Frequency of technical success of ultrasound-guided arthrogram injections in children

Background MR arthrography is an essential diagnostic tool to assess and guide management of labral, ligamentous, fibrocartilaginous, and capsular abnormalities in children. While fluoroscopy is traditionally used for intra-articular contrast administration, ultrasound offers advantages of portabili...

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Bibliographic Details
Published in:Pediatric radiology 2023-11, Vol.53 (12), p.2380-2385
Main Authors: O’Sullivan, Joseph, Kim, Helen H. R., Otjen, Jeffrey P., Ngo, Anh-Vu, Maloney, Ezekiel, Menashe, Sarah J., Iyer, Ramesh S., Thapa, Mahesh
Format: Article
Language:English
Subjects:
Abnormalities
Allergic reactions
Children
Elbow
Elbow (anatomy)
Fluoroscopy
Hip
Hypersensitivity
Imaging
Ionizing radiation
Joints (anatomy)
Medicine
Medicine & Public Health
Neuroradiology
Nuclear Medicine
Oncology
Original Article
Paresthesia
Pediatrics
Radiation effects
Radiology
Shoulder
Side effects
Ultrasonic imaging
Ultrasound
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Summary:Background MR arthrography is an essential diagnostic tool to assess and guide management of labral, ligamentous, fibrocartilaginous, and capsular abnormalities in children. While fluoroscopy is traditionally used for intra-articular contrast administration, ultrasound offers advantages of portability and lack of ionizing radiation exposure for both the patient and proceduralist. Objective The purpose of this retrospective study is to quantify technical success and frequency of complications of ultrasound-guided arthrogram injections at our institution. Materials and methods This retrospective analysis investigates the results of 217 ultrasound-guided arthrograms of the shoulder, elbow, and hip in patients aged 5–18 years. Successful injection of contrast into the target joint, clinical indication for MR arthrography, and complications were reviewed. Results Accurate ultrasound-guided intra-articular administration of contrast into the target joint was successful for 100% of shoulder cases (90/90), 97% of elbow cases (77/79), and 98% of hip cases (47/48). Leak of contrast outside the target joint occurred in 1.4% (3/217) of cases. No major side effects including excessive bleeding, paresthesia, allergic reactions, or infection occurred during or after the procedure. Additionally, no major vessel, nerve, or tendon complications were observed on MR images. Conclusion Ultrasound guidance is a reliable, effective, and safe approach to arthrography in children. Graphical Abstract
ISSN:1432-1998
0301-0449
1432-1998
DOI:10.1007/s00247-023-05777-5