Flashcards in Special Procedures and Pedi Deck (133)
Greek word "arthron" means
radiologic examination of the synovial joints and related soft tissue structures that employs contrast media.
___ or ____ exams may be used in place of, or in addition to, arthograms.
CT or MRI
Joints commonly examined via arthrography:
Most common: shoulder and knee
Knee arthrography does what?
Assess knee joint and associated soft tissue structures (joint capsule, menisci, and ligaments.)
Knee joint and associated soft tissue structures are visualized by introducing:
contrast into joint capsule.
Clinical indications for knee arthrography include:
tears in joint capsule
tears or degeneration of menisci
Contraindications for knee arthrography include:
Hypersensitivity to iodine-based contrast media or local anesthetics.
An example of a NONTRAUMATIC pathologic indicating arthrography is a:
Baker's cyst, which communicates with the joint capsule in the popliteal area.
Patient prep for knee arthrography:
No dietary prep
Advise of complications
Signed informed consent form.
Imaging equipment used for knee arthrography:
Fluoroscopy and spot imaging
Patient restraining device (provides medial or lateral stress)
Conventional radiography capability.
Accessory equipment for knee arthrography:
Arthrogram tray (Includes items needed for contrast injection and preparation of injection site.)
Needles with local anesthetics
Types of contrast media needed for knee arthrography:
Radiolucent (room air)
Double contrast: (5 mL of positive and 80-100mL of negative CO2 or air.)
Seven steps to needle placement and injection for knee arthrography:
1. Site prepared according to sterile technique.
2. Retropatellar, lateral, anterieor, or medial approach (site of injection is the site preferred by physician)
3. Skin anesthetized.
4. Fluid aspirated (discarded or sent to lab)
5. Contrast media instilled
6. Needle removed.
7. Knee exercised to produce thin, even coating of sift tissue structures with positive medium.
Knee stressed during fluoroscopy with use of:
What should be worn during fluoro?
lead gloves and apron.
Closely collimated views of what should be seen during fluoro imaging of a knee arthrogram?
What degree of rotation of the knee should be seen between each exposure?
A 20º rotation of the knee between each exposure results in:
9 spot images of each meniscus, which demonstrates the meniscus in profile throughout its diameter.
Conventional "overhead" projections for knee orthography shows:
entire articular capsule outlined in proper AP and lateral positions with optimal exposure factors and the correct markers visible.
What is often performed following a conventional arthrography?
What is the purpose of shoulder arthrography?
To demonstrate the joint capsule, rotator cuff, long tendon of biceps and articular cartilage.
Does a shoulder arthrography use single or double contrast injection?
Clinical indications for shoulder arthrography:
Tears in rotator cuff
What is the name for the tendons that surround the shoulder joint?
The rotator cuff is actually:
a group of four muscles and their tendons that wraps around the front, back and top of the shoulder joint.
The ends of the rotator cuff muscles form:
tendons that attach to the humerus. It is the tendinous portion that is usually involved in a rotator cuff tear.
Imaging equipment used for shoulder arthrography:
Contrast injection under fluoroscopic control
Conventional imaging done with overhead x-ray tube.
Accessory equipment used for shoulder arthrography:
Standard arthrogram tray
Specific accessory equipment need of particular physicians.