Ultrasound-guided gadolinium joint injections for magnetic resonance arthrography

Purpose To determine the feasibility and accuracy of ultrasound (US) -guided gadolinium injection for MR arthrography of shoulders, wrists, hips, and knee joints as an alternate technique to fluoroscopy. Methods One hundred patients referred to our center for an MR arthrogram of shoulders, wrists, hips, and knees were included in the study. There were 53 males and 47 females and ages ranged from 17 to 63 years (mean age, 37). US was used to guide the needle tip into the joint. The intra-articular location of the needle tip was confirmed by fluoroscopic visualization of injected iodinated contrast medium, prior to gadolinium injection. The patients then proceeded for the MRI examination. Results Ninety-nine of the 100 patients were successfully injected with gadolinium under US guidance. One patient had a vasovagal reaction after local anesthetic injection and the procedure was aborted. Conclusion US is an effective alternate guidance technique for the injection of gadolinium into shoulder, hip, knee, and wrist joints for MR arthrography. Its advantages are cost effectiveness, ease of performance, and lack of radiation. © 2010 Wiley Periodicals, Inc. J Clin Ultrasound, 2011