Patient’s Assessment of Discomfort during MR Arthrography of the Shoulder
Abstract
PURPOSE: To assess patient discomfort during (a) intraarticular contrast material injection (arthrography) and (b) magnetic resonance (MR) imaging in patients referred for MR arthrography of the shoulder and to compare the relative discomfort associated with each part of the examination.
MATERIALS AND METHODS: With use of a visual analogue scale (VAS) and relative ratings, 202 consecutive patients referred for MR arthrography of the shoulder rated the expected discomfort and that actually experienced during both arthrography and MR imaging. The Student t test was used for statistical analysis.
RESULTS: The average VAS score (0 = “did not feel anything," 100 = “unbearable”) was 16.1 ± 16.4 (SD) for arthrography and 20.2 ± 25.0 for MR imaging. This difference was statistically significant (P = .036, paired t test). The discomfort experienced during arthrography was as expected in 90 (44.6%) patients, less than expected in 110 (54.4%), and worse than expected in two (1.0%). MR imaging–related discomfort was as expected in 114 (56.4%) patients, less than expected in 66 (32.7%), and worse in 22 (10.9%). Arthrography was rated worse than MR imaging by 53 (26.2%) patients, equal to MR imaging by 69 (34.2%), and less uncomfortable than MR imaging by 80 (39.6%).
CONCLUSION: Arthrography-related discomfort was well tolerated, often less severe than anticipated, and rated less severe than MR imaging–related discomfort.
References
- 1 Flannigan B, Kursunoglu-Brahme S, Snyder S, Karzel R, Del Pizzo W, Resnick D. MR arthrography of the shoulder: comparison with conventional MR imaging. AJR Am J Roentgenol 1990; 155:829-832. Crossref, Medline, Google Scholar
- 2 Hodler J, Kursunoglu-Brahme S, Snyder SJ, et al. Rotator cuff disease: assessment with MR arthrography versus standard MR imaging in 36 patients with arthroscopic confirmation. Radiology 1992; 182:431-436. Link, Google Scholar
- 3 Chandnani VP, Yeager TD, DeBerardino T, et al. Glenoid labral tears: prospective evaluation with MR imaging, MR arthrography, and CT arthrography. AJR Am J Roentgenol 1993; 161:1229-1235. Crossref, Medline, Google Scholar
- 4 Robbins MI, Anzilotti KF, Jr, Katz LD, Lange RC. Patient perception of magnetic resonance arthrography. Skeletal Radiol 2000; 29:265-269. Crossref, Medline, Google Scholar
- 5 Blanchard TK, Bearcroft PW, Dixon AK, et al. Magnetic resonance imaging or arthrography of the shoulder: which do patients prefer? Br J Radiol 1997; 70:786-790. Crossref, Medline, Google Scholar
- 6 Newberg AH, Munn CS, Robbins AH. Complications of arthrography. Radiology 1985; 155:605-606. Link, Google Scholar
- 7 Huskisson EC. Measurement of pain. Lancet 1974; 2:1127-1131. Crossref, Medline, Google Scholar
- 8 Breivik EK, Bjornsson GA, Skovlund E. A comparison of pain rating scales by sampling from clinical trial data. Clin J Pain 2000; 16:22-28. Crossref, Medline, Google Scholar
- 9 Kopka L, Funke M, Fischer U, Keating D, Oestmann J, Grabbe E. MR arthrography of the shoulder with gadopentetate dimeglumine: influence of concentration, iodinated contrast material, and time on signal intensity. AJR Am J Roentgenol 1994; 163:621-623. Crossref, Medline, Google Scholar
- 10 Recht MP, Kramer J, Petersilge CA, et al. Distribution of normal and abnormal fluid collections in the glenohumeral joint: implications for MR arthrography. J Magn Reson Imaging 1994; 4:173-177. Crossref, Medline, Google Scholar
- 11 Hall FM, Rosenthal DI, Goldberg RP, Wyshak G. Morbidity from shoulder arthrography: etiology, incidence, and prevention. AJR Am J Roentgenol 1981; 136:59-62. Crossref, Medline, Google Scholar
- 12 Fellahi JL, Magues JP, Marquer B, Guerot A, Mansat M, Cathala B. Analgesia with intra-articular injection of buprenorphine after surgery of the shoulder. Cah Anesthesiol 1995; 43:313-318. [French]. Medline, Google Scholar
- 13 Johansen JG, Berner A. Arthrography with Amipaque (metrizamide) and other contrast media: a roentgenographic and histologic evaluation in rabbits. Invest Radiol 1976; 11:534-540. Crossref, Medline, Google Scholar
- 14 Hajek PC, Sartoris DJ, Gylys-Morin V, et al. The effect of intra-articular gadolinium-DTPA on synovial membrane and cartilage. Invest Radiol 1990; 25:179-183. Crossref, Medline, Google Scholar
- 15 Bjork L, Erikson U, Ingelman B. A new type of contrast medium in arthrography. Am J Roentgenol Radium Ther Nucl Med 1970; 109:606-610. Crossref, Medline, Google Scholar
- 16 Hall FM, Goldberg RP, Wyshak G, Kilcoyne RF. Shoulder arthrography: comparison of morbidity after use of various contrast media. Radiology 1985; 154:339-341. Link, Google Scholar
