Dynamic supine MR imaging performed with a closed-configuration unit before and after rectal contrast agent administration appears to be an alternative to sitting MR defecography performed with an open-configuration unit for diagnosis of clinically relevant pelvic floor abnormalities.

Functional disorders of the pelvic floor are a common clinical problem. Diagnosis and treatment of these disorders, which frequently manifest with nonspecific symptoms such as constipation or incontinence, remain difficult. Fluoroscopic x-ray defecography has been shown to aid in detection of functional and morphologic abnormalities of the anorectal region. With the advent of open-configuration magnetic resonance (MR) imaging systems, MR defecography with the patient in a vertical position became possible. MR defecography permits analysis of the anorectal angle, the opening of the anal canal, the function of the puborectal muscle, and the descent of the pelvic floor during defecation. Good demonstration of the rectal wall permits visualization of intussusceptions and rectoceles. Excellent demonstration of the perirectal soft tissues allows assessment of spastic pelvic floor syndrome and descending perineum syndrome and visualization of enteroceles. MR defecography with an open-configuration magnet allows accurate assessment of anorectal morphology and function in relation to surrounding structures without exposing the patient to harmful ionizing radiation.

Infraclavicular block using the modified Raj technique did not interfere with diaphragmatic excursion or respiratory function.

Differences in the diagnostic performance of suspected meniscal tears depend on reviewer experience rather than on the type of documentation.

Objective To evaluate the additional value of single-photon emission computed tomography/computed tomography arthrography compared with single-photon emission computed tomography/computed tomography alone in wrist, ankle, and knee joints. Materials and methods Retrospective evaluation of 68 patients including 74 joints (48 wrists, 13 upper ankle (talocrural joint), and 13 knee joints) was performed. Activity in single-photon emission computed tomography/computed tomography images was graded using a four-point scale: 0 no uptake, one low uptake, two moderate uptake, and three high uptake. Arthrography images were evaluated for the presence of cartilage/ligament/meniscal lesions, and loose bodies. Results Fifty-six joints (76%) showed increased activity in late planar and 58 (78%) in single-photon emission computed tomography/computed tomography images, the latter graded as follows: grade 1 in 20 (34%), grade 2 in 29 (50%), grade 3 in nine (16%) joints. 16 joints were inactive (grade 0) in single-photon emission computed tomography/computed tomography. In 57 joints (77%), intraarticular contrast unmasked additional pathologies (37 cartilage lesions, 25 ligaments tears, 25 triangular fibrocartilage complex tears, six meniscal lesions, and four loose bodies). There was matching findings between single-photon emission computed tomography and computed tomography arthrography in 57 joints (77%) and mismatching findings in 17 joints (23%). Out of these 17 mismatched joints, eight were metabolically inactive but showed some lesion in computed tomography arthrography, whereas nine metabolically active joints did not show any abnormality in computed tomography arthrography. Conclusion The addition of arthrography to single-photon emission computed tomography/computed tomography of wrist, ankle, and knee joints leads to supplementary visibility of lesions of cartilage, ligaments, triangular fibrocartilage complex, meniscus, or loose bodies in 77% of joints. Single-photon emission computed tomography/computed tomography arthrography can serve as promising alternative especially in patients with magnetic resonance imaging contraindications or metallic hardware.