Arthrography & Tenography Flashcards
What is arthrography?
injection of contrast dye into a joint to demonstrate abnormalities not evident on radiographs
what is the positive contrast?
iodinated radiopaque material (appears white on x-ray film)
what is negative contrast?
air
what are the indications for an ankle arthrography?
- soft tissue trauma - ligament tears, injury to joint capsule
- osteochondral defects
- loose bodies
What are normal findings of arthrography?
- SMOOTH surfaces- A/P recesses of the joint fill w/ contrast and will be smooth
- contrast can extend 1cm above joint surface and distally to talar head and neck
- contrast may extend btwn tibia and fibula 2.5cm above ankle
- communication to posterior STJ: 10%
- contrast along needle tract
what are some abnormal findings of arthrography?
- extravasation of contrast beyond the confines of the joint
- CFL tear with contrast in the peroneal tendon sheath
What is the most common place for an arthrography to be done?
- ankle is most common (looks for Calcaneo-fibular ligament tears)
- MPJ- 2nd MPJ esp.
* other joints are harder to enter and don’t have a well-defined capsule
what is a tenography?
injection of contrast dye into tendon sheaths to diagnose inflammatory or post-traumatic conditions
which tendons have tendons sheath?
tibialis anterior
tibialis posterior
peroneal tendons
What and where do the lateral group of tendons run?
(peroneus longus & brevis)
-sheath entered posterior and proximal to lateral malleolus
What and where do medial group of tendons run?
(tibialis posterior; FDL & FHL)
- TP enters medial & posterior to the distal tibial metaphysis about 3-4m above the ankle joint
- FDL and FHL enters at same level, but more posterior
What and where do the anterior group of tendons run?
(tibialis anterior; EDL & EHL)
-tendon sheaths enter 4-5cm proximal to ankle joint
what are indications for tenography?
- CFL tears (more accurate than arthrogram)
- tendon subluxation or dislocation
- tendon stenosis
- tendon rupture
