Epinephrine enhanced knee arthrography

The effect of .3 cc of 1:1000 epinephrine on iodine concentration, total iodine content, fluid volume and radiographic quality was evaluated in knee arthrograms in dogs. With the addition of epinephrine the iodine concentration and total iodine content were significantly higher initially and remained significantly higher than in controls over a one hour period. The fluid volume in the knee was significantly lower with epinephrine. Initially both contrast absorption and dilution have major effects in decreasing iodine concentration. With increasing time the effect of contrast absorption becomes the major factor, having a two of three times greater effect on decreasing iodine concentration. With epinephrine radiographs were judged significantly better early and while the quality deteriorated rapidly in the controls the enhanced quality with epinephrine persisted up to one hour. Epinephrine is a very useful adjunct in enhancing the quality of knee arthrography.     

Anterior approach for knee arthrography

Objective. To develop a new method of magnetic resonance arthrography (MRA) of the knee using an anterior approach analogous to the portals used for knee arthroscopy. Design. An anterior approach to the knee joint was devised mimicking anterior portals used for knee arthroscopy. Seven patients scheduled for routine knee MRA were placed in a decubitus position and under fluoroscopic guidance a needle was advanced from a position adjacent to the patellar tendon into the knee joint. After confirmation of the needle tip location, a dilute gadolinium solution was injected. Results and conclusion. All the arthrograms were technically successful. The anterior approach to knee MRA has greater technical ease than the traditional approach with little patient discomfort. Received: 18 December 2000 Accepted: 16 January 2001     

Pitfalls in knee arthrography.

Sources of error in performing and interpreting knee arthrograms are discussed. Normal anatomic structures and technical factors can simulate tears in most areas of both the medial and lateral menisci. These pseudotears, as well as unrecognized true tears, occur more commonly in the posterior horn of the medial meniscus. Inferior meniscal recesses and coronary ligament irregularities of the posterior medial meniscus often represent incomplete tears. Diagnostic, etiologic, and therapeutic aspects of these recesses, or pseudorecesses, are discussed. Excessive intra-articular positive contrast medium may become localized and simulate a loose body in the joint.     

A needle-catheter kit in knee arthrography

Use of a sheathed Teflon needle in knee arthrography facilitates removal of synovial effusion and eliminates trauma due to a rigid needle.     

Spiral CT arthrography of the postoperative knee

Computed tomography (CT) has gained multiplanar capability and submillimeter spatial resolution due to the development of spiral acquisition mode and multidetector row technology. Multidetector spiral CT arthrography of the knee is a valuable imaging modality for the assessment of lesions of the meniscus, anterior cruciate ligament (ACL), and articular cartilage. This article presents the value of spiral CT arthrography in the assessment of the postoperative knee with emphasis on the postoperative meniscus, articular cartilage, and ACL graft. This technique may be proposed as an alternative to magnetic resonance arthrography.     

MR and CT arthrography of the knee

MR and CT arthrography are important imaging modalities for the assessment of the knee in certain situations. Indications for MR arthrography of the knee include assessment of the postoperative meniscus, the presence of chondral and osteochondral lesions, and the presence of intra-articular bodies. The major indication for CT arthrography is evaluating suspected internal derangement in patients who are unable to undergo MRI. In addition to reviewing the established clinical indications for MR and CT arthrography of the knee, the commonly used techniques, normal variants that can simulate disease, and the most commonly found pathologies that can be diagnosed with these modalities are discussed. Potential indications that are not currently well established in the literature including the evaluation of anterior cruciate ligament injury and autologous chondrocyte implants are examined. Where appropriate, the literature on controversial topics or diagnoses is reviewed. The use of conventional imaging versus CT and MR arthrography is also compared.     

Scatter radiation from abdominal CT examinations

Several water phantoms were scanned under a number of conditions and radiation exposure due to scatter was measured at the center of one end. The decrease of the scatter radiation exposure is nearly exponential with distance from the slice plane. The half-value distance is a function of the slice cross-sectional area. An empirical equation is presented to relate exposure to the pertinent variables.