All-in-one magnetic resonance arthrography of the shoulder in a vertically open magnetic resonance unit

Background: Magnetic resonance (MR) arthrography frequently involves joint injection under imaging guidance followed by MR imaging in static positions. Purpose: To evaluate if MR arthrography of the shoulder joint can be performed in a comprehensive fashion combining the MR-guided injection procedure, static MR imaging, and dynamic motion MR imaging in a single test. Material and Methods: Twenty-three shoulder joints were injected with Gd-DTPA(2-) under MR guidance. Static MR imaging was performed and included a three-point Dixon method to achieve water-selective images. Dynamic motion MR imaging with and without applying pressure to the upper arm was used to evaluate glenohumeral joint instability. In 10 cases, surgical correlation was available. Results: The all-in-one MR arthrography technique was successful in all patients, and took an average time of 65 min. All but one glenohumeral injection procedure were performed with a single needle pass, and no complications were observed. Out of eight labrum tears seen with static MR imaging, seven were confirmed at surgery. In 10 cases, dynamic motion MR imaging correlated well with the surgeon's intraoperative evaluation for presence and direction of instability. Conclusion: MR arthrography of the shoulder joint using a vertically open magnet can be performed as a single comprehensive test, including the injection and the static and dynamic motion MR imaging. Good diagnostic accuracy for intraarticular lesions and glenohumeral instability was found in a small sample.