Direct MR arthrography without image guidance: a practical guide, joint-by-joint.

Direct MR arthrography (dMRA) is a fundamental technique in diagnosing pathology in major peripheral joints, allowing for precise evaluation of intra-articular structures. Although injection guidance is typically performed using imaging techniques such as ultrasound or fluoroscopy, puncture via anatomical landmarks may be useful in certain circumstances where it has been proven to be a safe and effective procedure. This paper describes the indications and injection technique of dMRA, joint by joint, focusing on the different technical details, from the most common locations, like the shoulder or hip, to those with more restricted clinical indications, such as the wrist, knee, elbow, or ankle.

Direct MR arthrography of the hip joint: anterior approach without imaging guidance.

Purpose: The purpose of this study is to describe the anterior injection approach, with anatomical landmark guidance, for direct MR arthrography (dMRA) of the hip joint, and to evaluate the effectiveness in joint distension and the security of the technique.

Material And Methods: Retrospective review of hip dMRAs was conducted on patients with suspected intra-articular pathology from two MR outpatient centers, performed by two radiologists with 25 and 5 years of experience, respectively. The analysis included assessing the presence of intra-articular contrast material (gadolinium-based solution), the number of injections performed, the degree of joint distension, and the degree of contrast extravasation.

[From bone marrow edema to osteonecrosis. New concepts].

The widespread use of MRI in the diagnosis of articular pathology has allowed for an improved knowledge of a series of disturbances that occur with epiphyseal bone edema as a main radiological sign, featured as low signal intensity of the bone marrow on T1 and high signal on STIR and fat saturated T2 sequences. The new etiopathogenic theories postulate a clear differentiation between primary and secondary osteonecrosis. While secondary osteonecrosis is related to risk factors, primary osteonecrosis is a result of a subcondral insufficiency fracture.

Bone marrow edema syndrome of the foot: one year follow-up with MR imaging.

Objective: To describe the MR findings of bone marrow edema syndrome (BMES) of the foot and its evolution at 1 year follow-up.

Design And Patients: Twenty-five of 32 patients with disabling foot and ankle pain unrelated to trauma diagnosed as BMES when MR imaging demonstrated a bone marrow edema pattern in one or more bones without any radiological or underlying clinical cause, were re-evaluated by MR imaging 1 year later.

Results: On the initial MR examinations an average of 4.