Prospective evaluation of two different injection techniques for MR arthrography

Abstract The aim of the study was toevaluate prospectively the technicalfeasibility and discomfort of twodifferent injection techniques for MRarthrography of the hip. Sixty-oneconsecutive patients undergoing MRarthrography of the hip (68 hips) wererandomlyinjectedeitheratthefemoralhead (36 hips) or the femoral neck (32hips). The patients rated discomfortduring and 0–72 h after arthrographyusing a visual analogue scale (VAS,0=“did not feel anything”, 100=“un-bearable”). The volume injected, thedistance between the needle tract andthe neurovascular bundle, the durationof the procedure and the extra-articu-lar contrast leakage were measured.No significant differences were foundfor the volume injected, the distancebetween the needle tract and the neu-rovascular bundle, or the procedureduration. Volume of extra-articularcontrast leakage was statistically sig-nificantly different (head 1±2 cm 3 ,neck 3±5 cm 3 , P=0.024). The VASscore for needle advancement wassignificantly different (head 25±20,neck 19±23, P=0.031). No significantdifferences were found for the VASscore regarding delayed discomfort.Before the examination the arthrogra-phy-related discomfort was overesti-mated by 74% (50/68), correctlyanticipated by 22% (15/68) and un-derestimated by 4% (3/68) of thepatients. MR-related discomfort wasoverestimated by 32% (22/68), cor-rectly anticipated by 57% (39/68) andunderestimated by 10% (7/68) of thepatients. Both hip puncture techniqueswere well tolerated. The neck injec-tion technique produced less discom-fort and was associated with greaterextra-articular contrast leakage.Keywords Hip . Arthrography .Technology