Browsing by Subject "Joint"

Now showing 1 - 3 of 3
  • Thumbnail Image
    Publication
    Restricted
    A simple technique for shoulder arthrography
    (SAGE Publications, 2006-09) Redondo, M.V.; Martínez Martínez, Francisco; Reus, M.; Alonso, J.; Parrilla, A.; Campos, P.A.; Berná Serna, Juan De Dios; Cirugía, Pediatría y Obstetricia y Ginecología
    Purpose: To present a systematic approach to teaching a technique for arthrography of the shoulder. Using an adhesive marker-plate with radiopaque coordinates, precise sites for puncture can be identified and the need for fluoroscopic guidance obviated. Material and Methods: Forty-six glenohumeral arthrograms were performed in 45 patients; in 1 case involving examination of both shoulders. The stages of the technique are described in detail, as are the fundamental aspects of achieving an effective glenohumeral injection. Pain intensity was measured in all patients using a verbal description scale.Results: Shoulder arthrography was successful in all cases. Average time taken for the procedure was 7 min, with no difference in the respective times required by an experienced radiologist and a resident. The procedure was well tolerated by most patients, with slight discomfort being observed in a very few cases.Conclusion: The arthrographic technique used in this study is simple, safe, rapid, and reproducible, and has the advantage of precise localization of the site for puncture without need for fluoroscopic guidance. The procedure described in this study can be of help in teaching residents and can reduce the learning curve for radiologists with no experience in arthrographic methods. It also reduces the time of exposure to fluoroscopy.
  • Thumbnail Image
    Publication
    Restricted
    MR arthrography of the shoulder using an anterior approach: optimal injection site
    (American Roentgen Ray Society, 2012-11-23) Redondo, María V.; Campos, Pedro A.; Reus, Manuel; Martínez Martínez, Francisco; Campos, Matilde; Domenech, Ernesto; Berná Serna, Juan De Dios; Cirugía, Pediatría y Obstetricia y Ginecología
    OBJECTIVE. The purpose of our study was to optimize anterior MR arthrography of the shoulder by comparing three injection sites. MATERIALS AND METHODS. Seventy-eight patients were divided into three groups of 26 each, according to the injection site selected: the upper third of the medial part of the humeral head, the lower third of the medial part of the humeral head, or the area between the middle and lower thirds of the glenohumeral joint. A marker plate with radiopaque coordinates was used in performing the technique. Radiologist time and exposure time were recorded, and the intensity of the patient's pain was measured using a Visual Analogue Scale (VAS). Groups were compared using variance analysis and the least significant difference method. RESULTS. Shoulder arthrography was considered satisfactory for all three injection sites. Mean exposure time was 20.9 ± 7.8 (SD) milliseconds, and mean radiologist time was 6.4 ± 0.8 minutes. Mean pain intensity registered by the VAS was 1.7 ± 0.9, the lowest values tending to be those recorded by patients who received an injection in the upper third. Exposure and radiologist times were lower for these latter patients; differences between the upper third and the other two areas were statistically significant (p < 0.005). CONCLUSION. The optimal injection site for anterior MR arthrography of the shoulder is the upper third of the humeral head, a simple, rapid procedure that is well tolerated by patients and reduces the radiation dose administered.
  • Thumbnail Image
    Publication
    Open Access
    Synovial histopathology in common orthopaedic joint conditions assessed with a modified Krenn synovitis score
    (2026) Lew Schon; Zijun Zhang; Biología Celular e Histología; Universidad de Murcia, Departamento de Biologia Celular e Histiologia
    Purpose. Synovial pathology impacts joint disease progression and clinical outcome. The goal of this study was to modify Krenn synovitis score for more accurate and comprehensive evaluation of common orthopaedic joint conditions. Methods. A total of 31 synovial samples were collected during foot and ankle surgery. Synovial sections were stained with hematoxylin and eosin, and picrosirius red. Immunohistochemistry for CD3 and α smooth muscle actin (α-SMA) was performed for inflammatory infiltration and fibroblast activation. Synovitis was evaluated with Krenn synovitis score and a modified Krenn synovitis score (MKSS), where the original subcategories of inflammatory infiltration and stromal cellularity were replaced with the density of CD3+T cells and collagen intensity, respectively. Results. Of 31 synovial samples, the average Krenn synovitis score was 1.5±1.3 and MKSS was 1.8±1.2 (p>0.05). The two scores were positively correlated in assessing synovial pathology (r=0.6; p<0.001). The dominant subcategory shifted from stromal cellularity (64%) in Krenn synovitis score to the density of CD3+T cells (80%) in MKSS. By MKSS classification, but not Krenn synovitis score, type III collagen intensity and the ratio of type III over type I collagen increased in the synovitis group. The density of α-SMA+cells did not correlate with the intensity of synovial collagen and was not different between synovitis and non-synovitis samples. Conclusion. While maintaining the concept and basic elements of the Krenn synovitis score, MKSS incorporated more accurate inflammatory infiltration and detailed fibrosis. It could provide a more comprehensive evaluation of synovial pathology in common orthopaedic joint conditions.