From my colleague Andy Sonin.
This is the guide we disseminate within our practice to new radiologists.
–Paul Hsieh, MD
E-mail: <paulhsiehmd@gmail.com>
For wrist- its best to ulnar deviate the hand and volar flex to open up the radiocarpal space and go distal to proximal along the joint alignment of radiocarpal articulation.
For hip arthrogram/inj- go little bit medial to lateral border of head and neck junction otherwise, one may end up outside the joint.
For hip aspiration- go to inferior recess- that’s where fluid pools most of the time if it’s there e.g. in periprosthetic infection.
does anyone have a good reference article on techniques for arthrograms? thank you so much!
Barbra A. Ross, MD
4891 E. Butler Drive
Paradise Valley, AZ 85253
650-996-6692 (cell)
ocad-msk
Regarding hip aspiration..
Putting fluid in rarely helps; found it more useful for the tech to flex the knee while I’m maintaining needle position. Increases pressure in the hip joint and the needle is the path of least resistance.
I’m out of the athrogram business as I’ve switched to home based telerad, but I’ve done all my arthrograms since 2007 by CT only.
Billy Morrison wrote a book on arthrography.
Classic back in the 80’s was:
Do not miss the days of knee arthrography and the medieval torture device as well as the radiation to the torso as you struggledto position the knee while running the fluoro
Best,
Frank
Very nice document.
Couple of modifications..
For wrist- its best to ulnar deviate the hand and volar flex to open up the radiocarpal space and go distal to proximal along the joint alignment of radiocarpal articulation.
For hip arthrogram/inj- go little bit medial to lateral border of head and neck junction otherwise, one may end up outside the joint.
For hip aspiration- go to inferior recess- that’s where fluid pools most of the time if it’s there e.g. in periprosthetic infection.
Pics look great!
Best!AC
Avneesh Chhabra, M.D. M.B.A.
Professor Radiology & Orthopedic Surgery
Chief, Division of Musculoskeletal Radiology
UT Southwestern Medical Center, Dallas, Tx
5373 Harry Hines Blvd.
Dallas, Tx-75390-9178
From my colleague Andy Sonin.
This is the guide we disseminate within our practice to new radiologists.–Paul Hsieh, MD
E-mail: <paulhsiehmd@gmail.com>
does anyone have a good reference article on techniques for arthrograms? thank you so much!
Barbra A. Ross, MD 4891 E. Butler DriveParadise Valley, AZ 85253650-996-6692 (cell)
________________________________
Sent: Friday, January 21, 2022 11:52 AM
WARNING: This email appears to have originated outside of the UW Health email system.
DO NOT CLICK on links or attachments unless you recognize the sender and know the content is safe.
does anyone have a good reference article on techniques for arthrograms? thank you so much!
Barbra A. Ross, MD
4891 E. Butler Drive
Paradise Valley, AZ 85253
650-996-6692 (cell)
This is the guide we disseminate within our practice to new radiologists.
–Paul Hsieh, MD
E-mail: <paulhsiehmd@gmail.com>
On Fri, Jan 21, 2022 at 10:53 AM ‘barbra ross’ via OCAD MSK < ocad-msk@googlegroups.com> wrote:
Couple of modifications..
For wrist- its best to ulnar deviate the hand and volar flex to open up the radiocarpal space and go distal to proximal along the joint alignment of radiocarpal articulation.
For hip arthrogram/inj- go little bit medial to lateral border of head and neck junction otherwise, one may end up outside the joint.
For hip aspiration- go to inferior recess- that’s where fluid pools most of the time if it’s there e.g. in periprosthetic infection.
Pics look great!
Best!
AC
Avneesh Chhabra, M.D. M.B.A.
Professor Radiology & Orthopedic Surgery
Chief, Division of Musculoskeletal Radiology
UT Southwestern Medical Center, Dallas, Tx
5373 Harry Hines Blvd.
Dallas, Tx-75390-9178
Office: 214-648-2122
avneesh.chhabra@utsouthwestern.edu<mailto:avneesh.chhabra@utsouthwestern.edu>
http://www.utsouthwestern.edu<http://www.utsouthwestern.edu/>
________________________________
Sent: Friday, January 21, 2022 11:57 AM
Cc: OCAD GOOGLE GROUPS <ocad-msk@googlegroups.com>
EXTERNAL MAIL
From my colleague Andy Sonin.
