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Arthrography of the Shoulder: A Simple Fluoroscopically Guided Approach for Targeting the Rotator Cuff Interval

Hélène Dépelteau1, Nathalie J. Bureau1, Etienne Cardinal1, Benoît Aubin1 and Paul Brassard2

1 Radiology Department, Centre Hospitalier de l'Université de Montréal, Hôpital Saint-Luc, 1058 Saint-Denis St., Montreal, QC H2X 3J4, Canada.
2 Division of Clinical Epidemiology, McGill University Health Center, Royal Victoria Hospital, 687 Pine Ave. W, Ross 4.29, Montreal, QC H3A 1A1, Canada.



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  		Fig. 1A. —33-year-old man with superior labral anteroposterior lesion. Radiograph shows initial position of humeral head during arthrography of left shoulder. Humeral head is positioned in external rotation. Pointer indicates site of needle entry at medial upper quadrant of humeral head.

 


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  		Fig. 1B. —33-year-old man with superior labral anteroposterior lesion. Radiograph shows 1.5-inch (3.8-cm), 22-gauge needle introduced into glenohumeral joint under intermittent fluoroscopy (not shown) at level of rotator cuff interval. Needle is advanced until it contacts humeral head.

 


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  		Fig. 1C. —33-year-old man with superior labral anteroposterior lesion. Radiograph shows intraarticular injection of contrast material. Short extension tubing was attached to 1.5-inch (3.8-cm), 22-gauge needle, and contrast material was injected under fluoroscopy (not shown). Contrast material flows freely away from needle tip. Distribution of contrast material toward joint line and subscapularis recess confirms intraarticular injection.

 


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  		Fig. 2. —Diagram of rotator cuff interval shows left shoulder in external rotation. Rotator cuff interval (asterisk) lies between supraspinatus (SUP) muscle and subscapularis (SUB) muscle. Long head of biceps tendon (arrow) courses in bicipital groove and is displaced laterally away from target site for needle.

 

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