Is the injection of iodinated contrast intra-articular?
Yes, contrast extends into the joint and surrounds the superior aspect of the humeral head.
What are additional findings that can be evident on the fluoroscopy in those with a history of shoulder dislocation?
Hill-Sachs impaction fractures, bony bankart lesions and/or ossified intra-articular bodies.
What equipment is required for a fluoroscopic guided arthrogram injection?
Skin marker and a metal rod for marking, skin cleaning product, sterile drape, sterile field and tray for sharps, syringe selection, larger bore drawing up needle/ quill, needle to administer local anaesthetic i.e. 25 gauge needle, needle to cannulate the joint i.e. 22 gauge Quincke needle, short extension tubing, sterile gauze and adhesive dressing. A suggested syringe selection for a fluoroscopic MR arthrogram injection is 5 mL syringe: local anaesthetic i.e. 1% lidocaine, 10 mL syringe: non-ionic iodinated contrast i.e. iohexol and a 20 mL syringe: arthrogram injectate.
Posterior approach: Injection of contrast
A 22G 90mm Quincke needle is inserted and targets the inferomedial aspect of the humeral head. Iodinated contrast freely flows into the glenohumeral joint, contouring the superior humeral head.