Radio-carpal wrist MR arthrography: comparison of ultrasound with fluoroscopy and palpation-guided injections

Ali, Abeer Houssein; Qenawy, Omran Khodary; Saleh, Waleed Riad; Ali, Abdelaziz Monsef; Monem, Eman Sayed Abdul; Omar, Nagwa M.

doi:10.1007/s00256-021-03845-1

Cited by 4 publications

(3 citation statements)

References 39 publications

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“…They concluded that fluoroscopic guidance can improve the accuracy of wrist IAIs [ 30 ]. Ali et al found that the accuracy rate for the dorsal radial contrast injection was 100% for ultrasound and fluoroscopy-guided injections compared to a rate of 72% for those done by palpation [ 31 ].…”

Section: Upper Extremitymentioning

confidence: 99%

Accuracy of Intraarticular Injections: Blind vs. Image Guided Techniques—A Review of Literature

Saha

Smith

Hasan

2023

JFMK

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Intra-articular injections are widely used for diagnostic and therapeutic purposes of joint pathologies throughout the body. These injections can be performed blind by utilizing anatomical landmarks or with the use of imaging modalities to directly visualize the joint space during injections. This review of the literature aims to comprehensively identify differences in the accuracy of intra-articular injections via palpation vs. image guidance in the most commonly injected joints in the upper and lower extremities. To our knowledge, there are no such comprehensive reviews available. A narrative literature review was performed using PubMed and Google Scholar databases to identify studies focusing on the accuracy of blind or image-guided intra-articular injections for each joint. A total of 75 articles was included in this review, with blind and image-guided strategies being discussed for the most commonly injected joints of the upper and lower extremities. Varying ranges of accuracy with blind and image-guided modalities were found throughout the literature, though an improvement in accuracy was seen in nearly all joints when using image guidance. Differences are pronounced, particularly in deep joints such as the hip or in the small joints such as those in the hand or foot. Image guidance is a useful adjunct for most intra-articular injections, if available. Though there is an increase in accuracy in nearly all joints, minor differences in accuracy seen in large, easily accessed joints, such as the knee, may not warrant image guidance.

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Section: Upper Extremitymentioning

confidence: 99%

Accuracy of Intraarticular Injections: Blind vs. Image Guided Techniques—A Review of Literature

Saha

Smith

Hasan

2023

JFMK

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“…Ultrasound guidance is also used for contrast injection prior to MR arthrogram of the wrist. One study of contrast injections found that ultrasound-guided injections were significantly more accurate than those done by palpation (100% vs 72%) [ 52 ]. Although ultrasound and fluoroscopy had similar accuracy of 100%, ultrasound-guided injections were significantly shorter and less painful than fluoroscopic-guided injections [ 52 ].…”

Section: Wrist/hand Jointsmentioning

confidence: 99%

“…One study of contrast injections found that ultrasound-guided injections were significantly more accurate than those done by palpation (100% vs 72%) [ 52 ]. Although ultrasound and fluoroscopy had similar accuracy of 100%, ultrasound-guided injections were significantly shorter and less painful than fluoroscopic-guided injections [ 52 ]. Ultrasound guidance may also be advantageous in patients with significant deformity or narrowing of the joint space from underlying arthritis.…”

Section: Wrist/hand Jointsmentioning

confidence: 99%

Ultrasound-guided interventions of the upper extremity joints

et al. 2022

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Ultrasound guidance is valuable for performing precise joint interventions. Joint interventions may be requested for therapeutic and diagnostic pain injections, joint aspiration in the setting of suspected infection, or contrast injection for arthrography. In practice, interventions of the shoulder girdle, elbow, and hand/wrist joints may be performed without any imaging guidance. However, imaging guidance results in more accurate interventions and better patient outcomes than those performed by palpation alone. When compared to other modalities used for imaging guidance, ultrasound has many potential advantages. Radiologists should be prepared to perform ultrasound-guided upper extremity joint interventions utilizing recommended techniques to optimize clinical practice and patient outcomes. Key points 1. Ultrasound-guided injections of the glenohumeral, acromioclavicular, sternoclavicular, elbow, and hand/wrist joints have higher accuracy than injections performed without imaging guidance. 2. Ultrasound-guided aspirations of upper extremity joints have advantages to fluoroscopic-guided aspirations because of the potential to identify effusions, soft tissue abscess, or bursitis. 3. Ultrasound-guided contrast injection prior to MR arthrography is as accurate as fluoroscopic-guided injection for upper extremity joints.

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SSR white paper: guidelines for utilization and performance of direct MR arthrography

Chang,

Bencardino,

French

et al. 2023

Skeletal Radiol

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Objective Direct magnetic resonance arthrography (dMRA) is often considered the most accurate imaging modality for the evaluation of intra-articular structures, but utilization and performance vary widely without consensus. The purpose of this white paper is to develop consensus recommendations on behalf of the Society of Skeletal Radiology (SSR) based on published literature and expert opinion. Materials and methods The Standards and Guidelines Committee of the SSR identified guidelines for utilization and performance of dMRA as an important topic for study and invited all SSR members with expertise and interest to volunteer for the white paper panel. This panel was tasked with determining an outline, reviewing the relevant literature, preparing a written document summarizing the issues and controversies, and providing recommendations. Results Twelve SSR members with expertise in dMRA formed the ad hoc white paper authorship committee. The published literature on dMRA was reviewed and summarized, focusing on clinical indications, technical considerations, safety, imaging protocols, complications, controversies, and gaps in knowledge. Recommendations for the utilization and performance of dMRA in the shoulder, elbow, wrist, hip, knee, and ankle/foot regions were developed in group consensus. Conclusion Although direct MR arthrography has been previously used for a wide variety of clinical indications, the authorship panel recommends more selective application of this minimally invasive procedure. At present, direct MR arthrography remains an important procedure in the armamentarium of the musculoskeletal radiologist and is especially valuable when conventional MRI is indeterminant or results are discrepant with clinical evaluation.

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Radio-carpal wrist MR arthrography: comparison of ultrasound with fluoroscopy and palpation-guided injections

Cited by 4 publications

References 39 publications

Accuracy of Intraarticular Injections: Blind vs. Image Guided Techniques—A Review of Literature

Accuracy of Intraarticular Injections: Blind vs. Image Guided Techniques—A Review of Literature

Ultrasound-guided interventions of the upper extremity joints

SSR white paper: guidelines for utilization and performance of direct MR arthrography

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