Under fluoroscopic guidance, a radiologist inserts a small needle into the joint. Contrast material is then infused to distend the joint, allowing exquisite evaluation of ligament, tendon, and capsular anatomy. Most commonly, MR Arthrography is performed in the shoulder, as it is the most accurate method of characterizing fibrocollagenous labral tears. A routine MRI shoulder was unable to clearly visualize capsulolabral structures since the patient had no significant native joint fluid. The referring physician requested an MR arthrogram be performed to allow ideal evaluation of the joint.
Shoulder impingement is a dynamic process.
By stretching out the joint capsule and distending it with fluid, we are able to visualize labroligamentous pathology and small undersurface rotator cuff tears that would otherwise go undetected. MR Arthrography with ABER is able to precisely define the involvement of cartilaginous, labral, and ligamentous structures. The foot and ankle constitute the most anatomically complex joints, which a large spectrum of pathology. Patients freqeuntly present with a spectrum of abnormalities that can be difficult to evaluate clinically. MRI is an important adjunct to developing a therapeutic plan.