A Comparison between the Anterior and Posterior Approach to US-guided Shoulder Articular Injections for MR Arthrography

ABSTRACT

PURPOSE: To assess the feasibility of ultrasound-guided shoulder joint injections by the anterior and posterior approaches for performing a MR arthrography. MATERIALS AND METHODS: Between April 2007 and June 2008, 28 patients underwent ultrasound-guided intra-articular contrast injections for a MR arthrography. This study was approached using the antegrade method. As well, all injections were performed by one radiologist. The patient selection criteria for the anterior and posterior approaches were randomly for the anterior approach and alternatively for the posterior approach. Each approach included 13 cases and each were injected by the anterior or posterior approaches exclusively . The patients were classified into three groups as follows 1) the successful intra-articular injection group, 2) the small leakage group, and 3) the injection failure group. RESULTS: Of the 15 patients that underwent the anterior approach, two were unsuccessful for the MR arthrography. Whereas, two other cases experienced small leakage. The two failed MR arthography cases using the anterior approach were later injected using the posterior approach. The 15 patients subjected to the posterior approach to perform a MR arthrogram were successful in all cases, without any leakage. CONCLUSION: The ultrasound-guided intra-articular injections were feasible with a high success rate by both the anterior and posterior approaches. However, better results were achieved from the posterior approach than the anterior approach in this study.