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Direct MR Arthrography of the Shoulder: Is Exercise Prior to Imaging Beneficial or Detrimental?¹

¹ From the Departments of Radiology (M.L.B., W.B.M., T.G.S.), Orthopedic Surgery (R.F.H.), and Medicine (P.M.), Wilford Hall Medical Center, 759th MDTS/MTRD, 2200 Bergquist Dr, Suite 1, Lackland AFB, TX 78236-5300; the Department of Radiology, Brigham and Women's Hospital, Boston, Mass (J.A.C.); and the Department of Radiology, 10th Medical Group Hospital, USAF Academy, Colorado Springs, Colo (C.A.N.). From the 1998 RSNA scientific assembly. Received April 28, 1999; revision requested June 15; revision received August 17; accepted September 3. Address correspondence to W.B.M.

PURPOSE: To define the beneficial and detrimental effects of adding exercise to direct magnetic resonance (MR) shoulder arthrography.

MATERIALS AND METHODS: Direct, intraarticular, gadolinium arthrography of the shoulder was performed in 41 patients, who underwent 1.5-T MR imaging before and after 1 minute of arm swinging. Fourteen milliliters of dilute gadolinium solution was injected. Two readers blinded to exercise independently graded the randomly distributed images with a five-point scale for capsular contrast material resorption; extraarticular contrast material leakage; rotator cuff, glenoid labrum, and anterior capsule conspicuity; and partial-thickness or full-thickness rotator cuff tear and labral tear detectability. The sign test was performed to evaluate the significance of differences between preexercise and postexercise grading for each reader. A second review was performed, with direct side-by-side comparison of preexercise and postexercise images.

RESULTS: There was evidence of increased capsular resorption after exercise but no alteration in the depiction of the rotator cuff tendons or glenoid labrum. There was no significant extraarticular contrast material leakage after exercise and no alteration in depiction of the anterior capsule. There was no difference in the detectability of rotator cuff or labral tears.

CONCLUSION: Exercise with direct shoulder MR arthrography has no beneficial or detrimental effect on image quality or on the depiction of rotator cuff or labral tears.

Index terms: Magnetic resonance (MR), arthrography, 414.121411, 414.121415, 414.122 • Shoulder, arthrography, 414.122 • Shoulder, injuries, 414.4813, 414.4819 • Shoulder, MR, 414.121411, 414.121415

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