MR arthrography of the shoulder and hip after fluoroscopic landmarking

To describe a technique for intra-articular injection in the MR suite after conventional fluoroscopic landmarking in order to streamline MR arthrography. This technique was performed on 33 consecutive patients referred for MR arthrography of the shoulder to evaluate the glenoid labrum and on 15 consecutive patients referred for MR arthrography of the hip to evaluate the acetabular labrum. The patients were landmarked in the fluoroscopy suite, followed by a conventional MR examination. The intra-articular injection was then performed on the MR table and the MR arthrographic sequences obtained. One of the 48 injections was extra-articular, requiring a second injection. The other injections were performed without incident, and the average total procedure time for all injections was 10 min. This technique is a reliable method of streamlining intra-articular injections when performing conventional MR imaging prior to the MR arthrographic portion of the examination. It shortens the total MR examination time by eliminating a visit to the fluoroscopy suite in the middle of the MR study, and its use of a straight anterior approach for both the shoulder and hip joints should be familiar to most people who perform conventional arthrography.