This is the guide we disseminate within our practice to new radiologists.
–Paul Hsieh, MD
E-mail: <paulhsiehmd@gmail.com<mailto:paulhsiehmd@gmail.com>>
does anyone have a good reference article on techniques for arthrograms? thank you so much!
Barbra A. Ross, MD
4891 E. Butler Drive
Paradise Valley, AZ 85253
650-996-6692 (cell)
Putting fluid in rarely helps; found it more useful for the tech to flex the knee while I’m maintaining needle position. Increases pressure in the hip joint and the needle is the path of least resistance.
I’m out of the athrogram business as I’ve switched to home based telerad, but I’ve done all my arthrograms since 2007 by CT only.
Billy Morrison wrote a book on arthrography.
Classic back in the 80’s was:
Do not miss the days of knee arthrography and the medieval torture device as well as the radiation to the torso as you struggledto position the knee while running the fluoro
Best,
Frank
Very nice document.
Couple of modifications..
For wrist- its best to ulnar deviate the hand and volar flex to open up the radiocarpal space and go distal to proximal along the joint alignment of radiocarpal articulation.
For hip arthrogram/inj- go little bit medial to lateral border of head and neck junction otherwise, one may end up outside the joint.
For hip aspiration- go to inferior recess- that’s where fluid pools most of the time if it’s there e.g. in periprosthetic infection.
Pics look great!
Best!AC
Avneesh Chhabra, M.D. M.B.A.
Professor Radiology & Orthopedic Surgery
Chief, Division of Musculoskeletal Radiology
UT Southwestern Medical Center, Dallas, Tx
5373 Harry Hines Blvd.
Dallas, Tx-75390-9178
Office: 214-648-2122
avneesh.chhabra@utsouthwestern.edu
Sent: Friday, January 21, 2022 11:57 AM
Cc: OCAD GOOGLE GROUPS <ocad-msk@googlegroups.com>
EXTERNAL MAIL
From my colleague Andy Sonin.
This is the guide we disseminate within our practice to new radiologists.–Paul Hsieh, MD
E-mail: <paulhsiehmd@gmail.com>
does anyone have a good reference article on techniques for arthrograms? thank you so much!
Barbra A. Ross, MD 4891 E. Butler DriveParadise Valley, AZ 85253650-996-6692 (cell)
[gallery]
Fundamentals of Joint Injection : American Journal of Roentgenology : Vol. 207, No. 3 (AJR)<http://www.ajronline.org/doi/full/10.2214/AJR.16.16243?src=recsys&mobileUi=0>
OBJECTIVE. Using image guidance for joint access is a valuable fundamental skill. The purpose of this article is to review fluoroscopic and ultrasound-guided techniques and the medications used for injection into the glenohumeral, elbow, wrist, hip, knee, and ankle joints.
http://www.ajronline.org
AJR article on the subject.
Best
________________________________
Sent: Friday, January 21, 2022 11:52 AM
WARNING: This email appears to have originated outside of the UW Health email system.
DO NOT CLICK on links or attachments unless you recognize the sender and know the content is safe.
does anyone have a good reference article on techniques for arthrograms? thank you so much!
Barbra A. Ross, MD
4891 E. Butler Drive
Paradise Valley, AZ 85253
650-996-6692 (cell)
I’ve found this article quite useful…
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4656236/
Kind regards,
Byron
Get Outlook for iOS<aka.ms/o0ukef>
________________________________
Sent: Saturday, January 22, 2022 6:52:59 AM
does anyone have a good reference article on techniques for arthrograms? thank you so much!
Barbra A. Ross, MD
4891 E. Butler Drive
Paradise Valley, AZ 85253
650-996-6692 (cell)
uwmsk.org/arthrography/
Cheers,
Mike Richardson
UW Radiology
Sent from my iPad
Hi Barbara,
I’ve found this article quite useful…
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4656236/
Kind regards,
Byron
Get Outlook for iOS<aka.ms/o0ukef>
________________________________
Sent: Saturday, January 22, 2022 6:52:59 AM
does anyone have a good reference article on techniques for arthrograms? thank you so much!
Barbra A. Ross, MD
4891 E. Butler Drive
Paradise Valley, AZ 85253
650-996-6692 (cell)