Special Radiographic Procedures: DMIR 4-8-8-4 Arthrography ...

Arthrography• Caveats:– Extra-articular spillage can occur if you use tomuch pressure or make multiple joint capsulepenetrations– Flexion or extension can cause someredundancy in synovial sheaths and jointcapsules, be sure what you see is persistant onmost viewsArthrography(213889 Normal)UNIVERSITY OF MINNESOTAVeterinary Medical CenterUNIVERSITY OF MINNESOTAVeterinary Medical CenterArthrography(260620 ? Normal)Arthrography(260620 ? Normal)UNIVERSITY OF MINNESOTAVeterinary Medical CenterUNIVERSITY OF MINNESOTAVeterinary Medical CenterArthrography(206068 Biceps Tendinitis)Arthrography(206068 Biceps Tendinitis)UNIVERSITY OF MINNESOTAVeterinary Medical CenterUNIVERSITY OF MINNESOTAVeterinary Medical Center2

Arthrography(263600 Biceps Tendinitis)Arthrography(263600 Biceps Tendinitis)UNIVERSITY OF MINNESOTAVeterinary Medical CenterUNIVERSITY OF MINNESOTAVeterinary Medical CenterArthrography(265524 Biceps Tendon Sheath Inflammation/Hyperplasia)Arthrography(265524 Biceps Tendon Sheath Inflammation/Hyperplasia)UNIVERSITY OF MINNESOTAVeterinary Medical CenterUNIVERSITY OF MINNESOTAVeterinary Medical CenterArthrography(265595 Biceps Tendinitis)Arthrography(265595 Biceps Tendinitis)UNIVERSITY OF MINNESOTAVeterinary Medical CenterUNIVERSITY OF MINNESOTAVeterinary Medical Center3

Arthrography(from Miller’s Guide to the Dog)Arthrography(240028)UNIVERSITY OF MINNESOTAVeterinary Medical CenterUNIVERSITY OF MINNESOTAVeterinary Medical CenterFistulography• Indications:– Look for foreign bodies in tissue tracts– Define the extent +/- communication of draining tracts– Define relationship between draining tracts• Contraindications:– Beware of spreading infectious agents– Beware of unintentionally flooding cavities (e.g.fistulas communicating with body cavities)UNIVERSITY OF MINNESOTAVeterinary Medical CenterFistulography• Supplies:– Sterile iodinated contrast medium(dilute to about 200 mg iodine/ml)– Catheter suitable to insert into the visible fistula and(hopefully) retain injected medium in the tract• Precautions:– Can be painful– Unintentionally flooding body cavities– Get any cultures or cytology BEFORE injectingcontrast mediumUNIVERSITY OF MINNESOTAVeterinary Medical CenterFistulography• Technique:– Place catheter just inside fistulous tract– Inflate balloon if catheter so equipped (otherwise usesome method to occlude the tract orifice to forcecontrast medium up the tract and not out the hole)– Infuse some “sensible” amount of contrast medium(based on guess of tract depth/distribution) or untilresistance encountered– Expose appropriate radiographic views to outline thetractUNIVERSITY OF MINNESOTAVeterinary Medical CenterFistulography• Interpretation:– Determine course and extent of tract– Clarify presence or absence of foreign body(don’t have overexpectations, however)UNIVERSITY OF MINNESOTAVeterinary Medical Center4

Fistulography• Caveats:– Easily miss small foreign bodies– Ability to define the extent of the tract isproportional to the pressure applied atinjectionFistulography(233532)UNIVERSITY OF MINNESOTAVeterinary Medical CenterUNIVERSITY OF MINNESOTAVeterinary Medical CenterFistulography(233532)Fistulography(image)UNIVERSITY OF MINNESOTAVeterinary Medical CenterUNIVERSITY OF MINNESOTAVeterinary Medical CenterFistulography(240517)Fistulography(266129)UNIVERSITY OF MINNESOTAVeterinary Medical CenterUNIVERSITY OF MINNESOTAVeterinary Medical Center5

Fistulography(268708)Fistulography(268708)UNIVERSITY OF MINNESOTAVeterinary Medical CenterUNIVERSITY OF MINNESOTAVeterinary Medical CenterFistulography(277519)Fistulography(277519)UNIVERSITY OF MINNESOTAVeterinary Medical CenterUNIVERSITY OF MINNESOTAVeterinary Medical CenterFistulography(235819)Fistulography(235819)UNIVERSITY OF MINNESOTAVeterinary Medical CenterUNIVERSITY OF MINNESOTAVeterinary Medical Center6

Arthrography & FistulographyDMIR #3• Closing Comments:– Very limited use techniques– Handy WHEN INDICATED– Interpretation not an exacting science– Waste of time if not performed correctlyUNIVERSITY OF MINNESOTAVeterinary Medical CenterUNIVERSITY OF MINNESOTAVeterinary Medical Center7