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Arthrography Week 2
Arthrography Week 2 RT 72
| Question | Answer |
|---|---|
| What is Arthrography? | A radiographic image of a joint space and its surrounding structures |
| What are indications for arthrography? What are the traumatic ones and pathologic? | A patient has symptoms that cannot be diagnosed with x-ray's. Tears of joint capsule, menisci, or ligaments are traumatic. Bakers Cyst is pathologic. |
| What are some of the joint structures that show up on arthrography? | Menisci, Ligaments, Articular Cartilage, Bursae. |
| What is Pneumoarthrography? | Arthrography performed with negative contrast in the joint space (usually air or gas) |
| What is Opaque Arthrography? What type of contrast is used? | Arthrography performed with positive contrast. With water soluble contrast, either ionic, or non ionic. |
| What is dual contrast arthrography? What type is injected first. Why is this? | A combination of positive & negative contrast. Positive contrast is injected first, then negative contrast. The negative contrast pushes the positive contrast to the outside of the joint capsule. |
| What are possible reactions to the contrast for arthrography? | Vasovagal reactions, allergic reactions, infection. |
| Why is the scout film taken for knee arthrography? | To verify patient position, for openness of joint to verify tube angle. Baseline to verify technique based on pathology & to verify there's no fracture. |
| Why is the small amount of contrast injected under fluoroscopy? | To verify the needle is in the correct place, make sure the contrast is going in the joint space. |
| If there's swelling at the joint what must be done and why? | Synovial fluid must be removed to avoid dilution of contrast media. |
| For knee arthrography what technique is used for spot films. Why is this? | low kVp with a small focal spot. Are checking for tears, not bone, so want long scale contrast. |
| For knee arthrography where is the ace bandage wrapped and why? Where should the contrast concentrate> | The ace bandage is wrapped around the knee & slightly above it. It keeps the contrast in the joint & the contrast collects in between the Tibia & Femur. |
| Why is the knee exercised for 30 seconds after contrast injection for knee arthrography? | To disperse the contrast around the joint structures. |
| For knee arthrography, which method uses the stretch device? Where is the stretch device placed for medial delineation? For later delineation? | Vertical/Overhead Method. Stress device is placed lateral just above the knee for medial delineation & medial just above the knee for lateral delineation. |
| For knee arthrography, how many exposures are taken for the Vertical/Overhead method & how many degrees is the knee rotated? For the Horizontal method? | Generally 9 exposures with 20-30 degree rotation between exposures for the vertical/overhead method. Generally 6 exposures & 30 degrees rotation between exposures, for the horizontal method. |
| For vertical/overhead method why is the leg placed in a stress device for knee arthrography? | It permits better distribution of the contrast material around the knee. |
| What are the scout films taken for knee arthrography? | AP, Lateral (possibly obliques & tunnel) |
| What type of contrast will be used for double contrast horizontal method for knee arthrography? Why is this? | Double contrast. Improves delineation of joint structures. |
| How much contrast, what size syringe, what size needle is used for knee arthrography for positive contrast? What size syringe is used for double contrast? | 10 ml syringe, 20 gauge needle, 5 ml contrast. For double contrast a 50 ml syringe. |
| Why is hip arthorgraphy commonly performed in adults? | To detect loose hip prosthesis, or confirm presence of infection. |
| Why is Barium Sulfate used as cement additive to fasten hip prosthesis? | To make the cement bone interface visible. |
| Why is subtraction used on the films of hip arthrography? | Contrast medium is readily distinguished by subtraction. |
| Why is hip arthrography commonly performed on children? | Evaluation prior to and after treatment of congenital hip dislocations. |
| Where is the common puncture site for hip arthrography? | 3/4" distal to inguinal crease & 3/4" lateral to palpated femoral pulse. |
| What type of needle is used for the injection on hip arthrography? Why this size? | The spinal needle. Need a pretty long needle to get in to the hip joint. |
| What are the 4 aspects of the shoulder anatomy demonstrated on shoulder arthrography? | Joint capsule, long tendons of the Biceps Musle, Rotator Cuff, Articular Cartilage. |
| What is the name for the 4 major conjoined tendons in the shoulder? | Rotator cuff |
| What are the overheads for the shoulder arthrography. | AP scout, AP internal & external rotation, 30 degree oblique, Axillary (Inferosuperior), Bicipital Groove, Glenoid Fossa |
| What are the clinical indications for shoulder arthrography? | Rotator cuff or Glenoid Labrum abnormalities, Persistent pain or weakness, Frozen shoulder. |
| Where is the injection site for shoulder arthrography? What size needle is used? How much contrast is used for single contrast & double contrast? | about 1/2" inferior & lateral to coracoid process. a 2 1/2" to 3 1/2" spinal needle. 10-12 ml positive contrast for single contrast. 3-4 ml positive contrast & 10-12 ml negative contrast for double contrast. |
| What may result in abnormalities of TMJ? | Trauma. Stretched or loose posterior ligament. |
| Where is the injection site for TMJ arthrogram? How much contrast is used? | 1/2" anterior to tragus of ear. About 0.5 ml to 1.0 ml of positive contrast. |
| What are the preliminary tomograms for TMJ arthrography? | open & closed mouth. |
Created by:
jamestkelley
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