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MR arthrography of the shoulder: tolerance evaluation of four different injection techniques

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Abstract

Objective

We sought to prospectively evaluate patients’ pain perception and technical success of four different arthrographic techniques for shoulder MR arthrography.

Materials and methods

A total of 125 consecutive patients were referred for shoulder MR arthrography. The patients were randomly injected under fluoroscopic guidance (n 1  = 37), with CT guidance using an anterior (n 2  = 29) or a posterior approach (n 3  = 32) and with ultrasound guidance (n 4  = 27). For each patient, absolute periprocedural pain on a numerical rating pain scale (0 = “no pain”, 10 = “intolerable pain”), technical success of the method used, and reason for referral were recorded.

Results

The technical success rate was 100 % for all injection methods. The results regarding absolute periprocedural pain were as follows: fluoroscopic guidance showed a mean pain of 4.05 ± 1.24, CT anterior guidance demonstrated a mean pain of 3.87 ± 0.95, CT posterior guidance showed a mean pain of 1.59 ± 0.81, and ultrasound guidance a mean pain of 3.63 ± 1.12. A significant difference (p < .05) was observed for the posterior route under CT guidance. The mean pain level was significantly higher for older (> 51 year) female patients.

Conclusions

No differences were found for the technical success rate of the aforementioned techniques. A CT-guided posterior approach seems to be a more comfortable method for the patient.

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Conflict of interest

The authors declare that they have no conflicts of interest.

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Authors and Affiliations

  1. Department of Medical Imaging, University Hospital, Heraklion, 71110, Crete, Greece

    Evangelos Perdikakis, Eleni Drakonaki & Apostolos Karantanas

  2. Department of Medical Physics, University Hospital, Heraklion, 71110, Crete, Greece

    Thomas Maris

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  1. Evangelos Perdikakis
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  2. Eleni Drakonaki
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  4. Apostolos Karantanas
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Correspondence to Apostolos Karantanas.

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Perdikakis, E., Drakonaki, E., Maris, T. et al. MR arthrography of the shoulder: tolerance evaluation of four different injection techniques. Skeletal Radiol 42, 99–105 (2013). https://doi.org/10.1007/s00256-012-1526-y

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  • DOI: https://doi.org/10.1007/s00256-012-1526-y

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