9: Arthrography and Tenography - Smith

Question 1

uses contrast injected into a joint to demonstrate abnormalities not evident on radiographs

Answer 1

arthrography

Question 2

positive v. negative contrast

Answer 2

iodinated radiopaque material

air

Question 3

indications ankle arthrography

Answer 3

soft tissue trauma
osteochondral defects
loose bodies

Question 4

technique arthroscopy

Answer 4

• inject lidocaine
• sterile betadine prep and sterile technique
• enter ankle with a 23 gauge needle just medial to the tibialis anterior tendon
• inject 8-10 cc of contrast material
• passive ROM of ankle
• examine under fluroscopy

Question 5

normal arthrography findings

Answer 5

• smoothness
• contrast can extend 1 cm above jt surface and distally to talar head and neck
• contrast may extend b/w tibia and fibula 2.5 cm above ankle
• communication to posterior STJ 10%
• contrast along needle tract

Question 6

abnormal findings in arthrography

Answer 6

• extravasation of contrast beyond the confine of joint

- CFL tear with contrast in peroneal tendon sheath

Question 7

most common places for arthrography in order

Answer 7

ankle
2nd MPJ
1st MPJ

Question 8

contrast injected into tendon sheaths to diagnose inflammatory or posttraumatic conditions

Answer 8

tenography

Question 9

how do you know if a tendon has a sheath?

Answer 9

if a tendon changes direction or angle it has a sheath

Question 10

lateral tendon group

Answer 10

peroneus longus and brevis

Question 11

medial tendon group

Answer 11

tibialis posterior

FDL and FHL

Question 12

anterior group

Answer 12

tibialis anterior

EDL and EHL

Question 13

tenography indications

Answer 13

CFL tears (*more accurate than arthrogram)
tendon subluxation or dislocation
tendon stenosis
tendon rupture