Magnetic resonance arthrography of the shoulder: a painful procedure?

Abstract

ObjectiveTo compare the pain expected to that effectively caused by magnetic resonance arthrography of the shoulder and, secondarily, to describe a simplified approach to the technique for articular access.Materials and MethodsWe prospectively evaluated 40 participants who used a visual analog scale and a simplified categorical scale to indicate the level of pain expected and that experienced after the procedure, comparing the two with the Wilcoxon matched-pairs test. We also determined gender-related differences in pain conditions using the Mann-Whitney U test. In addition, we described a modified technique involving radiographic localization and the use of standard puncture needles for articular access.ResultsAnalysis of the visual analog scales showed that the pain experienced was less than had been expected, with median scores of 1.75 and 3.75, respectively (p < 0.001). The level of pain expected was higher among women than among men, with median scores of 8.0 and 3.0, respectively (p = 0.014), as was the level of pain experienced, with median scores of 3.0 and 1.5, respectively (p = 0.139). The overall categorical evaluation corroborated that difference (p = 0.03). Articular access with the modified technique was successful in all patients.ConclusionMagnetic resonance arthrography of the shoulder is less painful than patients expect. In addition, digital radiographic guidance combined with the use of standard puncture needles appears to improve the efficiency of the method.

Upper-limb magnetic resonance lymphangiography: a useful new technique

“…Recent studies have highlighted the importance of magnetic resonance imaging in the evaluation of diseases affecting the musculoskeletal system (1)(2)(3)(4)(5)(6) . Contrast-enhanced magnetic resonance lymphangiography (MRL) is a recently developed minimally invasive imaging technique for the evaluation of the lymphatic system and its abnormalities.…”

Imaging evaluation of hallux valgus

“…The evaluation of the musculoskeletal system by magnetic resonance imaging (MRI) has been the subject of a series of recent publications in the radiology literature of Brazil (4)(5)(6)(7)(8) . Although MRI is not considered the gold standard for the evaluation of hallux valgus, because MRI scans are not acquired during weight bearing, we agree with Helito et al (9) that MRI could be used for the diagnosis of this condition, given its high prevalence and the frequent unavailability of radiographic studies during weight bearing, as stated in their study published in the previous issue of Radiologia Brasileira.…”

Magnetic resonance arthrography: what is its importance in the present day?

“…Some studies have also helped demystify the topic of patient discomfort during MRA. In an article published in this issue of Radiologia Brasileira, Nascimento et al ( 13 ) concluded, on the basis of the responses obtained on questionnaires applied before and after the MRA examination, that the procedure is less painful than patients expect. The authors also described a novel technique in which the puncture is guided by conventional radiography.…”