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MR Arthrography of the Glenohumeral Joint

A Tailored Approach

Christine B. Chung1, Jerry R. Dwek2, Sunah Feng1 and Donald Resnick1

1 Department of Radiology, Musculoskeletal Division, University of California, San Diego, and Veterans Healthcare System, 3350 La Jolla Village Dr., San Diego, CA 92161.
2 Department of Radiology, Children's Hospital of Columbus, 700 Children's Dr., Columbus, OH 43205.



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  		Fig. 1. —Photograph of axial anatomic section through inferior aspect of glenohumeral joint in cadaveric specimen. Wire (straight arrow) courses through anterior soft tissues, traversing anterior band of inferior glenohumeral ligament complex (curved arrow), and marks path of needle used in standard anterior approach for arthrography.

 


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  		Fig. 2. —Photograph of axial anatomic section through glenohumeral joint in cadaveric specimen. Tip of wire (curved arrow) is seen in anterior labrum (straight arrow) and marks path of needle used in standard anterior approach for arthrography.

 


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  		Fig. 3. —Photograph showing initial position of patient. Patient lies on side, facing operator, with symptomatic shoulder in nondependent position, internally rotated.

 


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  		Fig. 4A. —Photograph showing desired position of patient with corresponding spot fluoroscopic film. Photograph shows patient turned forward toward prone position while glenohumeral joint is examined fluoroscopically.

 


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  		Fig. 4B. —Photograph showing desired position of patient with corresponding spot fluoroscopic film. Spot fluoroscopic film shows desired position of patient with joint space viewed in tangent to beam. Humeral side of inferior third of glenohumeral joint (arrow) is localized as needle entry site.

 

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