectively. The incidence of contrast leakage was more frequent in the posterior group (p = 0.003). Conclusion: The posterior approach will be useful in shoulder MR arthrography with a suspected anterior pathology, a postoperative follow-up study or obese patient.
Keywords
Shoulder; Magnetic Resonance Arthrography; Anterior Approach; Posterior Approach;
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