The Use of Gadolinium in Musculoskeletal MRI—Time to Rethink?

Elawad, Arwa; Shah, Amit; Davies, Mark; Botchu, Rajesh

doi:10.1055/s-0041-1735500

Cited by 6 publications

(6 citation statements)

References 61 publications

(103 reference statements)

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“…Giaconi et al similarly evaluated post‐arthrography pain in patients receiving intra‐articular gadolinium, finding a higher incidence of post‐arthrography pain in hip MRA than in other joints [10]. Self‐reported surveys have found 66% of individuals describe an immediate onset of complications following gadolinium with 77.6% reporting bone/joint pain [4, 8]. Considering the half‐life of the most commonly used anesthetic compounds, it seems intuitive that this early increase in pain could mask any positive response following the injection.…”

Section: Discussionmentioning

confidence: 99%

“…Considering the half‐life of the most commonly used anesthetic compounds, it seems intuitive that this early increase in pain could mask any positive response following the injection. Moreover, these reported complication rates have led some authors to question the need for gadolinium enhancement for evaluation of hip labral pathology, especially with the advent and availability of 3 T MRI and improved image interpretation [8, 28, 29].…”

Section: Discussionmentioning

confidence: 99%

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Gadolinium injected concurrently with anesthetic can result in false-negative diagnostic intra-articular hip injections

Pullen

Curtis

Jamero

et al. 2023

Knee Surg Sports Traumatol Arthrosc

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Purpose The purpose of this paper was to evaluate the response to intra-articular hip injections with and without concurrent gadolinium administration. Our secondary outcome was to compare post-operative outcomes between patients with an initial false-negative gadolinium-containing injection and a matched control group. Methods Patients receiving a series of two hip diagnostic intra-articular injections (DIAI), the irst with gadolinium for concurrent MRA and the second without gadolinium, were retrospectively identiied. Pain response to DIAI, injectate volume, local anesthetic volume, inclusion of corticosteroids, and method of injection were compared between injections. False-negative injection was deined as < 50% pain relief with concurrent gadolinium, but ≥ 50% pain relief with subsequent anesthetic injection without gadolinium. False-negative injections in patients that ultimately underwent primary hip arthroscopy were identiied from this cohort and matched in a 3:1 ratio to a control cohort to compare short-term post-operative single assessment numerical evaluation (SANE) outcomes. Results Forty-three patients underwent a series of anesthetic injections with and without gadolinium and met inclusion and exclusion criteria. Pain response was signiicantly diferent in injections performed with and without gadolinium (18% vs. 81%; p < 0.001). There were signiicant diferences in total injectate volume, local anesthetic volume, corticosteroid use, and method of injection between injections, but these variables were not correlated with pain response. Fifteen patients with false-negative responses to injection underwent primary hip arthroscopy and were matched in a 3:1 ratio to a control cohort. There was no diference in short-term post-operative SANE scores between the gadolinium-sensitive and control groups (81.6 vs. 80.0, n.s.). Conclusion Concurrent administration of intra-articular gadolinium with DIAI may result in a false-negative response to anesthetic. Additionally, in patients with initial false-negative DIAI with gadolinium, short-term post-operative outcomes after hip arthroscopy are similar to a matched cohort. Level of Evidence Level III.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Gadolinium injected concurrently with anesthetic can result in false-negative diagnostic intra-articular hip injections

Pullen

Curtis

Jamero

et al. 2023

Knee Surg Sports Traumatol Arthrosc

View full text Add to dashboard Cite

show abstract

“…Furthermore, MRI can utilize contrast agents to enhance visualization in certain cases. This is particularly advantageous for detecting conditions like labral tears or tumors, where using contrast agents can improve the clarity of the images, making it easier to identify specific lesions and abnormalities [ 51 ].…”

Section: Reviewmentioning

confidence: 99%

High-Resolution Imaging Insights into Shoulder Joint Pain: A Comprehensive Review of Ultrasound and Magnetic Resonance Imaging (MRI)

Nunna,

Parihar,

Wanjari

et al. 2023

Cureus

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Shoulder joint pain is a complex and prevalent clinical concern affecting individuals across various ages and lifestyles. This review delves into the pivotal role of high-resolution imaging techniques, namely ultrasound and magnetic resonance imaging (MRI), in the comprehensive assessment and management of shoulder joint pain. We explore the anatomical foundations of the shoulder, common etiologies of pain, and the significance of precise diagnosis. High-resolution imaging facilitates the identification of various shoulder pathologies and is crucial in treatment planning, surgical interventions, and long-term prognosis assessment. We examine emerging technologies, discuss challenges and limitations, and chart potential future developments, emphasizing the ongoing evolution of imaging in this critical healthcare domain. In conclusion, high-resolution imaging is an indispensable tool, continually advancing to meet the diagnostic and therapeutic needs of individuals grappling with shoulder joint pain.

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“…MRI has both a high sensitivity rate (93%) and a specificity rate (97%). The sensitivity rate refers to the number of true positives (the number of people who do have cancer that will test positive for that cancer), and vice-versa the specificity test refers to the number of negatives [8]. Overall, MRIs have a high accuracy rate of 95%.…”

Section: Application Of Mri and X-ray In Cancer Diagnosismentioning

confidence: 99%

“…Gadolinium creates perturbation or disturbance specifically to protons of water atoms creating a strong contrast hence why it is referred to as a contrast media. Despite a high sensitivity rate of 89% to 100% Gadolinium-enhanced MRI, a specificity rate varies from 46% to 88% [8].…”

Section: Application Of Mri and X-ray In Cancer Diagnosismentioning

confidence: 99%

Effectiveness of early cancer detection method: magnetic resonance imaging and X-ray technique

Zhang¹

2023

TNS

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Cancer is a major problem plaguing human society today. With the research and development of nano-drug delivery technology and new non-surgical treatment methods, many types of early cancers can be cured or effectively controlled. However, the current treatment methods for advanced cancer are still limited, and efficient early cancer identification is crucial for enhancing patients prognosis and survival rates. Magnetic resonance imaging (MRI) and X-ray technologies are currently the mainstream and generally applicable means of early cancer detection. However, there is a lack of unified comparison and interpretation for their respective applicable cancer detection types. Herein, the paper first provides a comprehensive comparison and explanation of the working principles of the two technologies, as well as their advantages and disadvantages. Further, this article introduces the application of MRI and X-ray technology in the early detection of different common cancer types, including lung, breast, and brain cancers. The paper found that MRI is crucial in the early detection of brain cancer, and X-ray is a common method for lung cancer screening. With further advances in technology, cancer-related deaths can be further curbed.

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The Use of Gadolinium in Musculoskeletal MRI—Time to Rethink?

Cited by 6 publications

References 61 publications

Gadolinium injected concurrently with anesthetic can result in false-negative diagnostic intra-articular hip injections

Gadolinium injected concurrently with anesthetic can result in false-negative diagnostic intra-articular hip injections

High-Resolution Imaging Insights into Shoulder Joint Pain: A Comprehensive Review of Ultrasound and Magnetic Resonance Imaging (MRI)

Effectiveness of early cancer detection method: magnetic resonance imaging and X-ray technique

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