2. Shoulder MR- Arthrography Jalal Jalal Shokouhi -M.D. Aliakbar Ameri -M.D. Ali Saeidi -B.S. Mohsen Shamsolahrar -M.S. Rasoul Saadat -B.S.

8. Indications 1.Abscent effusion 2.Glenohumeral Instability 3.Slap Tear 4.R.C. Tear 5.Post Op.

15. Capsular insertion Perthes lesion: thick ant. Labrum,detached labrum ALPSA lesion: similar bankart avulsion ant. labroligament Slap lesion: ant. inf. Labrum nondisplaced tear Bufored Complex: abscent ant. Sup. Glenoid labrum, thick middle glenohumeral lig. “Congenital”

16. BHAGL lesion: avulsion of glenohumeral lig. GLOM lesion: glenolabrum ovoid mass “ avulsion of ant. Labrum in axial view” Bankart lesion: ant. Inf. Cartilagenous labrum injury Polpsa lesion: post. labral capsular periosteal sleeve avulsion

22. Technic: 1.T1 Abduction, External rotation (ABER) 2.Fat sat. 3.C. Arm, Guided puncture( I used CT guidance) INDIRECT MR ARTH. IV. GD EXERCISE AFTER 20 MINUTES Enhancement FAT SAT. IMAGES(increased joint signal) FDA not approved ? Arthro synthesis is no problem No problem to inject Gd in joint

40. 1381 – 1384 1.5 Tesla GE 1/200 Diluted GD in Saline CT Guided Puncture 9-12 cc Diluted GD+ Saline 32 Patients: 4 Women, 28 Men CT Arthrograms with GD + Air CT Arthrograms with GD + Air

41. Findings: R.C Tear 2 Cap. Tear 2 Labral detachment 4 Small Glenoid 2 Impingement with no R.C Tear 2 Normal 20 Most indication=instability and recurrent dislocation 45 other cases with air double contrast CT Arthrography MRI > CT except Loose Body