Presentation
Anterior glenohumeral joint instability. For MRI arthrogram injection.
Patient Data
Injection of contrast
A 22-gauge Quincke needle targets the inferomedial humeral head, with the injection of iodinated contrast confirming an intra-articular needle position by extending into the inferior portion of the joint and axillary pouch.
The arthrogram injectate distends the joint. A small amount of iodinated contrast is included in the arthrogram injectate (in the 20mL syringe) to aid this assessment.
Case Discussion
Shown is a technically successful posterior shoulder / glenohumeral joint arthrogram injection. Patient positioning is more technical compared to the anterior approach where the patient would lie supine with their arm by their side and hand supinated. In a posterior approach, the patient is prone and with the use of a wedge, they are angled at around 40 degrees from the table, therefore making the oblique glenohumeral joint in line with the x-ray beam 1.