Shoulder arthrogram injection (fluoroscopic guided)

Case contributed by Dr Dai Roberts

Presentation

Anterior glenohumeral joint instability. For MRI arthrogram injection.

Patient Data

Age: 20 years
Gender: Male
Fluoroscopy

Injection of iodinated 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.

Fluoroscopy

Post administration of injectate

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

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Case information

rID: 77277
Published: 12th May 2020
Last edited: 12th May 2020
Inclusion in quiz mode: Included
Institution: St. Paul's Hospital

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