An overview of MR arthrography with emphasis on the current technique and applicational hints and tips

Magnetic resonance (MR) arthrography has been investigated in every major peripheral joint of the body, and has been proven to be effective in determining the integrity of intraarticular ligamentous and fibrocartilaginous structures and in the detection or assessment of osteochondral lesions and loose bodies in selected cases. Several methods could be used to create arthrogram effect during MR imaging, however, direct MR arthrography using diluted gadolinium as the contrast agent is the most commonly used technique and is the most reliable of all. MR arthrography is useful for demonstrating labrocapsular-ligamentous abnormalities and distinguishing partial thickness rotator cuff tears from focal full thickness tears in the shoulder, identifying or excluding recurrent tears following meniscal operations in the knee, demonstrating perforations of the triangular fibrocartilage complex (TFCC) and ligaments in the wrist, showing labral tears in the hip, diagnosing ligament tears in the ankle and identifying osteochondral lesions or loose bodies in any of the aforementioned joints. In this article, an overview of techniques of MR arthrography is provided with emphasis on direct MR arthrography using diluted gadolinium as the contrast agent. The current applications of the technique in major peripheral joints are reviewed, with emphasis given to the shoulder joint where the role of this technique has become well established.