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Shoulder Arthrogram

ax T1

ax T2 FS

oblique cor T1 FS

oblique cor T2 FS

oblique sag T1

oblique sag T2 FS


Wrist Arthrogram

ax T1

ax T2 FS

cor T1 FS

cor T2 FS

cor 3D gradient echo

sag T2 no FS (TE =80 to 90)


Elbow Arthrogram

ax T1

ax T2 FS

cor T1 FS (use the interepicondylar line to determine cor plane)

cor T2 FS

sag T2 no FS (TE = 80 to 90)


Hip Arthrogram

cor T1 - whole pelvis

cor T2 FS - whole pelvis

small FOV - hip of interest

ax T1

ax T2 FS

cor T2 FS

oblique ax T1 (NO FS)

sag T1 FS

sag T2 FS


Knee Arthrogram

ax T2 FS

sag PD

sag T2 FS

sag T1 FS

cor T1

cor T2 FS

if medial or lateral

cor T1 - bilateral

cor T2 FS or STIR - bilateral

if medial or lateral

cor T1

cor T2 FS or STIR


Gadolinium Mixture for Arthrography

High iodine concentration in the contrast mix or too high of a concentration of Gd can cause dephasing artifact on both T1 and T2 weighted sequences - black joint in this case.

Here is the dilution mixture I'd like to propose: (1:200 dilution of Gd)

20 mL syringe

1. 5 ml of 1% lidocaine (for patient comfort)

2. 10 ml of normal saline

3. 5 ml of Omnipaque 300 or Isovue 300 (seems to be the ubiquitous contrast available in all hospitals)

4. 0.1 ml of diluted Gd (Omniscan, Magnivist, or Multihance all ok)

Mix the solution well before purging the bubbles. Inadequate mixing can cause layering of the iodine contrast at the dependent portion of the joint after injection causing dephasing artifact due to high iodine concentration.

For wrist arthrograms, take fluoro images after the injection, profiling the scapholunate, lunotriquetral and distal radioulnar joints.